Saturday, 23 August 2008

The Placement Workbook

Turns out I did have some time to write a bit more that day. I'd done as much of my workbook as I could for the time being.

The workbook is the equivalent of the stroppy supervisor standing over me telling me what to do. It's a monster. 70-odd pages divided into sections covering the ward work, food analysis, shadowing dietitians and an Induction section at the start with questions like "How do you warn everyone else of a fire?" Actually, that's an easy one, a more challenging question was "Where is the Health and Safety manual kept in the department in which you are based?" I asked four or five people who had never heard of it; the fire officer didn't know, neither did two of the first aiders I asked, and finally the H&S rep said it was 'in the main office'. He didn't say which office (there are several), and I'd had enough by then, so that's what I put in the workbook.

The biggest single task in the workbook (and it's one of many tasks) is to analyse a day's food intake for energy, protein, carbohydrate, fat and two other nutrients (iron and calcium, say). Then work out the cost of the whole thing per portion if you were to buy the ingredients in a supermarket, and the same again for a smaller local shop. Then do the whole thing again, but with low sugar/low fat versions of everything: nutrient content and cost in a supermarket and smaller shop. Then, of course, comment on the findings.

Another big job is to create a 7-day meal plan for a family of four including parents and two children aged 4 and 7 who eat ready meals/convenience food 4 times a week - then price the whole thing within a budget of £40. Thankfully, I don't have to analyse the nutrient content of this one, unlike the Buffet Lunch task. For a budget of £1.50 per person, I have to create a real buffet for members of the department, making a lower fat version of one savoury dish and a lower sugar version of one sweet dish, and labelling these with energy, fat and sugar content per portion. I present it to the supervising dietitian, and am quizzed on the whole thing at length before it gets eaten. The workbook proudly states that I can use the facilities in the Dietetic Department Kitchen - this contains a sink and a microwave and no work surfaces, not even a table. I've scheduled my lunch for a Monday and I'll be doing any necessary cooking at home.

In the catering department I've been comparing the size of portions of hospital food with the 'standard' textbook portions, and looking at the different versions available for gluten-free, diabetic, pureed/minced and high protein menus. I tasted three different rice puddings, and none of them was very nice. It's not surprising that rice pudding gets a bad name - perhaps this is why I wouldn't touch the stuff for twenty years after leaving school. Properly made rice pudding is delicious; this was rather bland and tasteless, not even very sweet. I've got the recipe: you'll need 4 gallons water, 4 lb milk powder, 4 lb rice, 2 lb sugar and 2 tins evaporated milk to make some for yourself (and 199 friends). But I don't recommend it.

The dietetic department is quite big for a not-very-big hospital (around 800 beds.) The department is divided into different 'teams', but these seem conceptual rather than relating to the type of work undertaken. Some dietitians work in the hospital, some in the community, and some specialise in a field like oncology and palliative care, diabetes, and enteral feeding - that's when a liquid feed is put directly into the stomach, either via a naso-gastric tube or through a 'PEG' directly through the stomach wall. Yesterday I was shadowing a diabetes specialist. I might write about that later - the diabetes stuff was absolutely fascinating, but it was also the most annoying frustrating experience at the same time.

Most of the dietitians are friendly, but this seems directly proportional to their seniority. Perhaps the newer, younger ones remember more clearly how grim it was to be a student on a placement; the older ones are really rather snooty, and the manager is very fierce. Alyson is looking after me; she is a Dietetic Assistant, the lowest of the low. DA's can do quite a lot of the work of the registered dietitians, but not all, because they haven't done the degree I'm doing and aren't registered. Alyson is definitely the nicest of the lot, and the most normal of them all.

Being Saturday now, I'm home again for the weekend, including the Bank Holiday on Monday. Lola II is coming to visit, which makes up for the music festival that I was going to attend being cancelled, again. Last year it was flooded off, this time it's something to do with licensing. Maybe next year...


aims said...

That's quite the mouthful you bit off to chew when you decided this is what you want to do.

It's a good thing you find it so interesting!

Amy said...

Wow. Sounds like you've got a lot of work ahead of you. I hope having the car helps you feel less desperate. Those student accomodations sound pretty bleak. Maybe it was deliberate to encourage studying?

travelling, but not in love said...

Lola, you're certainly not afraid of hard work! I'm so impressed at the workload you've taken on...keep going, the end is nigh (sorry, in sight!).

Lola said...

Thank you all for your encouragement - just one more week to go, thank goodness.