Wednesday, 24 November 2010

So how's it going at university?

Construction of a new university building
There hasn't been any university news on here for three weeks or so, but obviously I've been beavering away at various course-related projects. I was expecting a great deal from this semester, thinking it might provide as much interest, stimulation and challenge as previous years or the clinical placement. In fact it's been rather disappointing on all counts.

We only have two taught modules, one termed 'Nutrition in the Community', and the other advertised as 'Advanced Dietetic Practice', but the latter turned out to have the qualification 'and Professional Issues'. The Professional Issues bit, it seems, are the things that are deemed useful for a basic grade dietitian to be taught before they leave university, rather than learning over time from the University of Life. Like last week's lectures: aspects of business management, coping with stress, time management, teamwork, managing change, leadership and motivation, and the role of the Human Resources department.

I got the distinct impression that the lecturer, who is also the university course manager, felt the same way about it as I did, but is forced to deliver the material because the Health Professions Council (who regulate the profession, and therefore the course) demands it. Certainly she would have picked up our reaction on being asked, yet again, to consider what might be the advantages and disadvantages of working in teams.

For me, it was an exercise in nostalgia and reflection. I don't think anyone can have reached my age without considering their response to stress, and I have had a few close calls. I have a vivid memory of the one time that I was properly affected, and how I was helped out of that particular hole. I was brought down by the end to a relationship, and what prompted me to recover was the recommendation by my boss at the time to seek help. I didn't seek help, and I managed to recover under my own steam, but I would never underestimate the illness that is depression - I have stood on the edge and looked down, and it isn't pretty.

I attended a time management course in my 30's - it was one of the most useful courses I ever did, and I continue to use some of the techniques that were introduced to me. I also spent some considerable time even earlier in my career trying to unpick whether management is something one can learn or is born with, joined an evening class to consider the subject, and then much later on had to grapple with the reality of being a manager. I have come to the conclusion that one can learn to be a manager, but to be a good manager requires something extra. I have also determined that I don't wish to be a manager ever again. I have some warm thoughts about teamwork, which I may share in a future post.

So all of these subjects are relevant to a working life, but I don't know whether introducing them to 21-year-olds in their final year at university makes much difference. Perhaps other people learn to avoid disaster through classroom teaching - I have only ever learned anything about avoiding disaster from living through it.

More useful in this module were two practical tutorial sessions, where we were given case studies to discuss in small groups, directed by an experienced practitioner, and a mock job interview conducted by a dietetic manager. The interview was particularly valuable, giving an insight into what skills and knowledge might be demanded by an interview panel. As it happened, my interviewer recently retired from the location where I am to do my next clinical placement, and was able to answer my very real questions about that department. I don't think I would have got the job, but I can now prepare much more effectively for the real thing.

We have also had some external speakers topping up our knowledge on various random topics: I have mentioned diabetes, communication skills and obesity but there was also a lecture from a Sports and Exercise Dietitian, who also provided an introduction to dietetics in private practice. While most of these lectures were relatively interesting, they were more like seminars, and I didn't feel as though I was learning very much, either in terms of the evidence base, theory of dietetics or dietetic practice.

The other taught module has been even worse. It has been a random series of lectures on Public Health to an mutinous group of students under pressure of work who really don't want to be there but have to turn up to sign a register of attendance. It is convened rather than taught, and I don't think the group has a great deal of respect for the convener. And rather than Nutrition in the Community, it should probably be called Public Health Nutrition, and that subject is definitely not one of my favourites.

Despite this, I was almost looking forward to the talk about mental health, and the lecturer definitely had plenty of experience as a Community Psychiatric Nurse, but she wasn't that good at conveying the specifics of the job. She also confessed that she knew nothing about dietetics, and had never worked with a dietitian, so she made a number of misplaced assumptions e.g. about our knowledge of legislation relating to vulnerable adults and children. All I really learned was that if I were presented with a patient who had a mental illness, then I should go find a CPN with proper expertise to help me.

I wasn't looking forward to the talk about food service in Derbyshire schools, but it was actually very good, and surprisingly interesting to hear about what can be done for £1.85 per child per day in primary schools and £2.15 in secondary schools. That's a really rewarding role for a dietitian, and it was very clear how we might fit in and contribute our expertise.

There are only one or two lectures left, thank goodness, and for the next few weeks I have coursework to deliver and more to do on my research project, which is going quite well at the moment, and you will definitely hear more about that. This week I have to present a poster about Assistant Practitioners and Dietetic Support Workers and where they fit into the dietetic profession, and next week I must outline my thoughts about a community nutrition intervention of my choice. The main coursework this term apart from my project is to define and scope a research idea, which has given me no end of trouble, and is threatening more. My project tutor has been wonderfully helpful with that, and is substituting for the supportive group of fellow students that I lack.

And for light relief on my day off this week, I attended a local group meeting of Coeliac UK. I joined the organisation as a 'professional' member some time ago, when I had that project to do about eating out with coeliac disease. I thought it might be interesting and educational to go along to a meeting, and it was.

There was a presentation about the new EU labelling regulations for gluten content of food, then a demonstration of a gluten-free dough mix made of cassava, and then tea, gluten-free cake and chat. The biggest shock was at the beginning when everyone was welcomed to the meeting, "and we have a student dietitian here, would you raise your hand?" Not what I was expecting at all, but luckily there was also a 'real' qualified dietitian, so I was able to deflect difficult dietetic questions*, and also talk to her about the employment situation in the region where I live, rather than in the regions where I attend university or go on clinical placements. The best bit was when one of the attendees asked me for my recipe for gluten-free lemon drizzle cake. In front of the dietitian. Yes!

As ever, the final weeks of term leading up to deadlines is hard work, and I'll be doing 6-day weeks until mid-December, but Mr A is doing a magnificent job with meals and research into our proposed snowboarding holiday. Maybe there will be lighter and more amusing news to report next time - this post has been a bit of a rant. I don't do it often, so I hope I'm forgiven.

* "Apart from having coeliac disease, I have no salivary glands, what do you suggest?" and "Are oats contaminated with wheat gluten in the field where they are grown, or in the factory where they are processed and packaged?"


Lola said...

No salivary glands: apart from using artificial saliva or drinking liquids with foods, the dietitian suggested incorporating fruit or vegetables into dry foods, like adding sundried tomatoes into bread or soaked dried fruid in cake, so that they would release their liquid when chewed.

Oat contamination: both. You have to buy special labelled uncontaminated oats to be safe from gluten.

Sparx said...

OK, you answered my question in your post; but my oh my, what must it be like to live with no salivary glands??

Thanks for dropping by the blog!

aims said...

I knew the answer to the oats - and was interested in her answer as well.

I never touch oats - just no trust whether they say they are safe or not. I don't think I can take many more run-ins with gluten so stay far far away.

Has anyone suggested the use of acidophilus in the diet for celiacs? My doctor has me taking 3 capsules a day or 18 billion cells. It is supposed to help with the gut. I couldn't tell you if it makes eating gluten any easier - I'm not willing to try. I do notice an increase in flatulence but that may be from the glycerin in the opium and belladonna suppositories. (too much info?)

Lola said...

Acidophilus is a recognised treatment, but not as a direct result of the coeliac disease, more a consequence of the damage to the walls of the gut. The bacteria do a bit of digestion for you, so it's easier to absorb nutrients (I think they chop up medium chain saccharides, i.e. partly digested carbohydrate). As the bacteria digest, they do produce gas, which may explain the flatulence.