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Why can't there be a Clinical Nutrition Practitioner?

Posted by SF8N at Jul 14, 2011 06:35 PM |
July 14, 2011
Why can't there be a Clinical Nutrition Practitioner?

by Joe Krenitsky, MS, RD

It has been an interesting experience to see the clinical role of Nurse Practitioners expand at UVA.  I have worked alongside several of these nurses before they became a nurse practitioner and now in their new roles of administering care as part of the covering team for ICU patients.  Watching this transition has made me think about our own nutrition profession, and I have found it ironic that nurse practitioners can enter active orders for enteral or parenteral nutrition support, while a registered dietitian with an advanced degree and 20+ years of nutrition support experience (who has provided the recommendations for the nutrition support) cannot enter the orders!

I really wonder why there is no discussion about using the nurse practitioner model as a guide to create a Clinical Nutrition Practitioner degree?  A clinical professional that can do physical exams, place nasogastric or nasoenteric tubes, enter enteral and parenteral nutrition orders, and who would be able to act as a true physician extender and bill for their service would be a true asset to a healthcare facility.  Heck, they would probably even be paid a livable wage commensurate with their degree!   Given the paucity of physicians practicing in nutrition, as well as the shortage of physicians overall in the near future, it makes even more sense for us to get creative. 

The ADA’s Summit on Dietetic Practice, Credentialing and Education in March 2011 fashioned a Pilot Initiative to, “evaluate the perception of external stakeholders,” regarding an advanced practice credential:


The current ADA goal is only to build a survey tool and see what other people (physicians, other allied health professionals and health care/facility administrators) think which suggests that an advanced practice degree is not something we will see any time soon.  We really need to see more action from our professional organization to prevent the loss of more of our best and brightest moving on to be physicians, physician assistants, or away from the field entirely.  I would love to see our profession shake off the hairnet and become the true clinical nutrition professionals that our patients deserve - within my lifetime.


“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.”

- M. Scott Peck


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