Year

2012

Degree Name

Doctor of Business Administration

Department

Sydney Business School

Abstract

This thesis examines how NSW public-hospital dietitians are affected by their workplace. It could be said dietetics was born in the hospital environment: this workplace has undergone rapid changes over the last 50 years from a place of convalescence and recovery to one of advanced technological interventions, diagnosis and assessment and short-stay procedures. Despite these changes there has been very little research exploring their impact on the hospital-based dietitian. Yet 43% of the Australian dietetic workforce is within a hospital environment, therefore a study examining this area is both timely and warranted.

This thesis explores this topic using a multimethod approach, investigates the question from three different perspectives: a direct overt observational study of 19 dietitians, across a range of hospitals and services; a cross-sectional structured-survey that measured the level of burnout amongst New South Wales public- hospital dietitians; and 32 in-depth interviews of dietitians across NSW public-hospitals, analysed using a grounded-theory approach.

The major findings from this thesis include: the majority of tasks undertaken by the hospital dietitian occurred away from the patient; there were low to moderate levels of burnout experienced by dietitians across NSW, but there were factors associated with higher levels of burnout, such as level or years of experience and the type of hospital in which the dietitian worked; and dietitians sought validation from their workplace from five sources. These five sources of value were: acquisition of knowledge, relationships with others, the work culture, role clarity and self-attributes. The relative importance of these values changed according to the career stage of the dietitian.

The professional implications of this research include: the development of a career-support program tailored to the different stages of the dietetic career; the need to foster functional interdisciplinary health-care teams; the importance of role identity for the hospital-based dietitian; the creation of the dietetic consultant and the need to recognise inefficient and ineffective work processes.

This research has several limitations: the fact only one single nutrition service was involved in the observational study; potential bias in the response rate in the burnout survey; and the use of a grounded-theory approach for the in-depth interviews means the results are only applicable to those dietitians, hence limiting the generalisability of the findings.

The question is ‘NSW public-hospital dietitians and their workplace: True love or a marriage of convenience?’ It would appear; from this study that the ‘marriage’ is initially based on true love: but as with many marriages, the success of the union relies on an ongoing commitment, compromise and adaptation. Dietitians and NSW public hospitals are no exception.

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