Monday, 27 February 2012

Training continues

Walk in the New Forest, Feb 2012
The job is so much better than my student clinical placements; I am hugely relieved. My dietetic colleagues are universally pleasant and helpful, and I am starting to become familiar with some of the staff on 'my' wards.

Most of the Dietitians don't wear uniforms, which is a shame, because I found the tunic pockets really useful. Some of the renal Dietitians wear a uniform, but it is a purple polo shirt and has no useful pockets. Uniforms that other professionals wear are really helpful in identification of the various species. Nurses are various shades of blue depending on seniority and specialism, Healthcare Assistants are burgundy, Ward Hostesses (the food service staff) are black, Physiotherapists are white with blue trim, Occupational Therapists are white with green trim. The most striking are the Speech and Language Therapists who wear bright crimson shirts, as vivid a red as you can imagine. It is a scary colour, and I can't imagine why they chose it. Doctors don't wear white coats any more (infection risk) but sometimes wear stethoscopes and harried expressions, and say things like "It's half past two, I've been working since seven thirty this morning and I haven't yet had a break." We all defer to the Doctors. They are the omnipotent rulers of the wards.

My patients are mostly uncommunicative. On the stroke ward they are usually either unconscious or have lost the ability to speak, understand speech or express themselves (dysphasia/aphasia). On the elderly ward they are often asleep, dysphasic, have dementia, or all three. One day I was delighted to be able to speak to two patients; by the time I visited the ward again one had already been discharged. I get the feeling that if they can talk, then the nurses can sort them out without the help of a Dietitian. This is a shame, because I would like to have a bit more interaction with the patients, but there's plenty of time for that once I've mastered this first stage of my professional life. I sat in on an outpatient clinic to see how things worked, and there was plenty of interaction between the patients and the senior Dietitian I was observing which went waaaay beyond the scope of my limited abilities.

There are many computer systems in use, including standard packages like Outlook for email, and specialised ones for clinical results like blood tests, x-rays and scans. I have done some small online training packages in order to be given access to other systems, but I had to attend a proper IT training session for half a day on something called iPM. About ten minutes of it was relevant, but I am now fully trained and authorised to operate the tracking system to request and log receipt of archived patient notes from off-site storage. This is a task that I will definitely, absolutely, never undertake. My second session of iPM training was shorter (it was one-to-one), and only took 40 minutes of which about 5 minutes was relevant, but I can show you the screen that will give you a list of patients that are expected to be treated on a day-care basis on a ward. Again, I will definitely, absolutely never need it again.

I've also had the first part of the training that will help us to supervise the Dietetic students we will be hosting on their placements. The B placement students have actually arrived in the department, but with me being so new I won't have to supervise them until later in their placement. The training was at the University associated with the hospital, and was very interesting. The first day was primarily about setting the scene and understanding the way that placements operate in this 'cluster', which is slightly different from the one where I studied. It was a welcome break from the unremitting pressure of patients on wards, as well as a chance to meet and share experiences with some other new Dietitians who are in a similar position to me. The second day of this training is this week.

In between writing and publishing this, I have had a lovely weekend with Lola II, which is why this post is late. It was actually ready on Saturday, but I was too busy cleaning the house to remember to click 'Publish'...

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