My first months working here as a dietitian have been quite interesting and it’s been an adjustment getting used to the metric system, the UK medical abbreviations, and the different oral nutritional supplements used here. I’m glad to be working in long term care mental health hospital, where the more relaxed pace gives me time to get a grasp on all these things! Here are some of the major differences I’ve come across.
Weights: All patients here are weighed in kilograms. Dietitians in the US do use kilograms in estimated needs equations and in calculating BMI so it isn’t completely new for us, however, we are generally more familiar with pounds and when estimating a person’s weight will typically think in pounds. Despite being weighed in kilograms, many patients here will also want to know their weight in stones as this value is widely used throughout the UK and Ireland. My patients will often express their weight in stones and pounds for example – 8 stone 7lb. One stone is equivalent to 14 lbs so simply multiple the stone by 14 and add the remaining pounds. 8 stone, 7 lb = 119lbs
I carry around a scale from ward to ward and weigh my own patients to ensure I have a current and accurate weight (that isn’t stated! Lol- dietitian joke). I’ve never done this before as it’s usually done by nursing in acute settings, but the patient population here is young enough that they don’t need assistance and it’s great to be able to collect my own data for my assessments.
· 1 pound = 0.45 kilogram
· 1 kilogram = 2.2 pounds
· 1 stone = 14 pounds
Medical Abbreviations: Here are some of the most common abbreviations used. Most are fairly similar to what we use in the US. The absolute worst one for me is “BNO” which means “bowels not open” which is used when referring to whether or not a patient has had a bowel movement. Often, I’ll hear, “has he opened his bowels yet?” That brings about a visual I’d rather not have. In the US, we just refer to it as a bowel movement and abbreviate as “BM” which is the abbreviation many staff use here for “blood glucose management” though it is despite it not being an officially recognized abbreviation. All day I hear people talking about BM’s and in the back of my head I’m still thinking feces! Ugh!
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USA |
UK |
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QD (qua que die) |
OD (omne in die) |
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BID (bis in die) |
BD (bis die) |
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TID (ter in die) |
TDS (ter die sumendum) |
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QID (quarter in die) |
QDS (quarter die sumendum) |
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HS (hora somni) |
Nocte |
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BM (bowel movement) |
BNO (bowels not open) |
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DPOA (durable power of attorney) |
LPA (lasting power of attorney) |
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Advanced Directives |
Advanced Decisions |
Spelling: From what I can tell so far, British English basically just adds more a’s, o’s, and u’s to words while reversing the “er.” I’d rather save space and ink so I continue my American English spelling for now unless it’s auto-corrected for me. ;) Here are some examples:
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USA |
UK |
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Meter |
Metre |
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Celiac |
Coeliac |
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Diarrhea |
Diarrhoea |
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Pediatric |
Paediatric |
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Hemoglobin |
Haemoglobin |
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Fiber |
Fibre |
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Flavor |
Flavour |
Supplements: Nutritional supplements are referred to as “sip feeds” here. The major companies include Abbott, Nutricia, and Fresenius Kabi. We currently use Abbott at our facility and the products, packaging, and flavors are different compared to what Abbott has available in the US. My co-workers and I have had some great tasting sessions already!
Lab Values: Lab values for blood glucose and cholesterol are in expressed in mmol/L whereas the US uses mg/dL so I’ve had to get used to looking at much smaller numbers (Example: UK Cholesterol goal = <5 mmol/L versus USA <200 mg/dL). There are some others, but I won’t bore you anymore. :P
Dietitians in the UK seem to be under the impression that American dietitians do muCh more “catering” (food service) dietetics in the USA. I don’t have experience as a UK dietetics student, but in the USA food service is part of the university curriculum and also in our internship so I think we are exposed more. From my experience so far, there is more overlap with dietetics and food service departments in the USA -often sharing office space and having the same manager over dietitians and food service workers whereas it seems more separate in the UK. I really enjoyed working in these combined environment back home as there seems to be more understanding of each other’s roles and you feel like you have a bigger team working together toward the same goal of providing the best nutrition for your patient.
Despite some of these minor differences, the role of the dietitian in the UK and USA is generally the same which I suppose is why the USA degree is recognized in the UK. It is unfortunate that it doesn’t work the other way around as UK dietitians would be expected to complete the year long, unpaid USA dietetic internship in order to practice as a dietitian.