January 2020 Monthly Update
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This Update includes information on the following items:
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- Board of Director Nominations and Election
- Modernization of the BC Health Regulatory Framework
- Congratulations—(New Full Registrants!)
- Private Practice Business Name Approvals
- MJEDC Grant Update
- Clarifying Scope in Enterostomy Feeding Tube Care
- Reminder:
- 2020 Continuing Competency Program
- Announcement:
- CDBC has moved
- Website Updates
- You Asked About… Cannabis and Dietetic Scope of Practice
- Questions? Comments?
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Board of Director Nominations and Election
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The call for nominations to the Board of Directors for the 2020-2022 term closed on December 15, 2019. Nominations were open for the following electoral regions:
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• Interior/North (1)
• Vancouver Coastal (1)
• Vancouver Island (1)
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The CDBC received one nomination for Interior/North, one for Vancouver Island and two for Vancouver Coastal. The nominees for Interior/North and Vancouver Island were elected by acclamation and will begin their new 2-year term on April 1, 2020.
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Two nominations were received for Vancouver Coastal electoral region and the CDBC proceeded to an election in accordance with the Bylaws (section 7). On January 14, registrants received an email with the election procedure and instructions, including a link to vote.
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On January 29, one of the candidates withdrew her candidacy for personal reasons. The election was closed and the following candidate was elected by acclamation. Election results will also be published on the CDBC website, February Monthly Update and emailed to registrants.
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Congratulations to Jill Worboys (Interior/North), Anita Marriott (Vancouver Island) and Theresa Cividin (Vancouver Coastal) and thank you for your commitment to the CDBC!
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Modernizing BC’s Health Regulatory Framework
On January 10, 2020, the College of Dietitians of BC submitted a response to the Ministry of Health’s
proposal to modernize health profession regulation
and amalgamate the CDBC with other health regulatory colleges . The College remains committed to regulating Dietitians to deliver safe, ethical and competent services to the BC population and looks forward to collaborating with the Ministry on the next steps of the modernization. The CDBC will post to its website the response submitted in the next few weeks. Members of the public and Dietitians can reach the College at any time with questions and concerns on dietetic practice.
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Congratulations to New Full Registrants!
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Congratulations to 46
new Full Registrants
who
passed the Canadian Dietetic Registration Examination (CDRE) held from November 25
th
to November 30
th
, 2019
. The CDRE is the national competence examination for Dietitians in Canada. It is developed and administered by the Alliance of Canadian Dietetic Regulatory Bodies. The CDRE is required by every Canadian province, except Quebec, for full registration privileges.
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The College is very pleased to welcome successful CDRE candidates to the profession as “Full” registrants. Your registration status has been updated from “Temporary” to “Full” registration on the
Public Register of Dietitians
.
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There are now 1403 Registered Dietitians practicing in BC – 1367 Full Registrants, 4 Temporary Registrants and 32 Non-Practicing Registrants – and the numbers keep growing!
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Private Practice
Business Name Approval
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The College has recently been receiving requests for approval of business names, and would like to clarify that the CDBC does not regulate corporations and other forms of businesses. The College can only confirm that you are registered in good standing in BC, allowing you to legally use the protected titles indicated in legislation. It isn’t within the mandate of the College to authorize or approve business names. Rather, the CDBC regulates you as a registered individual and our legislation is applicable to you.
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While you are authorized to use the title as part of your business name, CDBC would like to remind you that the title is only legally binding when you are a registrant of the College. Protected titles are a pledge of safe, competent and ethical services and behaviors that Colleges regulate and enforce. Using a protected title while you are no longer registered with the CDBC may imply or project to the public expectations of skills and competencies that we can no longer verify.
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Therefore, you must monitor your registration renewals closely to avoid breach of the Health Professions Act. If at any given time there is a breach of the Health Professions Act, or a complaint is raised by a member of the public, you may be sanctioned, and the College may be required to take further actions.
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From CDBC’s past experience, this may create issues with BC Registry for the approval of your chosen business name. You may however, suggest alternative business names that the BC Registry would be able to approve.
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MJEDC Grant Update
On August 6, 2019, the College received a grant from the
Ministry of Jobs, Economic Development and Competitiveness (formerly known as the Ministry of Jobs, Trade and Technology)
. Work on the website redesign project has been planned to match with the timing of the Ministry of Jobs, Economic Development and Competitiveness project grant. The Registration Committee selected Gia Zheng, RD as the successful contractor
to the request for proposal
circulated in November 2019. Ms. Zheng will oversee the creation of an information portal to provide an acknowledgement-feedback loop and updated website content for international applicants.
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Clarifying Scope in Enterostomy Feeding Tube Care
The CDBC had addressed scope of practice questions related to enterostomy tubes in its
April/May
and
November 2019
monthly updates. The CDBC has since consulted with the College of Physicians and Surgeons of BC to clarify that the rotation of an enterostomy tube (of a ¼ turn or more) does not constitute a restricted activity. It is therefore considered to be within a dietitian’s scope of practice, when competent and safe to practicing Restricted Activity C. As a dietitian, you ensure that this specific activity is within your personal scope and that you are registered with Restricted Activity C before you perform it.
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Reminder: 2020 Continuing Competency Program
This is a reminder to full registrants in the 2020 CCP Group who have not yet submitted their Professional Development Plans. If you missed the October 31, 2019 deadline, please
login to your online CCP
to complete your 2020 Professional Development Plan as soon as possible. Remember, you must successfully complete the CCP requirement in order to renew your registration by March 31, 2020 and to avoid the $300 non-compliance late fee. Registrants in the 2020 CCP group who wish to be removed in good standing must also complete the CCP requirement by March 31, 2020.
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The Board and staff are happy to announce that the College has officially moved to the new office space since January 1, 2020. The office is centrally located with easy access for the public, staff, and Board and Committee members
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New Mailing Address
College of Dietitians of British Columbia
900 – 200 Granville St
Vancouver, BC, V6C 1S4
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New Contact Information
Phone: 604.742.6395
Toll-free: 1.888.742.6395
Fax: 604.357.1873
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Website Updates
The College circulated a request for proposal to modernize the website in November 2019. The contractor Spryberry was selected on December 10, 2019. Spryberry is a British Columbia firm with experience with non-for-profit organizations and the healthcare sector. The website is expected to be completed and launched in the Spring of 2020.
CDBC Website updates include:
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You Asked About…
Cannabis and Dietetic Scope of Practice
Cannabis Survey Results
In October 2019, the College circulated a survey to registrants to find out more about the impact of cannabis legalization in their practice
(education, perceived risks, etc.)
Thank you to everyone who took the time to answer the survey!
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Last year, the College published a Q&A on cannabis as well as a Resource Kit (1). The results of the survey, as well as practice questions received by registrants, have driven the direction of this Q&A.
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Q: Considering that purchase of cannabis has been legal for the past year, including personally producing edibles for consumption, why is edible cannabis legalization now newly important for me, as a dietitian?
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Cannabis edibles became legal for sale on October 17, 2019. Cannabis edibles are now available for purchase from retailers that possess the appropriate license. The use of cannabis in edible products can bring cannabis into the spotlight for dietitians. Given potential work opportunities and expectations, you are encouraged to understand your role limitations in this new area.
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It is important for you to recognize that there is limited published literature on the health benefits of cannabis (2). Performing a literature search that considers the quality of the study design and the evidence is also an important aspect that Dietitians need to consider when planning their nutrition recommendations (3). New evidence is expected to improve robustness of evidence as legal edible cannabis becomes more popular and mainstream. CDBC has updated its Cannabis Resource Kit (1), which may be helpful in directing clients to reputable resources online and addressing health risks associated with cannabis consumption.
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Q: What should I do if a client asks me for information about edible cannabis?
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The first step to take is to consider whether the client’s request falls within a BC dietitian’s scope of practice. It is within the scope of dietitians in BC to discuss nutritional aspects of cannabis edibles, given that the definition of dietetics in the Dietitians Regulation (4) is:
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“the assessment of nutritional needs, design, implementation and evaluation of nutritional care plans and therapeutic diets, the science of food and human nutrition, and dissemination of information about food and human nutrition to attain, maintain and promote the health of individuals, groups and the community.”
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Once you have determined that the question from the client is within the dietetic scope of practice, the CDBC encourages you to reflect on your own personal limitations on scope of practice. Do you have the knowledge, skills and judgement to take on a new aspect of practice safely, ethically and competently? Included in the Standards of Practice (5),
“a Dietitian uses critical thinking to obtain assessment date, determine practice problems, plan, implement and evaluate professional services.”
You may consult the CDBC Decision Tool for New Aspects of Dietetic Practice (6) to help you determine whether counselling on cannabis is right for you. If you determine that you are outside of your personal scope, you may choose to refer to another health professional for independent or collaborative practice, as appropriate.
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Q: Can I recommend medical/therapeutic cannabis? (7)
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Cannabis is a scheduled drug (8) and prescribing drugs is a restricted activity (9). For any questions you receive from a client considering medical/therapeutic cannabis use, you must refer to the client’s physician.
For example, a dietitian working in an interdisciplinary setting in cancer care, is approached by a client who is experiencing poor appetite as a side effect of the disease or medication and feels that medical cannabis may help. Your first step is to refer to the physician for an assessment, who may prescribe medical cannabis as an appetite stimulant, at which point, you would collaborate as a member of the healthcare team and include a comprehensive nutrition care plan that takes this into consideration.
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Q: Can I discuss the impact of cannabis on appetite with a client who uses cannabis? (7)
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It is within dietetic scope to discuss a client’s current cannabis use as an appetite stimulant for a client whose goal is weight loss, for example. You are not prescribing, nor are you recommending cannabis, but you are rather commenting on the potential nutritional side effects cannabis may have.
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Q: What about recipe development and recommendation? What about providing information about CBD/THC to appear on nutrition labels? (7)
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Commenting on dosing, recipe recommendations/development to achieve a specific dosing, nutrition labeling of amounts of cannabis in a given product, is outside of scope. Phytocannabinoids are scheduled drugs and dietitians are not authorized prescribers in BC (10,11). You can speak to health risks associated with consumption of food containing cannabis and refer patients to consult with their physician regarding dosages. For example, you can comment on the carbohydrate amount of the edible for a client with diabetes or on the salt content for a client with hypertension. You could, in these cases, propose changes to the recipe of the edible but not in relation to the amount of cannabis in the edible.
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Q: I work in a practice where I see clients in-person and I also have a social media presence. Can I advertise or write about medical or recreational cannabis (ex: Instagram, blog, newspaper article, research paper)?
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First, you should define the purpose and scope of what they will write about. As mentioned previously,
cannabis is scheduled drug and dietitians have a limited role when it comes to both therapeutic and
recreational use. The next step is to consider the relevant legislation, standards and guidelines applicable
to dietitians.
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- The Cannabis Act (12) sets out rules and exception for the promotion of Cannabis in Canada. For
example, the
Cannabis Act
prohibits Canadians from advertising, promoting or selling cannabis to minors
(under the age of 19 in BC). Any questions, comments or complaints about the Cannabis Act should be
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- You may also choose to seek legal advice on the interpretation of this Act for your practice. The
College’s policy on Marketing, Sales and Conflict of interest (13) provides direction on the type of information Dietitians may not include in advertisement such as misleading information, endorsement of products not related to dietetic scope of practice or recommendation of exclusive use of a product. Additionally, identification and management of conflict of interest should be documented.
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Q:
What should I do if a client comes to an appointment with me and they are under the influence of cannabis? (15)
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If a client is under the influence of cannabis, similar to if they were under the influence of alcohol or any other substance that impairs judgement, you must determine if you can proceed with the appointment. The first step is to use your professional judgement to determine if a client has the capacity to consent and if the appointment can proceed.
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If you are unable to provide services, you can discuss how the appointment may be rescheduled. You can also have a discussion with the client about your inability to provide services if the client repeatedly arrives under the influence.
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It is also important to address any safety risks to the client or others. If the client drove to the appointment under the influence of cannabis and is visibly impaired, you should take steps to address the safety concern. This could involve calling emergency services, notifying other professionals, or contacting the client’s emergency contacts. You should follow established organizational policies and processes. If no such procedures exist, you should consider developing such a policy for your practice setting. Be sure to document your interaction in the medical record, per the CDBC Standards for Record Keeping (16).
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Please contact College staff if you have questions about items in this Monthly Update or
if you’d like to schedule a CDBC liaison session.
We look forward to hearing from you!
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