End of my dietetic C placement

I can't believe it, but C placement is over. C placement is my last placement before I have my final exams at uni and qualify as a registered dietitian. It’s so scary how quick everything has gone! I started this blog when I was in the first year of my course to give an insight into studying dietetics and now, we’re almost at the end of my degree. C placement has been a massive learning experience and I’m so happy with how it went!

Consolidation:

Consolidation is the last 2 or 3 weeks of your final placement where you have to act as a newly qualified band 5 (entry level) dietitian. You're in charge of your own caseload and have to see all your patients independently. This means, gathering the information to make your assessment, speaking to the patient, making a plan, and speaking to any staff that need to be informed of the plan. At my placement hospital, we were given 2 wards to be in charge of and see those patients. The wards I had were a neuro rehab ward and a care of the elderly ward.

My caseload fluctuated a lot, especially on the care of the elderly ward. Sometimes I only had 2 patients to see but other times I’d have more, and I would have to prioritise who is most important to see. Being able to have a reasoning/justification for what you're doing or who you're choosing to see is really important. Developing this clinical reasoning is something that occurs over the course of C placement and in your career as a dietitian. The times that I didn’t have many patients to see I’d take patients on different wards instead. Being proactive is so important, it’s better to say you have no patients to see and help someone else with their caseload rather than reviewing patients for the sake of it.

Another part of consolidation is team working, as you're on the wards alone acting as the dietitian you have to be familiar with the ward layout and the staff. Speaking to nurses and healthcare assistants can be really helpful to find out about how a patient is eating, and if you're concerned about a patient’s blood results or you think tube feeding should be considered, then speaking to the doctors is essential. Introducing yourself to the staff on the ward will make it easier to work with them and you can become familiar with them during the weeks you're there.

Something else to consider in consolidation is the learning objective sign offs. All throughout placement you have to provide evidence that you're competent and meeting the learning objectives by filling in different forms. These are checked every 3 weeks but during consolidation I had weekly sign offs for the learning objectives. It’s done weekly so that each week you have a clear idea of where you're at and what you have to improve on. It’s not important to get everything signed off in the first week of consolidation but you do need to show that you're meeting some of the objectives and are progressing to become a competent independent practitioner.

It’s important to remember that you're not alone on consolidation. If you need help or are unsure you can always ask the supervising dietitians. It is better to recognise your limitations than to do something you're unsure of and possibly cause harm. I called my supervising dietitian to check over my plan if I was unsure or if I had a question about something. Having to ask for help doesn’t mean you're a bad student as even when qualified, dietitians ask each other for help to clarify things.

Personal growth:

One thing C placement has shown me is how I’ve grown as a clinician. I noticed that I had increased confidence and independence towards the end of C, and I felt much more comfortable taking charge and seeing patients alone. It did feel like a natural progression for me going from being supervised to doing things alone and I felt ready for it. If you're a dietetic student, don’t worry if you're still feeling a bit nervous by the time it’s consolidation. It’s normal to be nervous as we get more responsibility and have more to do.

Having a neuro rehab ward as one of my consolidation wards meant I got some experience with tube feeds. This is when a patient is fed via a tube and there are many ways for a tube to inserted but the one’s I had the most experience with was PEG tubes. This is where the tube is inserted into your stomach. Making a feed regime can seem quite scary at first, but over the course of consolidation, I got more confident at making and changing feed regimes. The only way to get better is to practice!

What does the future hold?

I’m looking for an acute band 5 job, this means working in a hospital. There are many places a dietitian can work but I know that I want a few years of NHS experience before I venture into anything else. I think it will help me develop a sound knowledge of dietetics and get plenty of patient contact.

Of course, I’ll keep Kaego’s Kitchen updated with my progression in the world of dietetics. I’ve applied for some band 5 jobs and have had interviews for different positions. I’ll be doing another blog post on my job hunting experiences at some point. But for now, I need to get ready for my final exams, wish me luck!

I hope you enjoyed this blog post/reflection!

Bye for now! 👋