Fourth-year Nutrition and Dietetics student, Danielle Timmins has enjoyed all her hospital placements. In her NHD Blog, she outlines all you need to know about making the most of your dietetics degree placement.

I am a fourth-year Nutrition and Dietetics student at the University of Chesterr, just about to embark on my C placement (as I write this NHD Blog), which is split between Lancaster Royal Infirmary and Queen Victoria Community Hospital in Morecambe Bay and am really looking forward to getting experience in new areas, such as paediatrics, gastroenterology, intensive care, diabetes and stroke.

Placement can be daunting for students, so it helps to prepare as best you can. This means that when you are on placement you can focus on learning as much as possible. The tips I have gathered together are mainly from my personal experience in my A and B placements at Macclesfield District General Hospital and Royal Liverpool and Broadgreen University Hospitals.

HOW TO PREPARE

1. Refresh your knowledge of key conditions and treatments. If you are told in advance what areas of dietetics your placement will be in, it can be really helpful to refresh your knowledge in these areas. I found it helpful to read the sections that related to my placement areas in The Manual of Nutrition and Dietetics as well as looking at NICE guidelines and BDA food fact sheets. Having the theoretical knowledge fresh in your mind can make you feel a lot more confident when going to see patients in that area for the first time.
   
   
2. Connect. I found social media really helpful to prepare for placement. LinkedIn, Instagram and Twitter are full of student dietitians and registered dietitians from all over the country, who all work in a variety of areas and specialisms. Reading through their posts in which they share their own experiences and knowledge of the profession, was so helpful. I found that if you reach out to the dietitians, they are usually happy to answer any questions you have and some even signposted me to really useful resources.
   
   
3. Download apps. I have used several apps whilst on placement that conveniently give you lots of information that you can access quickly. The BNF app is essentially a dictionary of medications that can be useful to quickly look up medication information, as you will come across lots of new medications whilst working with different conditions. Companies which develop nutritional supplements for the hospital you are working in may have free apps with compendiums of nutritional products, which you can use when looking up nutritional information about supplements and feeds.

WHAT TO BRING

1. Portfolio Documents For paper-based portfolios, it’s useful to have blank copies of the forms you need printed out. This means you have the paperwork ready to fill out if a consultation goes well or is interesting and you want to ask for feedback from a member of staff or a patient. If you are doing your portfolio electronically, it may be helpful to have all the documents you need saved into a specific folder, so they are easy to access and fill out.
   
   
2. Ward Folder On my B placement, one of my supervising dietitians suggested compiling a ‘ward folder’ containing commonly used guidelines, copies of special menus and patient information, leaflets and booklets. This ensures you have everything you need when seeing patients on the wards. The folder could include the following:
   
   - The Eatwell Plate
   - The Bristol Stool Chart
   - A ready reckoner of the hospital menu, special menus and snacks
   - Trust refeeding syndrome guidelines
   - Common abbreviation lists
   - Common medication lists
   - A trust list of the supplements/feeds
   
   
3. Notebooks It is practical to have a small notebook when going to see patients. It is useful to jot down key questions prior to the consultation, giving yourself a structure to follow. It also helps to write down the patients answers or diet history, so it is easier to remember key information when writing up medical notes afterwards.
   
   
4. Calculator and PENG Book Your pocket guide and calculator are great on the wards for calculating estimated nutritional requirements. I also found it really useful to have small sticky notes labelling my PENG book for the pages I would need to access. This cut down the amount of time I spent flipping through my PENG looking for the right energy requirements.
   
   
5. Pens and highlighters As well as taking notes and filling in portfolio forms, a pen and highlighter can be used when going through information with patients to highlight certain points, or in order to leave the patient with the department contact details. Having a white board pen in your pocket is handy if you need to write anything on the board above the patient’s bed, on the board on a side room door, or to write a food preference list to stick up on the wall.
   
   
6. Clip-on Hand Sanitiser A small bottle of hand sanitiser can be clipped onto your trousers, bag or lanyard and is helpful for when you are around the hospital, in the office, doing home visits or commuting to and from work.

WHILST ON PLACEMENT

1. Don’t be afraid to ask questions
   Whilst on placement, you will be shadowing and working alongside qualified dietitians who have experience in many different areas. Remember that you are still learning and it is okay to ask questions, as you aren’t meant to know everything yet. This is a great opportunity to learn from dietitians who may be experienced in specialist areas and who are happy to share their knowledge with you.
   
   
2. Keep up to date with your portfolio work
   Although it may be easy to forget about paperwork when you are busy shadowing dietitians and are out on the wards talking to patients, it is really important to make sure you are updating it as you go along. This makes sure you are continually reflecting on your progress and learning, so that you can identify areas for development and make the most out of your placement experience. It also means that the amount of paperwork doesn’t get too overwhelming as you make your way through placement.
   
   
3. Familiarise your self with Trust Documents
   It is helpful to familiarise yourself with the different menus available and patient information booklets, so you can confidently talk patients through the menu choices available. If you have any allocated study time or a spare half an hour, it can be helpful to spend some time getting to know these documents.
   
   
4. Take any learning opportunities for shadowing in different areas
   Grab any opportunities to attend lectures, training and shadowing other healthcare professionals. This will increase your clinical knowledge and you will get to see how the hospital multidisciplinary team works and will learn about the roles of other healthcare professionals. Whilst on my A placement I had the opportunity to shadow speech and language therapists. They explained to me how they assess swallows and decide on thickness levels. This experience was invaluable, as I got to see how their work impacts on how dietitians advise patients based on SALT recommendations and the importance of multidisciplinary team working and communication. On my B placement I was given the opportunity to go to a wound healing lecture open to all healthcare professionals. This highlighted when to involve other healthcare professionals and to make referrals. It was very helpful on top of the theoretical knowledge I had already gained, as it framed how I would use this knowledge when seeing patients.
   
   
5. Take breaks
   Placement is hard work, as you are thinking and learning all day long, which can be very tiring. So, it is really important to take regular breaks in the evenings and on weekends to recharge your batteries. This will help you avoid burning out and will help you enjoy your time on placement even more.

Good luck to anyone who is going out on placement! I hope you enjoy it as much as I have.

Danielle Timmins
Student RD at Chester Uni

Danielle is a fourth-year Nutrition and Dietetics student studying at the University of Chester.
She is interested in clinical research and promoting diversity and inclusion in dietetics.

Twitter@: Dannitimmins

Instagram: Dieteticswithdanni