The End of My Dietetic B Placement

 

It feels so crazy to say it, but B placement is over! My 7 week hospital placement ended last week, and it absolutely flew by. I enjoyed the experience so much and it’s definitely solidified that dietetics is the right career for me. This blog post is a reflection on my placement experience and what I’ve gained from it. My other blog post about placement talks more about what to expect on B placement and some tips to help along the way.

The learning curve

This placement was a steep learning curve. It was the first time I really felt like I was in the hospital environment and taking part in it. My A placement was also in a hospital, but it was only observing so this was my chance to get stuck in. B placement was shortened from 12 to 7 weeks due to Corona so it felt like there was a little pressure to get to a certain level quicker than we normally would. But I think the shortened time frame helped me. I had to jump in and take every opportunity as I didn’t have time to waste. In the first week it was mainly observing and then after that I started gathering information and starting off the patient consultation. I would let the dietitian take over when it came to giving advice and making a plan but around halfway through, I started doing more of it myself.

I started placement not having spoken to real patients before and feeling scared at the thought and I ended placement doing full patient consultations by myself. I impressed myself with my progress and how quickly I picked up on things. The best way to develop your skills is to speak to patients and have a go. Learning things in lectures is one thing but seeing that theory being put into practice and applied to real patients is invaluable.

Specialties I like

Another thing I gained from B placement was lots of experience in different specialist areas. This allowed me to see what areas I’d like to specialise in and do more of. From A placement I liked critical care, weight management, and oncology (cancer). At my B placement I didn’t get to see any weight management as the hospital I’m at doesn’t provide that service. And I realised that I don’t think oncology is for me. It’s not that I don’t like this area but there are other areas that interest me a bit more. I really enjoyed critical care, and renal (kidneys).

I like critical care because all the information needed to perform our assessment is recorded meticulously.  Before speaking to a patient, we’d ideally like to know their weight and any changes in it, their blood test results, their dietary intake, their bowel habits and if they’ve had any other symptoms like nausea or vomiting. On a normal ward all this information isn’t always available but on critical care it is provided on a massive spreadsheet that nurses update hourly. Having this information can give you a clearer picture about the patient. Critical care is also a different environment to other wards. It’s usually much calmer, almost eerie, as most patients are sedated and unconscious so there's not much noise apart from the hospital machinery. Critical care is for the most ill patients and there is a large emotional burden working there. About 20% of patients in critical care will die so I’m aware I will need a lot of emotional resilience to specialise in this area.

Liking renal surprised me as I always feared that area, it seemed so complex and difficult! There is a lot to consider with renal, and some things are looked at in more detail, like a patient’s blood test results. Being a renal dietitian can mean advising patients on many different types of diet, depending on their kidney function. Patients could need a low potassium diet, a low phosphate diet, a low salt diet, a fluid restriction, or a low protein diet. This can be difficult to manage alongside any other conditions they may have. I liked the variety of dietetic management within renal, but it also means there is a lot to learn!

You have all the knowledge already

Before going on placement, it can be scary and you may feel like you don’t know anything, that’s certainly how I felt. But don’t worry about it, you have all the knowledge needed. While you do need to have an understanding of different conditions, you won't be expected to be a specialist in every medical area. There may be diseases you haven’t heard of or some treatments you don’t know about, but the basics of dietetics will always apply. As long as you remember the principles of nutrition support – food first, food fortification, oral nutrition support and then enteral (tube) feeding you will be fine!

 

My final placement, C placement starts at the end of January next year. This is a 12 week placement in which we will have more responsibility. At the end of C placement, we will be acting as an independent practitioner and managing some wards alone. I’m nervous but excited for it and of course I will keep you guys updated with how I get on!

I hope you enjoyed this blog post, and it gave you a bit more insight into the second dietetic placement.

Bye for now! 👋