We chatted with registered dietitian, Jen Hernandez, to learn more about her practice and what it’s like to work virtually from her home in Hawaii. Board-certified in renal nutrition, Jen has a passion for helping those with kidney disease slow, stop, or even reverse the disease progress with plant-based nutrition changes. She works with clients one-on-one and also runs a Plant-Powered Kidneys group program.
Let’s dive in and learn more about what Jen is working on in her practice.
— A Conversation with Jen —
What drew you to focus your practice on diabetes and kidney disease?
When I was a fairly new dietitian about one year in, a friend and colleague of mine had mentioned to me the opportunity to work in a dialysis unit. To be honest, I was totally scared of the renal diet where I would have to focus on so many details, and know many different parts of nutrition – macros, micros, acid/base balance – it was kind of terrifying.
But I wanted to be a great dietitian, so I took the job and studied hard to know everything. I taught my patients with end-stage kidney disease on dialysis how to eat well so they could feel well while on dialysis. But as I spoke to more and more new patients, they all said the same thing: “I wish I made changes in my diet before I ended up here. I wish I had seen a dietitian.”
That experience inspired me to start my private practice helping people with chronic kidney disease do everything in their power with the right nutrition, to slow or even stop the progression of CKD.
What is it like working with renal patients virtually? Are there any challenges for patients acclimating to virtual consultations?
I love working with renal patients, especially virtually, because I feel our connection is actually stronger with a virtual setting rather than in an office. In this way, they can connect with me from wherever they feel most comfortable; their office, their couch, their patio, or their kitchen. One of my favorite things to do with clients is to have them pull things from their kitchen to practice label reading, sort through foods that are “often” and “occasional” things to include, or even create a healthy meal together. Clients also seem to be more open to talking about painful subjects when they are in their home because they feel safer.
When I first started, the challenge was really in creating a good onboarding system for new clients. This meant more time in making welcome emails, linking tutorial videos, and setting times to check-in via chat to see how things were going. And the way Practice Better makes it so easy for both the client and practitioner to use telehealth, even my 80+-year-old clients can comfortably make our sessions!
Diabetes & kidney disease can be very complicated for patients and can lead to information overload. How do you help simplify the process of educating and guiding your patients so they don’t feel overwhelmed?
That is one of the biggest concerns and complaints I hear from new clients. Yes, it can definitely be overwhelming if you try to tackle everything at once! What I do to help my clients stay calm and focused is to break it into smaller sections. We start off with what their primary concern is, for example, it might be potassium. I start with reviewing their lab and medical history, along with their diet recall and preferences. Then I provide education on why potassium is important and how important it should be to them, depending on all of these factors.
The education part is key! We as practitioners can’t just say “watch your potassium.” We need to explain why it’s important, what could happen if they aren’t careful with potassium, and what it means to “watch your potassium.” The more we explain – and the more they can verbalize back to you – the more impact will be made.
You incorporate nutraceuticals and meal planning into your practice. Why has this been an important piece of working with your clients?
The right supplements are so key to kidney function support. Often, I get clients that are on literally dozens of supplements, and they’re not even sure why. They pick up a lot of information from “Dr. Google” and think it will be helpful when it can actually be harmful. I focus on ensuring my clients remain on or begin taking the right supplements that will benefit and support their kidney function and nutrition goals, while also making sure they aren’t wasting money on supplements that won’t be helpful.
I used to be against meal plans, like most dietitians. Here is a blog I wrote about changing my opinion on meal planning.
I felt it was like putting a band-aid on a bullet wound – it just doesn’t help. But what I’ve also learned from the marketing and business side of my private practice is that in order to get that potential client in the door, you need to give them what they want. So I provide sample meal plans, recipes, and even cooking demos in my private Facebook group, so I can gain their trust and respect. Then once they can see I know what I’m talking about and that I have something to help them, I provide more value in 1:1 care and support.
I also really like the way EatLove allows clients to have their own access. This takes so much off my plate and puts the responsibility on the client. They can use it for just a recipe here and there, or they can create full meal plans for a week at a time. So many of my clients have said this was one of the best parts about working with me – they didn’t feel restricted as they had been prior to working together.
Can you share more about what lifestyle factors have the most impact on your client’s health and their health goals?
Stress and sleep are major conversations that come up with every single client. Which makes sense when you think about it. The more we stress, the more inflammation occurs in the body. Chronic inflammation leads to poorer health including poor blood pressure or poor blood sugar control. Both of these can lead to worsened kidney function. We talk about ways to set up a better stress management system so they can feel better day-to-day with the stressors in their life that aren’t going anywhere.
What has been your biggest obstacle starting and growing your renal nutrition practice and what encouragement, advice, or tools can you offer those just starting out?
My biggest obstacle was getting over my imposter syndrome (which can still come up). I often got in my own way when I questioned if I should be doing this at all. But with each client that comes to me and thanks me for doing what I’m doing, it helps squash that voice in my head.
I found that one of the best investments I made was always in myself. Each month I find myself purchasing something that will better my practice, whether it’s a course about renal nutrition, business or marketing, or an assistant to delegate a project. I’m always looking for another way to invest in my business to let it grow more. And not all investments mean money. You can invest more of your time by listening to a podcast to motivate or inspire you, or a book that will teach you a new perspective, or trying new recipes to learn more cooking skills that you can share with others.
To those just starting out: keep your head down and push on. When I first started my business in 2018, I made $800. For 2020, I’m projecting to make more than $80,000! Don’t worry about what everyone else is doing. Focus on what you’re doing and how you can grow!
What are you working on now that you’d like to share with our community?
I’m getting ready to launch my third live round of my Plant-Powered Kidneys group program. It’s a program intended for those wanting to learn more about how to break down their best kidney health by starting with the basics. If you know someone who needs to learn more about the basics so you can dive into more of their whole health, this is a great program to help them learn a ton in just 6 weeks that is focused on their kidney health!
Thanks so much, Jen!
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