Question and answer session with Anna Richardson, BSc Hons Human Nutrition and Dietetics graduate (Glasgow Caledonian University) and recent double award winner (BDA award for the best placement related performance and The Queens College Prize for best overall academic performance).
Did you know what you wanted to do with your degree when you first started university?
Not at all. I had no idea which area of dietetics I wanted to end up in. This was never something I was concerned about though as I knew I would find my specialism with time and experience. As the course progressed, I found I was naturally more interested in some topics than others and I started to take note of these on my phone. On placement (and through my own research) I then began to whittle down these areas of interest until I had a list of areas I could see myself working in.
Would you have done anything differently at university?
Yes, I would have Networked! I was very focused at university and I dedicated all of my academic time to my university work. I knew other students who were attending student BDA and networking events from an early stage, but at the time I thought this was too early for me. Looking back now, I realise that it is never too early to start building professional relationships in the career you plan to work in. Networking can also help you to find out which path you want to take with your dietetics degree, making that looming job search a little bit easier when it comes!
What advice would you give to an RD2B currently at university?
- Don’t skip the science.
One of the first things I realised on placement was how important the clinical section of the dietetic assessment was. Knowing and understanding the pathology of the patient’s clinical condition is integral to allowing you to create an accurate pass statement and person centred nutritional care plan. It also guides you in completing all other aspects of the dietetic assessment, helping you to understand the reason for any biochemical abnormalities or symptoms.
- Take time to learn and develop your counselling skills.
Counselling skills have been invaluable in my dietetic practice. Learning how to listen actively, reflect, paraphrase and empathise (instead of sympathise!) with patients has helped me to approach challenging consultations with confidence and success.
What were your placement experiences like?
Placement A: I spent 2 weeks in Shetland’s Gilbert Bain hospital (pre-Covid) for my Placement A. This involved me shadowing dietitians in the acute, community and public health departments and was my first real life experience of clinical dietetics. I witnessed my first NG tube being placed and had training on how to create bolus and enteral feeding regimens.
Placement B: My placement B was 12 weeks long and was completed in NHS Tayside. I spent the first induction week working from home and then moved on to the acute environment for four weeks. After working in acute I spent one week completing a project from home and then finished up my placement with 6 weeks in community. This was a really varied placement which involved working in lots of different dietetic specialisms and patient settings. I was delighted that I got to experience working in both the acute and community settings as it can be hard to know which environment you prefer working in without the first-hand experience.
Placement C: For placement C I returned to NHS Tayside for 8 weeks. I spent another two weeks in acute, three weeks with the learning disability service and completed my final 3 weeks (including my independent practice) in acute. Despite the obvious pressures that come with independent practice, I found working autonomously for the first time to be the most incredibly rewarding and exciting experience of my placement.
What resources did you find useful on placement?
- PENG – this was especially useful in my acute placement.
- Patient information leaflets – these are a great evidence based source of concise information.
- BDA Manual of Dietetic Practice – this was (and still is) my dietetic bible. If it doesn’t have what you’re looking for in it, the chances are the best person to ask is your supervisor or lecturer.
- Carbs and Cals – this helped me to make a mental bank of how many calories and grams of protein exist in different foods.
What advice would you give a student going out on placement now?
- Take every opportunity you can to practice your skills.
Taking that first leap from shadowing dietitians to starting to engage with and assess patients yourself can definitely feel daunting at the start. I found that tackling these nerves and volunteering to get involved early on really helped me to grow in confidence quickly and get more out of my placement experience.
- Listen. Reflect. Adapt.
This motto always kept me moving forward on placement.
- Listening to the wisdom and advice given by colleagues allowed me to learn quickly and understand the areas of practice I needed to strengthen.
- Reflecting on my practice daily allowed me to further understand myself better and helped me to come up with a plan of how I could develop myself both professionally and personally.
- Adapting my dietetic assessment to meet the demands of every patient and environment helped me to remain calm and efficient when things didn’t go as planned.
- Look after yourself.
Placement is full of new people, experiences, expectations and environments. It’s normal to get tired and even exhausted at times. Everyone has their own ways of taking care of themselves, but I found that good food, sleep and time with friends and family helped me to feel refreshed for my next week ahead. When you feel better, you learn better!
Transitioning from RD2B to RD
What did you do after you graduated?
When I was on placement one of my supervisors mentioned that I should apply for a band 5 bank dietitian post in the health board. Bank work is a great way for students to gain entry into a health board if there are no dietitian posts advertised in that health board at the time. It works by the health board making the shifts they need covered available in an app and the employee simply choosing which of these shifts they would like to work. Lots of health boards will even take you on as a band 4 dietetic support worker until your HCPC comes through. Shortly after finishing placement, I applied for a band 5 bank dietitian position in NHS Tayside. I was successful in this and started work a month after finishing university. Soon after starting in this post, a permanent position became available in the hospital that I was working in. I applied and subsequently started as a permanent band 5 dietitian a month later.
What opportunities were available to you after graduating?
Although I was already in employment before I graduated, there was a time on placement where I would spend all of my commute time searching for career, research and volunteering opportunities on my phone. From my own research I found that most opportunities advertised in Scotland were clinical NHS roles. However, when I looked a bit deeper I found a couple of research opportunities and one remote private job opportunity. At the time of researching, I couldn’t find any third sector job opportunities for newly qualified dietitians in Scotland.
Life as a newly qualified NHS Dietitian
How does being a band 5 NHS dietitian differ to being on placement/at university?
- Independent working – Although there is always a supervisor to go to for support, band 5 dietitians are expected to work autonomously in managing their own caseload. This means you will spend a lot more time working on your own than you did on placement.
- Responsibility – As a band 5 NHS dietitian, you are fully responsible for your own professional actions and consequences. You are also legally responsible for providing safe practice and you need to find your own ways of making sure you have covered all the bases. This definitely feels a little scary at first, but it all becomes a routine part of practice!
- Multi-tasking – You will be expected to juggle many different tasks and responsibilities at the same time. If you’re not confident in this skill now, you will be soon!
- Prioritising – Everything you do at work needs to be prioritised. There will always be patients to see and daily admin tasks to do. Building on your prioritisation skills from placement is therefore hugely important in order for you to work efficiently (but don’t worry, this comes with time and practice!)
- Work life balance – Full time working life in the NHS requires you to be fully focused for long hours every day. It is a very structured way of working and you no longer have the privilege of deciding to spontaneously go out for lunch that day and finish your work at 11pm at night. This takes time to get used to at first and can feel exhausting until you get used to your new routine.