CAREERS
DIETETICS ON WHEELS The challenges of becoming a dietitian when you are in a wheelchair.
Rasleen Kahai RD Manchester University NHS Foundation Trust Rasleen is a recently graduated dietitian, currently working at MFT within general respiratory and pulmonary oncology.
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“Isn’t she supposed to be in her room?” a paediatric doctor asked the nurse. “I think she’s a member of staff,” the nurse mumbled back. Slowly, I turned around and realised who they were talking about…me! As dietetics only has a small degree of physical patient contact, it would seem a good career for a wheelchair user. However, from my short experience in this healthcare sector, it is a battle I seem to be continually fighting. I have encountered a myriad of issues, including preconceptions from staff and patients about what my role is, and a complete lack of access. My journey to becoming a Registered Dietitian started at university, where the accessibility issues unfortunately began. Little did I know that I would be fighting the same battles as Ed Roberts, a disabled activist in the 1960s. On multiple occasions, I was unable to attend lectures because the rooms were only accessible via stairs, with seemingly no possibility of re-timetabling them, despite months of prior warning and extensive email conversations. The ongoing difficulties I frequently faced often made me question my path. Should I continue to train as a dietitian, or drop-out? Happily, my time on placements helped me reconsider. I found myself really enjoying both the hospital and the public health environment and especially working directly with patients. This reminded me why I wanted to be a dietitian in the first place – the people. Graduating brought a mix of feelings and emotions, the foremost being pride. I had proven my resilience to overcome all the hurdles I had faced. This goes hand-in-hand with the positive and tangible changes I helped contribute towards, for future disabled students, with the hope that they won’t have the
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same struggles as I did. Such changes include automated doors, wheelchairlevel lab benches, accessible ramps and dropped kerbs (to name but a few!). However, I was feeling worried as to where I would go in the future and whether I would face the same difficulties through my working life. Many dietitians I had spoken to throughout my time as a student, often told me that their dietetic departments were inaccessible. How was I supposed to practice as a dietitian if I couldn’t even reach the department? That was a sobering thought. ACCESSIBILITY IN THE WORKPLACE
When I began applying for jobs, I realised that despite the NHS being ‘disabled confident’, little information was given about wheelchair accessibility to dietetic departments. This often put the onus on me to email and find out. Just as I had thought, I found an equal split of accessible and inaccessible departments. Those who had inaccessible departments would still recommend applying, on the basis that reasonable adjustments could be made. With previous experience of reasonable adjustments not being fulfilled, I was often left feeling anxious about what could be done. Nevertheless, I applied and persisted. With a little bit of thought, innovation and a fairy-godmother manager, I can now happily say that I am working as a Registered Dietitian within a hospital with an inaccessible main dietetic department.
Graduating brought a mix of feelings and emotions, the foremost being pride. I had proven my resilience to overcome all the hurdles I had faced.
Sadly, I was not given my very own office as a reasonable adjustment, in case you’re wondering! I’m a part of the separately funded cystic fibrosis dietetic team on the ground floor. There are logistics that have been worked out internally about how I can receive and give back patient record cards when working with the main department. From a patient perspective, I often find that some patients can resonate with me and the chair: “You’re like me, disabled too”, “Taking one for the wheelchair team!” I also never have to worry about standing over patients! OVERCOMING DIFFICULTIES
Nonetheless, a number of difficulties remain. It can be tricky to take a face-to-face referral from a ward doctor, as the records are held within the inaccessible main department. Additionally, ward staff often query why I’m wearing a ‘watch’ on the ward. Unknown to them, the ‘watch’ is actually part of my wheelchair, which connects via Bluetooth to the wheel on the back. This allows the wheelchair to be electric to meet my clinical needs (as well as having a good party trick up my sleeve!). These issues are mainly resolved with better
disability awareness and education, something I hope one day will be available in all Trust inductions. On top of that, I am currently working in partnership with infection control and the health and safety team to change the foot pedal bins to automated bins. However, it’s also important to highlight that small changes can also make big differences. These can include shifting miscellaneous items which are blocking corridors, moving boxes of gloves to an accessible height at the nursing station and asking your disabled colleague if they need help reaching something. All of these positive steps remove barriers towards working independently as a dietitian in a wheelchair. Despite dietetics making it into the 21st century, in my view, we still have a long way to go until disabled dietitians have an equal and accessible working environment within the healthcare sector. However, it can also take one rolling dietitian’s experience to be shared to bring hope, awareness and improve accessibility within dietetics in the future.
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