My placement experience during COVID

Hi there, my name is Eimear McCoy and I am a fourth year dietetic student studying at Glasgow Caledonian University.  I have recently finished my 2nd block of placement (B placement) which lasted twelve weeks. I wanted to take some time today to share my experience of what it was like doing placement during COVID.  My twelve weeks were split into three 4 week sections, wherein I spent the first four weeks with the community dietetic team, the middle four with the acute dietetic team and the final four weeks with the diabetes and weight management team.

Fears and worries before starting

Below are some of the fears and worries I had before embarking on my placement but it is likely that students from other AHP courses who are awaiting placement as well as some AHP professionals will be also feeling a few of these same things; I did not know what to expect before starting, I had anticipated that I would be doing a lot of remote working and I therefore felt  worried that I wouldn’t get to see many patients face to face. I was also concerned if I was working from home that I wouldn’t be able to progress as quickly as I needed  in order to reach competency and meet all the placement learning objectives. I was anxious about moving somewhere new  (particularly during COVID) and meeting a lot of new people. I was worried that my placement may be interrupted by COVID and that I would have to stop mid-way. Or even worse I was afraid of potentially being exposed to COVID and having to stop completely.

Community placement

As mentioned my first four weeks were spent with the community dietetic team. During this time I was  based mostly in an office. Instead of doing the usual home visits we contacted patients either on the phone or via NHS near me. Myself and my fellow student  were based in our own little room beside the dietitians office as it was easier to socially distance this way.

Tip:  If it feels more comfortable/ is easier to socially distance give students a separate little room/space close to yours that they can base themselves out of. 

Phone calls

When it came to doing telephone consultations we would usually put the phone on loud speaker so that I could talk with the patient but the supervising dietitian could also listen in. This method I believe worked really well,  I thought it was a nice way to get comfortable chatting with patients. The telephone calls did however have their limitations, I found it difficult  at times not being able to see the patient. I couldn’t tell what their body language was like or how they looked so I couldn’t read their non-verbal cues. Therefore whilst telephone calls were successful and I learned a lot doing them, I would say that nothing trumps actually being able to see the patient whilst doing a consultation (either in person or on NHS near me).

Tip:  My practice educators and I found the most effective way to conduct telephone consultations was to put the patient on loudspeaker. 

NHS Near Me

Throughout placement we  frequently used NHS near me. As many of you may be aware NHS near me is a video chat system that was developed so that practitioners and patients could conduct virtual consultations over a secure network. Please see the link at the end of the blog  for more information on NHS near me. I found that near me video calls felt more like  “proper consultations” mainly because I could see the patient when I was talking to them. Patients were  given the option of either a phone call or video call and as expected it was mostly younger generation patients that were willing to opt into the video chats. Initially it felt quite unusual for both myself and the dietitians  talking to patients over the phone and on video. However I found that we all adapted really well. 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 didn’t feel too alien.

Tip:  Opt for NHS near me consultations with students when possible; these video consultations for me felt like a more realistic representation of what a face-to-face consultation is like.  

Face to face

Once I moved over to the hospital setting, I began to see patients predominately face to face. There were however aspects of the face to face contact that I found challenging such as wearing a mask all day long. I found that the  mask acted as a communication barrier at times; patients could not see my facial expressions nor could I see theirs.  I also found myself regularly having to speak very loudly so that patients could hear me, this initially felt unnatural and  uncomfortable as I did not have that much confidence and am quite a soft spoken person in general. From a practice educator point of view I think it may be useful to reassure students that it’s ok to speak louder than usual although it may feel uncomfortable and that sometimes that’s what you need to do in order  to ensure that patients can hear what you are saying.

Self-isolation

Unfortunately, at the beginning of my placement I had to do two weeks of self-isolation. Of course, this was far from ideal. The dietetic team were however amazing and  set me up to work from home. It took a day or two to get all the technology up and running but we managed. I got an Ipad and work computer allowing me to access patient notes when needed. I still joined NHS near me video calls and I rang the dietitian’s multiple times throughout the day on Microsoft teams. Throughout my two weeks I got to write up patient notes and I did quite several tutorials and case studies which were all really beneficial. Although at the time it felt like the worst possible thing to happen, alongside the support of the dietitians we managed to overcome the challenge. I don’t feel like my time in isolation was a waste or that I missed out on valuable experiences.

Tip: If a student needs to isolate it is still possible for them to continue their placement working from home. It may be useful to provide them with case studies/ tutorials, encourage them to join into NHS near me consultations and if possible provide them with a work laptop to access patient notes.  

To conclude

Students understand that providing a placement during COVID is challenging and new for practice educators. We understand that this is a learning curve for you just as much as it is for us and therefore, we do not expect things to go perfectly. The main priority for placement during COVID is getting the necessary experience, confidence and competence, and we understand that practice educators are trying their best to ensure that we achieve this. I hope my blog has illustrated that placement is still very doable despite the challenges of COVID. I feel like my learning has not been hindered and throughout my twelve weeks I have managed to progress  to competency and meet all my learning objectives. 

Thank you for taking the time to read my post,

Find me on Instagram @health_aligned

Further information on NHS near me : https://tec.scot/nearme/ and here https://tec.scot/nearme/covid-19-implementing-near-me/ for more info on Near Me.

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