Jonathan Yuhas, MS, RD is a renal dietitian at the Fresenius Kidney Care in Roanoke, Virginia. He graduated from IUP in 2010 with a BS in Nutrition/ Dietetics. He completed his dietetic internship and Master of Science degree in Nutritional Sciences at Oklahoma State University in 2013.
What is an Average Work Week Look Like for Jonathan?
He is the dietitian for around 125 ESRD patients in his dialysis clinic. Each month, he is responsible for the analysis of all of these patients' renal nutrition lab work and related counseling. This includes markers of bone mineral metabolism, protein status, iron metabolism, and more. Specific nutrition issues that may arise for a dialysis patient include: excess fluid intake, inadequate protein intake (1.2 grams protein/kg is the general recommendation), and excess mineral intake (calcium/phosphorous/potassium/sodium). Furthermore, Jonathan is able to make medication management recommendations in his role under the guidance of the nephrologist.
Weight management is also an important part of his position. These patients may lack the needed appetite to achieve weight stability or are unable to commit to a healthful weight-loss for a variety of reasons.
In order to effectively counsel his patients, Jonathan must determine their willingness to change their health behaviors. These patients vary in age, socioeconomic status, physical well-being, and psychosocial well-being. By routinely utilizing the Transtheoretical Model (or "Stages of Change"), he adapts health-related goals to each patient.
What are Some of the Challenges of His Position as a Renal Dietitian?
After passing the RD exam and beginning his career as a dietitian, Jonathan quickly learned that no two patients are alike. A person can neither be completely defined by their medical history, nor the verbal history that they may provide. Dialysis patients, for example, often have completely different problems when compared to each other. One patient may have minimal struggles maintaining normal labs, whereas another patient may rarely have normal labs despite following the appropriate diet recommendations. He frequently relies on collaboration with the clinic's nurses, dialysis technicians, social workers, nurse practitioners, and nephrologists in order to provide comprehensive care for our patients.
What Does Jonathan Enjoy Most About His Position?
The continuity of care in the outpatient setting is quite rewarding. In the clinical setting, these dietitians may see patients for up to a week at a time. In a dialysis clinic, on the other hand, he has known a large number of his patients for years. This allows you to really get to know a person. For instance, since becoming a new father, Jonathan has received parenting advice from almost all of his patients. He hasn't found a better icebreaker for patient counseling than getting someone to talk about their own kids or grandchildren!
How Has Jonathan's IUP Education Benefited Him in His Career?
His education at IUP introduced him to effective counseling methodologies, evidence-based medical nutrition therapies for a wide range of medical conditions, and in-depth learning of metabolic processes. Jonathan's interactions with both faculty and students greatly influenced his decision to pursue a career as a dietitian. IUP prepared him well for the breadth of opportunities that this field has to offer.
What Does Jonathan Want to Tell Prospective and Current IUP Food and Nutrition Students?
Look outside the classroom for opportunities to work with and engage with people from different backgrounds than your own. IUP itself offers a large variety of clubs and organizations with present opportunities to diversify your interests and broaden your world views. As president of the IUP cycling club, Jonathan developed leadership skills that he taps into today in his current work life. He also gained a lifelong passion for cycling and created some lifelong friendships.
What Does the Future Hold for Jonathan?
Long-term, he is interested in starting his own private practice. He has worked with a variety of patient populations, and he has realized that the majority of these patients lack adequate nutrition education.
He has learned that there is only so much information that you can cover with a patient in the hospital prior to their discharge. Even then, he says, they are so overwhelmed with their own medical situation that their ability to retain nutrition education is rather limited.
In the meantime, Jonathan is aiming to continue work in various settings as an RD. He has had experience in the broad role of a hospital clinical nutrition dietitian, as well as that of a dietitian working specifically with renal patients. Since the field of nutrition is quite broad, he would like to experience the different ways in which he can help people improve their well-being through nutrition. This, in turn, will increase his confidence to work with these patients in his own future practice.