Press releases and Feature stories | St. Maarten Medical Center

Jeshneila Carti always wanted to work within a health care setting. She pursued nursing studies in Groningen for a short time, but when she tried dietitian clinical and research, she knew that she was doing the right thing. She wanted to be a Dietician.

A year after returning home, Jeshneila started her practice as a registered dietician with the opening of her clinic Vital Health, in Philipsburg. A year later, she is employed as a dietician at the St. Maarten Medical Center (SMMC).

Why does the SMMC have a Dietician?

Contrary to the common belief, the role of the dietician in the hospital is not to tell the patient what they should or should not eat. Rather it is to guide their nutrition in an effort to achieve optimal holistic health for the individual.

The dietician can also give courses and lectures to the kitchen staff to upgrade them on new research in nutrition and diets that can help them make peoples’ favorite foods into healthy foods.

What do you do on a daily basis?

“As a registered dietician, I work with the patient and their physicians. When I am in, I check the inpatient records and begin by checking the sugar levels of the diabetic patients,” says Jeshneila. From there a conversation begins, where she educates and empowers the patient to make healthier food choices, eat regularly and monitor their sugar levels. “Diabetes does not cure but it can be stable and that is what we want to achieve.”

Sugar levels for non diabetic persons should be between 70 and 90 before meals. When the level reaches 105, that person may be considered borderline diabetic.

“I also try to help the patient enjoy their hospital meals by asking if it is palatable to their taste. Sometimes we can make it more enjoyable for them; we try to meet the needs of the patients to keep them happy and healthy. I also communicate to the kitchen after speaking with the patient and the attending specialist. This is important so that the kitchen staff can know how many calories the patient should have or what food the patient should avoid.”

Is it different working as a hospital dietician than in your clinic?

Yes. The main medical problem of persons living on St. Maarten is obesity, which is often a risk factor for diabetes and hypertension. “These are the cases I get on a daily basis in my practice” says Jeshneila.

“In the hospital I see ‘everything’ and I like that because it is challenging.” There is pediatric nutrition, especially for babies who were born premature and thus need counted calories. Counted calories are also need for adults who require tube feeding or are malnourished.

These are just a few of the special diets for patients admitted in the hospital.

Which group of patients requires the most nutrition attention?

Dialysis patients have the most restricted diet that you may come across. They may have many dietary restrictions of protein, sodium, potassium and or phosphorus. Yet, these foods are healthy and so it is very difficult to follow a new diet. Even though the blood is being filtered through the dialysis treatment, it is important to watch these levels otherwise the person is putting extra pressure on the already minimal functioning kidneys.

The dietician gives each dialysis patient a calculated diet based on their medical needs, personal taste and lifestyle choices. This new diet is a lifelong plan unless the dialysis patient would have successfully received a kidney transplant. Every month, the patients do laboratory work and if there are significant changes in their nutrition levels a new dietary plan may be recommended.

The dietician suggests how patients can enjoy the same foods but in a more healthy form. For example, baked and fried potatoes are high in potassium. Soak potatoes for a few hours to lower potassium levels.

How does dietary follow-up care work after being discharged?

In a hospital setting, follow up care with the dietician is somewhat challenging after the patient is discharged. However, before their discharge, the dietician gives them advise and a dietary plan. She emphasizes paying close attention to food portion size. Then, it is becomes the patient’s responsibility to maintain and follow a healthy dietary plan. In some cases, SZV patients may get a referral letter for continued care at Vital Health.

“It is important for women who have gestational hypertension and or gestational diabetes to pay keen attention to their nutrition even after having their babies, especially if they are breastfeeding.”

“Many people have the motivation to start but to continue is always a problem with every day (food) temptations.” Jeshneila hopes that follow up care can be improved in the future with patients realizing and accepting their responsibility to take good care of their bodies.

Healthy Foods tips:

Carbohydrates have a big impact on your blood sugar levels-more so than fats and proteins-but you do not have to avoid them. Choose carbohydrates that are packed with fiber.