The placement continues

I am firmly of the belief that if you don't have anything nice to say, then it's as well to keep quiet. That is the main reason why there has been silence in my blogspace for a week - it was a bad week, a hellish week, one that I think might rank as one of my worst weeks ever. Today I am feeling more positive, so I am taking the opportunity to squeeze out a blog post before everything goes wrong again, as it quite possibly will.

I continued with stroke and diabetes last week, and this week there will be more of the same. I am feeling more confident with individual consultations in outpatient and GP clinics, which are generally about weight reduction or type 2 diabetes (or both), although I saw someone this morning (was it only this morning?) with Irritable Bowel Syndrome. I have just 21 more working days before this placement is at an end, and I am confident that I will reach the finishing line, although there may not be much blogging activity until May begins.

I have spent some time revising the BDA Conference abstract according to the suggestions provided, have sent it back to them so they can decide whether I need to produce a poster or an oral presentation. I spent Saturday working on that, and then on Sunday I worked on a presentation that I delivered today about a journal article describing a study to determine whether people in hospital who have many illnesses are more likely to have barriers to their access to food at mealtimes. I produced an uninspiring performance talking about an uninspiring article, but at this stage I don't care as long as the relevant Assessment Tool is signed off to say that I did it and it wasn't a disaster.

Job applications have had to wait. I received some useful feedback from one of the jobs I applied for - they are looking for a qualified dietitian rather than waiting for me to qualify (which won't be before July), but suggested a couple of things for future applications. I'll get back to that later, because with the workload from here onwards it will be tough to find the time that a good job application needs. It was a good idea to get a couple out, though, and will definitely make future applications easier.

Placement dietetic experience

There really has been a lot of stuff happening. I thought that coming to an unfamiliar town and living in someone else's house would mean I had a load of free time - that's what happened last time. In fact, because of what happened last time I made a lot more effort to find a good place to live, and have now signed up to play at two badminton clubs. This has resulted in me enjoying my evenings immensely, but having no spare time for homework or blogging at all. And there is homework that I should be doing, at this very moment.

It's been a while since I ventured into the territory of describing the actual dietetics I've been doing, what with having had a bit of a breakdown in weeks 3 and 4, but things are really much better now at the end of week 6. Half way.

I have now seen an adult with a BMI of 9.4 and a weight of less than 4 stone (56 lb, 25 kg), and someone weighing more than 24 stone (335 lb, 150 kg). A patient with kidney failure kindly allowed me to feel the 'bruit' or 'thrill' from their newly constructed arteriovenous fistula that will be used to facilitate haemodialysis. I observed a cooking session carried out by one of the Food Educators, where parents and their young children cook something that they can then cook again at home. Cooking used to be taught in schools when I was young, but now this seems to be one of the only ways that people can gain the skills that I took for granted. If you've never tasted a courgette or chopped an onion, for example, you're not going to buy them for your family.

I have to admit that the GNT dialect is giving me a few food-related difficulties. Bread rolls/baps are called bread cakes (in Manchester they were barm cakes), which is straightforward enough, but it gets more complicated with meals. The main meal is dinner, and is eaten at dinner time, which is often in the middle of the day, except when dinner is eaten at tea time. Tea time is in the evening. Here is a direct quote from a patient that I wrote down: "We eat our dinner at dinner time, not tea time." One patient didn't seem to understand when I was talking about lunchtime, and I had to explain that I meant the middle of the day. Supper often means a snack taken after tea, i.e. before bedtime. 'While' is used in place of 'until', e.g. "I work 8 while 5 during the week." Now all that is sorted out, I can usually understand what they're all talking about.

During the past week I have been on stroke and diabetes, with an outpatient clinic or two thrown in for luck. I like stroke and diabetes, particularly diabetes, which I find fascinating in a very nerdy way. All those lovely numbers! Blood glucose readings, HbA1c numbers, cholesterol and triglycerides, blood pressure, BMI, waist circumference, carbohydrate portions and units of insulin. Then there's Oral Hypoglycaemic Agents, different types of insulin, meters, pumps, lancets, strips and a team of doctors, specialist nurses, dietitians, pharmacists, podiatrists and opticians. I observed a fairly complex set of patient consultations, did a couple of fairly straightforward ones myself, and almost felt like a real dietitian for some of the time.

The feedback I'm getting is good, and apart from the backlog of homework, I think it's going well. There's also a bit of exciting news from the world of University - my supervisor persuaded me to submit an abstract of my research project, on visual impairment and food choices, to the annual British Dietetic Association Conference. This week I found out that they have accepted it for presentation (with modifications). This is good news for my CV, but bad news for my workload - now I have to make the modifications and re-submit the abstract. I will only find out nearer the time whether they want an oral presentation or a poster, and then I will have to create that. My placement supervisor also suggested that I could practise by presenting the paper to the department. Oh boy.

So I have plenty to be getting on with, but the priority has to be a job application this weekend, and then I must sort out my placement portfolio. I should mention that it was nice to see Mr A again, and I managed to recognise him despite his long hair. That was another job for me this weekend!

What I've been reading

Mansfield Park
by Jane Austen

"The novel's heroine, Fanny Price, is a 'poor relation' living with the Bertrams, acutely conscious of her inferior status and yet daring to love their son Edmund—but from afar. However, with five marriageable young people on the premises, the peace at Mansfield cannot last. Courtships, entertainments and intrigues throw the place into turmoil, and Fanny finds herself unwillingly competing with a dazzlingly witty and lovely rival."

I'd say this isn't one of her best books, and I actually found it quite difficult to read. The language seemed to take my attention away from the story, which wasn't gripping enough to keep me engaged. The heroine is also quite a drippy character, always needing to sit down for a rest or being too overcome to speak. The story unfolds really slowly, and then all the concluding action is packed into one or two chapters at the end, by which time I'd lost all sympathy with Fanny, and wouldn't have minded if she did live out her life as an unhappy spinster.



Memoirs of a Geisha
by Arthur Goulden

"The book tells the extraordinary tale of a geisha, summoning up a quarter century, from 1929 to the post-war years of Japan's dramatic history, and opening a window onto a half-hidden world of eroticism and enchantment, exploitation and degradation."

Although I didn't remember it beforehand, I have actually read this before, and thought then it was a true story, rather than being based on a whole load of research. Well-written certainly, and much easier to read than Jane Austen. But I feel uncomfortable not knowing what is true and what is author's imagination. Despite all the research he might have made stuff up. So it's a good read but I remain wary of the contents.



The Queen's Fool
by Phillipa Gregory

"It is 1553, Henry VIII is dead and his young son Edward is now king. 14-year-old Hannah Green, a determined Jewish girl with the gift of foresight, has come to England with her bookseller father to escape the Inquisition in Spain. After a chance meeting with the dashing Lord Robert Dudley at her father's bookshop, Hannah finds a new life as a court fool - and a spy. Reporting to Dudley all that happens around the sickly king, Hannah is also sent to spy on Princess Mary, with whom she strikes up a loyal and lasting friendship."

I've been toying with the idea of Phillipa Gregory in audio book form, but Landlady Lola has several in print so I've taken advantage. It's interesting, a story woven around real events and personalities, and while I have no idea of the level of historical accuracy, I don't really care. And MUCH easier to read than Wolf Hall.

The last two weekends

The week of low self esteem the week before last was followed by a family weekend. I went home on Friday night and Mr A and I became reacquainted - I recognised him straight away, and I think he knew who I was, even though he denied it. I reminded him that I'm the one who used to do most of the laundry. Then we went to the pub. He says that without me there, the house is rather quiet, mysteriously messy, and his clean clothes don't magically appear on the kitchen chair. We had a lovely evening, but all too soon I was away down south to visit mum and dad and meet up with Lola II.

Lola II has been reading me books at bedtime whenever we're in the same location. We started with 'My Friend Mr Leakey', and we're now coming to the end of 'The Phantom Tollbooth', and were wondering what to read next. Lola II had forgotten to bring a book with her this time, so I chose a book of Fairy Tales by Hans Christian Andersen from the bookcase, and asked for the last story, which happened to be called 'Booby Hans'. Booby Hans follows his brothers to see if the princess will marry him, and brings her presents that he found on the way: a dead crow, an old shoe and some mud. I think it's the translation that made it so funny. It's definitely going to be our next bedtime book.

Then this weekend I was off to Sheffield and meeting Lola II and sister D on one of their rare journeys into the North. On Saturday we experienced a large number of policemen, which was unexpected but could have been anticipated, because the Liberal Democrats were having a Spring Conference. We caught a tiny bit of a demo from a distance, but the police were far more prominent than any rabble.

In brief, we went on a geological walk in the city centre looking at different rocks that have been used for paving, shop fronts, benches and decorative stuff, visited a shop that sells amazing hot chocolate four times, ate Japanese, Korean and Moroccan food, saw a film, went to a museum with a Sports Science exhibition and an Art Gallery whose cafe was closed, spent a short time in the botanical gardens and the Winter Garden. It only rained on Sunday morning. The Bed and Breakfast where we stayed was astonishingly good and thoroughly recommended, and we all had a lovely time.

Back at work now, and I'm going to be doing stroke and diabetes for the next three weeks, which I am looking forward to a great deal more than what I have done so far. I have a lot of things I ought to be catching up with at home, but instead I have been to badminton this evening and will do the same tomorrow, and may even go out on Thursday as well. It's slightly frustrating that I am not devoting much time to blogging, but I'm sure I'll get back to it when time allows - I still have lots to say!

It gets better

Here I am again. It's been too long, hasn't it? But my days are full at the moment, especially as I've been applying for jobs. Applications take up much spare evening time, and I'm not prepared to compromise on badminton time. Last week I played on both Monday and Tuesday, and I did the same this week. I also spent quality time with Landlady Lola III, and there's homework from school. At some point I will need to spend probably more than one evening on my 'Journal Club' assignment, which is where I present an interesting article from a recent journal to members of the dietetic department. I haven't even looked at the article since I chose it in week 1.

Enough excuses, what has actually been going on? I have more than a week of work to write about, seeing as how I refused to write about it last time.

I have been doing work.

There, that just about covers it. Last week was not nice, I did not enjoy it, but it turns out I was being overly sensitive and self-critical and I was actually doing very well, rather than astonishingly badly. Who'd have thought?

The sort of work I was doing involved watching other people doing dietitian-type activities and wondering how on earth I could possibly presume to offer dietetic advice to sick people. I had a go a couple of times, but I thought I was a bit rubbish, except for the presentation I did about healthy eating to a group of five patients with lung disease and three of their relatives. I like giving presentations and I'm good at them, so it was very demoralising to think that I was being criticised. Except it turns out that I wasn't. Really, this work experience lark is very confusing.

So it has been much better so far this week, although I am still having to spend time in different hospitals all the time. On Monday I was at one hospital, on Tuesday at an 'intermediate care' home (where they put patients who are not ill enough to be in hospital but not well enough to go home) and then a GP clinic, and today I was at the same hospital as Monday in the morning, and then a school in the afternoon. Tomorrow and Friday I'm at two more different hospitals before the dreaded 'Reflection' on Friday. And then a weekend with Lola II and sister D. I'm hoping for some adventures!

I am not going to talk about work

After that horrible Friday, I stayed in GNT for the weekend, because Mr A was due to be away with friends (even though, as it turned out, he wasn't). I went into town to explore on Saturday, and bought a ton of fruit and vegetables at the market, which I then had to carry around for some time. I visited the 'big church' in the middle of town, and was welcomed by a very friendly lady who gave me a small guide to the Minster. When I got home and mentioned to Landlady that I'd visited the Minster, she told me it wasn't a Minster but just a big church. I get the feeling that this is a matter of some local importance.

Anyway, back in town, after the 'big church' (which was pleasant enough but not that exciting), I went to the local museum. It was fine. There was the usual stuff you get in local museums about the geology of the area, some stuffed animals in realistic poses in a reconstruction of their natural setting, some local history including the compulsory display on 'GNT in Roman times', and displays about past and current activity: mining, railways, horse racing and football. The two most interesting things were:

• a description of a house that had been carved inside a sandstone cliff and was lived in during the 19th century (but is no longer there), and
  
• a museum attendant having his wallet stolen, and chasing and catching the perpetrator.

The theft of the wallet was marginally more interesting than the contents of the museum. I then took a wrong turn, and with my increasingly heavy load of vegetables I walked for quite a long way before getting home. If I'd been on the right road, I'd have taken a bus.

Later on Saturday I went to meet another student, J, who was with me on my B placement and is on her C placement nearby. We watched True Grit (good film) and let off steam about how we're getting on. It was very nice to see her, and felt like a little bit of a holiday. On Sunday I think I spent the whole day indoors, and I have now submitted my application for a job. A real job, as a dietitian, just about within reach of my home. Although at the moment I not only feel that I can't do the job, but that I'm not sure I even want to. But I'm not going to talk about work. There's another job, just been advertised, also within reach of home, and I must apply for that too. I couldn't face it this evening; I will have to do it tomorrow.

Home news: the cats have worked out how to get into my bedroom - the door doesn't always latch shut when I close it. This is usually when I am on a tight schedule to get out of the house in time for some important deadline, like catching a bus. Other than this, I have no complaints, since I am not going to talk about work.