A Day in the Life…A Burns Dietitian

Celebrating 25 years of Children’s Burns Trust and our relationship with the incredible people working in the UK Burn Services, we have asked those involved in the care of children who experience burn and scald injuries and who receive treatment in the specialist Burns Centres to answer a series of questions about their work. 

Our latest story comes from Rebecca Anelli, a Specialist Paediatric Dietitian working in the Paediatric Intensive Care Unit (PICU) and Burns unit at Royal Manchester Children’s Hospital. 

I’ve worked in Burns care for around 5 years.

I work on the Burns ward and also the Paediatric intensive care unit (PICU) and review children on both. Firstly, I will check my caseload for the day and answer any queries that have come in overnight. If any children have changed wards or gone home I will hand over to the appropriate Dietitian for ongoing follow up, or arrange a phone call with the parent to check on their progress a few days after discharge.

I will review the child’s notes on our electronic system and then attend the bedspace to discuss with the child, their family and nurse about how they have been eating, or check their tolerance of a tube feed. I will then work with them to modify the plan as necessary, aiming to meet nutritional requirements for wound healing.  

Once a week we have a multi-disciplinary team (MDT) meeting with the whole Burns team where we discuss all the children with burns. My role in this is to update on each child’s nutritional intake and growth, highlight any concerns I have with any recent biochemistry results, and discuss discharge planning – for example how to wean off tube feeds to help them to get home. 

I love working with the MDT: we all acknowledge each other’s skills and I feel that the importance of nutrition is appreciated. I feel passionate knowing that by helping a child improve their nutrition I can make a real difference in their wound healing and length of stay in hospital. 

Often a child will need a tube feed initially when they are unwell, but the feed can lead to them feeling full or uncomfortable and not wanting to eat. It can be a tricky balance to work out when to wean down the feed to ensure they still meeting their nutritional requirements for wound healing, whilst also encouraging them to eat.

Working with the nurses and families can help with this to encourage the child to eat and to monitor food charts.

It is very important to involve parents with any decision making – they know the child much better than any professional ever will, and if you can get them on board with the treatment plan you’ve got a much better chance of the child complying. It’s also important to make information relevant and age appropriate to the child so they can understand it for themselves.

I love seeing the children progress from tube feeds back to eating their favourite foods again and being able to support and reassure families throughout their journey.

The Burns Camps are very popular and give the children chance to feel normal again and do fun things with other children that have been through similar experiences to them. 

Be aware of all the risks around children: they are more curious and can reach higher than people tend to think. Keep hot drinks, kettles, hair straighteners and other dangers well out of reach all the time, even if you think your child is uninterested in them.

We are learning all the time, with each child that gets admitted we are learning more about the best methods of treatment so each one leaves a small legacy behind. We also share our learning with other Burns centres so we can support each other to ensure each child receives the best treatment possible.

Happy Anniversary, and keep up the great work!

Your donations to the Children’s Burns Trust 25 year anniversary fundraiser will go directly to help us continue our work for the next 25 years. Contribute to our fundraiser.