Hi there! My name is Eimear (@Health_aligned) and I am a fourth year student studying in Glasgow. I am currently in my 7th week of B placement and today I wanted to take a bit of time to share my experience so far. Hopefully by doing this it will help put some of your minds at ease because I know I was worried about lots of things before starting my placement. Throughout this blog post I will be sharing some background information about my placement, offer some tips of things I have found useful and reassure you that completing B placement is still very much possible despite the challenges of COVID.
As I already briefly mentioned I am heading into my 7th week of placement so over half way there already! My first four weeks were spent with the community dietetic team, my middle four weeks which I am still currently in have been spent in the acute hospital setting and my last four weeks are scheduled to be with the diabetes and weight management team. I am on placement with another student from a different university, we both have had to move away from home but thankfully are now staying in the same placement accommodation.
My fears and worries before starting
I thought it might be useful to share some of the worries and fears that I had before starting placement. I am sure that many of you awaiting your B placement are also feeling some of these same things…
I really did not know what to expect before starting. I had anticipated that I would be doing a lot of remote or home working and I therefore felt a bit worried that I wouldn’t get to see many patients face to face.
I was also a bit concerned if I was working from home that I wouldn’t be able to progress as quickly as I would like and that I wouldn’t meet all the portfolio learning objectives by the end of the 12 weeks.
I was anxious about moving somewhere new and meeting a lot of new people.
I was worried that my placement may be interpreted by COVID and that I would have to stop mid -way through. Or even worse I was afraid of potentially being exposed to COVID and having to completely stop placement.
During my time with the community dietetic team I was mostly based in an office. Pre COVID the community dietitian's would spend most of their days doing home visits but of course this isn’t possible at the moment. So instead of doing home visits we contacted patients either on the phone or on NHS near me video call. In regard to COVID measures we kept 2m distances at all times, wore a mask when walking around (but took them off when sitting) and just ensured to sanitize our hands regularly. Myself and my PAL were based in our own little office just off the main one.
When it came to doing phone calls what we would usually do is put the phone on loud speaker so that I could talk with the patient but the supervising dietitian could also listen in. This method worked really well, I would usually start the call by just having a little chat with the patient, gather some relevant information, do a diet history and then I would let the supervising dietitian finish the call with implementing the appropriate intervention.
Doing telephone calls I thought was a nice way to get settled into placement because sometimes it can be very daunting especially at the beginning to have a patient sitting in front of you. Speaking on the phone was defiantly a good way to get comfortable chatting. Telephone calls do however have their limitations, it can be difficult sometimes not being able to visually see the patients. You can’t tell what their body language is like or how they look . Some people also don’t like staying on the phone for too long, I definitely noticed that it was easier for the patient’s to get distracted because they were at home. Other times of course the phone connection was poor especially if the patient lived in a remote area. One thing I learned however is not to be afraid to get the patient to repeat something if you couldn’t hear. It is more important to get the correct information rather than writing something into your notes that you are not 100% sure about. Despite all of these little limitations the telephone calls worked really well, it is a good way to get some practice speaking with patients without it being too daunting or overwhelming.
NHS near me
I also got the opportunity to join into some NHS near me video calls. NHS near me is a video chat system that is being used widely across the NHS at the moment. It is basically the same concept as face time but it just has a more secure network. As expected, it was mostly younger generation patients that were willing to opt into the video calls. The dietitians preferred doing video chats although patients were always given the choice of either a phone call or video call. From a student perspective the video calls may feel more like a “proper consultation” just because you can see the patient. Doing the video calls really doesn’t feel that much different to the telephone consultations, it just feels like a facetime really! Of course at the beginning it is going to feel a bit weird talking to patients over the phone and on video but you will find yourself getting use to it quickly. I think most of us are really quite good at using technology to talk with friends and family and so adapting to using these methods of communication in dietetic practice doesn't feel too alien.
USEFUL TIP- if you are speaking to someone over the phone or on video call, have your notepad out and prepare the questions you want to ask them in advance. Write down the questions and have them sitting in front of you to act as a prompt. I found this technique really useful!
I have finished my time with the community dietetic team and am now based in the hospital which has been great so far. I have had the opportunity to see a lot of patients face to face. In regard to COVID infection control measures we have to wear our masks everywhere we go , higher level PPE (i.e gloves and aprons) is only worn when seeing patients who are identified as “high risk” (which is indicated on their bedroom door or in their medical notes). We must always keep a 2m distance from one another although this can be difficult at times, sanitizing hands before and after seeing a patient is also an essential. I have got the opportunity to speak with quite a lot of patients in person and if you are based in a hospital for your placement you probably will too. Other than the infection control measures it doesn’t feel too different talking with the patients . I had envisaged having to wear full PPE into every patient, but this has not been the case at all. Most of the time, I would say I just have to wear a mask and maybe gloves and of course sanitize. It can be challenging at times wearing the mask all day and a good tip to remember when speaking with patients is to raise your voice a bit louder than you normally would to ensure that they can understand and hear what you are saying. Clearly my pre-placement fear of not getting to see patients face to face hasn’t become a reality, and most likely won’t for you either. Your supervising dietitian is going to try their best to get you speaking with patients face to face as much as possible so try not to worry!
Self - isolation
Unfortunately, at the beginning of my placement I had to do 2 weeks of self-isolation. Of course, this was far from ideal, I was worried that my placement would stop and that I would have to make these 2 weeks up at the end. This was not the case at all, the dietetic team were amazing and set me up to work from home almost immediately. I got an Ipad and work computer where I could access patient notes if needed. I still joined into NHS near me video calls and I rang the dietitian’s multiple times a day on Microsoft teams to ask questions etc. I got to do a lot of practice on the information gathering side of things during these 2 weeks, I wrote up patient notes on the online portal system, I did quite a lot of tutorials and case studies which were all really beneficial.
So if it happens that you have to isolate during your time on placement don’t panic! You won’t miss out on those two weeks, the dietitians are prepared for things like this to happen, they expect it to so don’t worry if you find out you have to isolate. The dietitians are there to support you and they want you to get through placement just as much as you do. I don’t feel like my time in isolation was a waste or that I missed out on valuable experiences, I learned a lot during my 2 weeks working from home. So try not to stress too much if this happens to you as well, your placement will not just suddenly stop, everyone is prepared for stuff like this to happen.
Top Tips for your B placement
If you have a chance to speak with a patient take the opportunity, whether that be on the phone, video or in person. We just don’t know what’s going to happen over the next few months with COVID and so getting as much experience and gathering as many IPC tools as possible is always best.
The criteria for filling in an IPC has been adapted for COVID so that the dietitian can fill one in based on a telephone call, online video chat or face to face appointment. Don’t think that you can only get IPC’S from face to face consultations try to gather as many as possible from a variety of consultations.
The portfolio has also been adapted for COVID and so there is no need to worry about not being able to complete a task. All tasks have been changed to ensure that we can complete them even if we are working from home.
Your dietetic team want you to get through placement just as much as you want to get through placement . They are there to support you so make sure to voice any worries/ fears and ask for help if needed.
Remember that all of this is new for the dietitians as well as for us, they have had to adapt and change their methods of teaching and so this is a big learning experience for everyone.
Wearing PPE/ a mask all day long can be difficult in terms of feeling very warm and getting headaches etc. It is important to make sure you are staying hydrated, going for a walk outside at lunch time I found has been really beneficial as it is an opportunity to get some fresh air and not wear the mask.
Although it may not seem like it there are a lot of positives to take from doing placement during COVID ; As dietitians we have to be flexible and COVID is helping us to develop our flexibility skills which will most certainly stand to us in our future careers. Learning to work with technology/ remotely is going to also be useful in the future as It is likely that at some point we will be using technology to reach our patients.
COVID is something that is out of our control so the best thing we can do is to focus on each day and just enjoy the experience of being on placement. There is no point in worrying about something that we cannot change, although this is much easier said than done! It is so much better to focus your energy on the positives rather than on the potential negatives. There are times that things will feel overwhelming and quite challenging and that’s ok. It’s important to realize that not everything is going to go exactly to plan. I hope that by sharing my experience you can now see that placement B is still very doable despite the challenges of COVID. I feel like my learning has not been hindered and that I am progressing well through placement. I hope that this has helped to put your mind a little bit at ease and acts as a reminder that you too will make it through placement. The dietetic teams are there to support you and remember to ask questions and voice any worries or concerns you may have with them.
I hope that your placement goes well, thank you for taking the time to read this post.