What?

This year’s counselling assignment had a bit of an added challenge compared to last year, in that we were given one session only in which to assess and advise our clients. I was paired with a client whose assessment form said she was seeking advice for losing weight and consuming a more balanced diet, and although I felt fairly confident about being able to speak to those topics, my concern was that she might come into the session with new, unexpected issues and I wouldn’t have time to do my research before responding to them. All the same, since she seemed like a very busy person, I didn’t ask her to fill out any dietary recalls or give me more information before coming into the session. In the end, it all worked out because her needs were within the range of what I was expecting going into our session.

I had made a couple of personal improvement goals for this year’s assignment; they were focused mostly around the type of language I use during the session. My goals were (1) to avoid giving advice in terms of my own habits (i.e. “I like to have salad mix on hand” or “I like hummus and veggies for a snack”), since I don’t feel like this is necessarily motivational and sometimes can come across as ‘holier-than-thou’ in the wrong situations; and (2) to avoid using ‘filler words’ such as ‘like’, ‘um’, and ‘uh’.

So What?

My counselling experience was overall a very positive one. My client had a clear idea of what she wanted, was motivated by improving overall health so already valued the idea of a balanced diet, and was very open to suggestions. I found a lot of success with the two of us talking through an average day of how she eats, and teasing out different areas where she may be able to make improvements. The biggest difficulty I had this year was coming up with ideas on the spot during the session; for example, I made a point of letting her know that we don’t want to take away foods that fit the texture cravings she has, but then I had a tough time coming up with nutritious foods that fit that need. The way that I attempted to solve that problem was by offering a follow-up e-mail with resources and ideas, such as online meal planning tools as well as lists of recipes. My client seemed to respond really well to that offer.

In terms of my personal goals, I had a hard time completely avoiding the phrases that I was trying not to use. Despite my best efforts, I couldn’t get rid of ‘like’ in my vocabulary, and I found myself once or twice offering up some of my own habits as part of my advice. However, I think that having the goal in mind helped me to keep the habits to a minimum, and also led me to put some more consideration into how these habits might impact the experience for my client.

Now What?

Overall, I think that I have improved as a counsellor over the past year in a few areas. I came into the experience with much more confidence in my knowledge base, ability to adapt, and capacity for applying the counselling skills that we have discussed in class. This confidence allowed me to be more relaxed and take the necessary time to listen to my client, rather than trying to stick to a script. I find that when we discuss counselling in class with guest RDs, I feel excited about taking on more counselling experiences in the near future, and locking in to my own personal style. I found that the goal-setting portion of the assignment was helpful not just for this assignment, but also for considering how I will continue to set goals for myself throughout internship and beyond. Areas where I’m looking forward to improving include choosing my words and phrases better, reading and responding to the body language and facial cues of my client, and learning more about when to offer advice and when to sit back and listen. Counselling is a big part of what I look forward to in my dietetics career!

The three weeks we spent in FNH 381 provided a wealth of skills and knowledge building in a very short time. Between job shadowing, client counselling, consumer-focused writing, group education sessions, and elementary school nutrition workshops, the course kept us all on our toes with scheduling challenges and learning experiences. We learned a lot from one another in class about various specific counselling practices through our group education sessions. Now that the course is done, we have reviewed our ICDEP learning assessments from the winter, and I was able to extend the deadlines for my original goals – 1) reviewing important dietetics-related subject matter from previous courses, and 2) learning more about dietitians working in public health and policy – so that I can spend time working on those goals this summer before going into 4th year.

One of the most interesting parts of these professional practice courses is the potential to make connections with Registered Dietitians who are practising in various fields, including clinical dietetics, counselling, and writing. I appreciated the opportunity to meet and work with Melissa Baker, who has extensive experience with writing for online nutrition blogs and was able to pass on some important tips to us as we put together an article for the BC Dairy Association website. Her guidance was a crucial part of building a nutrition article geared to consumers, which turned out to be a much trickier task than we had originally expected.

Another valuable part of the course for me was the afternoon that I spent job shadowing Li Jiang in the long term care facility at UBC Hospital. We were lucky enough to have her narrate her tasks to us and explain, beyond the steps and routine of a dietitian in her role, the nuances within the health care team and the details involved in charting and communications. Although two and a half hours may not seem like much compared to the past full year in the dietetics program, the visit served to solidify many concepts that we’d learned in class over the past year. What surprised me most about Li’s role in the hospital was the vast number of factors seemingly unrelated to nutrition that she had to consider when making decisions about patient menus.

Our class got our first taste of nutrition counselling these past few weeks with volunteer clients. While the initial idea of counselling a client for the first time was overwhelming, the experience turned out to be a positive one, and I was able to build a number of new skills. My client was very open, receptive, and communicated his goals clearly. I found that the most difficult part of the process was in the advising (second) session, when I had a list of resources and tips that I was excited to share with my client, and had to be very conscious that I was checking in regularly and not rushing through my ideas.

Finally, we also had the chance to do some nutrition education sessions in elementary school classrooms. My partner and I were paired with a school that specializes in teaching children with learning disabilities, which presented a unique challenge, especially considering that we had been asked to cover the sensitive topic of positive body image. We struggled with making it all the way through our prepared lesson in our morning session with a grade 6/7 class, but on a positive note, this time constraint was in part due to a large amount of enthusiasm from the students which led to a lot of contribution from the class. Also, we were able to overhaul the lesson and make some large adjustments for the later session with a grade 5/6 class, and found that time management and communication of concepts was much easier and much more successful in the second session.

Overall, I have been pleasantly surprised at how much I have been able to learn and grow in these past three weeks. To me, this course has really confirmed the idea that hands-on learning involving application of knowledge, and teaching what we know to others, provides a learning experience that is exponentially stronger than we can obtain through lectures and readings. I am certainly moving on from third year with a much stronger sense of confidence in my capacity for work in the field of dietetics, as well as a sense of excitement for what is yet to come!

 Click here to have a look at my self-assessment form for FNH 381.

Through FNH 381, we were given the opportunity to expand our nutrition writing skills by putting together a written piece for a practising dietitian. Carly and I had the chance to write a blog post for the BC Dairy website on the topic of camping food. The post was requested by Melissa Baker, an RD with plenty of valuable writing experience and knowledge to share with us.

Click here to read our article and learn more about the factors we considered while putting it together.

On May 12, 2016, my friend Carly and I visited Kenneth Gordon Elementary School and facilitated nutrition workshops with two classes. The groups we worked with were grades 5/6 and 6/7, and their teachers had asked us to focus on the topics of positive body image and healthy snacks.  Kenneth Gordon is a private school that presents unique challenges for educators because the school specializes in teaching children with learning disabilities.

Click here to view our lesson plan for the sessions.

What?

Together with my classmates Sharon and Carla, I put together an education session on the topic of Personal and Professional Balance (Self-Care), and we presented our tutorial to our fellow future dietitians in FNH 380 in the last class of the semester.

So What?

The timing of this presentation was very appropriate for the topic of balance and self-care, and it was interesting to be talking about placing high priority on your own well-being during this hectic time of year when so many students tend to lose track of the things that contribute to their own health. Because of this, Sharon, Carla, and I worked hard to make sure that our tutorial had a fun, light-hearted feel while really emphasizing the importance of self-care.

We found scientific research on the topic, and we were surprised to learn that burnout is relatively common in dietitians. Perhaps this is related to the limited amount of self-care-related resources available to dietitians; when we searched the Dietitians of Canada website, we struggled to come up with anything directly discussing self-care and work-life balance. This prompted us to contact Sonya Kupka, the DC Regional Executive Director for British Columbia. She had some valuable insights into this, saying that perhaps the lack of discussion on this topic could be related to how dietitians have historically worked (ie. as a giving profession, not taking much time for themselves). She pondered whether the tips that dietitians give to their patients for effectively managing stress and prioritizing physical activity are things that dietitians put into action in their own personal lives as well. We had an interesting discussion with the class about this, and got to hear their reactions to the idea that RDs need to practice what they preach.

We also found a self-assessment tool for evaluating one’s own personal vulnerability to stress, and had the class fill it out. This was a good guiding tool for understanding the main factors that can affect a person’s ability to handle stress.

The most valuable part of our presentation may have been the video that we decided to make. We felt that it would be helpful for students to hear from dietitians themselves about techniques for practicing self-care and balance; and so we asked several practicing dietitians to participate in a video and answer the question, “How do you practice self-care and work-life balance?” I feel that we gained a lot from making this video, from the task of contacting dietitians to request their participation, to communicating and coordinating meeting times to film video clips, to discussing the finer points of self-care with them, to the editing and uploading side of things, this was an opportunity to build various useful skills. And in the end, we came up with a video that I think was very helpful for our classmates!

Now What?

Beyond the skills that I built from helping to facilitate this workshop, I have also been reminded of the importance of self-care and the techniques that make it happen. I feel better equipped to practice self-care and balance in my own life (although, maybe that has to do with the fact that I’m on Christmas holidays now), and I hope to be able to carry that forward into other busy times that are sure to come.

I also found myself, as we went through this assignment, wondering about how I can work to make an impact in bringing better self-care resources to the community of Registered Dietitians. I haven’t figured out how yet, but it seems like there is truly a demand for it and I would be interested in being a part of making that happen.

See my end-of-semester reflective self-assessment here.

What?

On November 20th I attended the Foundations of Ethical Practice (“iEthics”) workshop, along with some of my dietetics classmates as well as students from other health disciplines. We were sorted into groups encompassing representatives from the various health professions, and we were guided through a case study, an ethical decision-making framework exercise, and we had the chance to explore our own professional codes of ethics and compare them against the codes held by other professions in the group. My group was a bit lacking in variety, perhaps, as we only had one dietetics student (me), one social work student, and four pharmacy students – but what we lacked in variety, we made up in thoughtful, lively discussion and enthusiasm for the topic.

So What?

I enjoyed having the chance to look more closely at the College of Dietitians of BC’s Professional Code of Ethics. I found it interesting to note that all of us in my group, regardless of the actual guidelines laid out on each code of ethics, seemed to share similar opinions about the components that should be included in a typical code of ethics – for example, we all felt that inter-professional collaboration and patient-centred care should be top priorities for all health professions. It made me wonder whether this is something we all felt going into our respective programs, or something that we’ve picked up in the few months that we’ve been a part of the inter-professional health curriculum.

The most helpful part of this workshop, to me, was the ethical decision-making framework. Because ethics can sometimes come across as a topic that is crucial in health care but at the same time can be sort of nebulous, I really appreciated having a concrete guide for ethical decision-making made available to me for tough situations that I’m sure to encounter in the future.

Now What?

I have already found myself thinking more about ethical decision-making in everyday life since I attended this workshop. The fact that the facilitators approached the topic from a day-to-day, low-risk ethics perspective was helpful in starting to apply the concepts in daily life. I also feel much better equipped to handle more difficult decisions in my future as a dietitian, both because I have a more concrete framework to apply and because I know I will have the rest of the health care team to offer support and varied perspectives.

What?

My friend Julia and I were hosted by the team of dietitians at Royal Columbian Hospital (RCH), an acute care facility run by Fraser Health. To start the visit, we had a chance to sit with two of the clinical dietitians as well as the managing clinical dietitian, and heard about their work. They gave examples of how their average day on a ward at RCH would look, and we had the opportunity to ask questions about everything from how charting works to the way that each of their careers led them to where they are now. Following that, we met the dietitian who manages the RCH foodservice unit and took a thorough tour of the kitchen and trayline areas.

For a more detailed description of our site visit, please see our summary here: acute.rch.chan.site visit report 2015

So What?

I really appreciated having the chance to chat with clinical dietitians Alison, Davina, and Jan about their work. I often feel that, of all the ways that dietitians work, the clinical side of things is where I have the least experience and understanding. It was great to get a peek into the space where the clinical dietitians at RCH work, and to get an understanding of how their average day unfolds. It was extremely helpful to gain insight to the way that patients’ diets are determined, and I was surprised to learn that RCH, as the main trauma care facility for Fraser Health, covers such a large area of the province and such a wide array of ailments.

Having worked in a hospital foodservice unit before, it was interesting for me to visit the tray preparation site and make mental comparisons to what I’d previously experienced. It was interesting to learn that throughout Fraser Health, all of the meals are cooked on-site rather than imported, frozen, from elsewhere. Throughout the site I found that I spent a lot of time considering what an immense task it is to provide food for so many sick people; although I have experienced this type of work before, I was amazed all over again at the many, many things that need to be taken into account in order to properly feed the patients, and how crucial it is that all staff play their part and follow food safety protocols. I also noted the key role of the people who originally designed the kitchen area; the kitchen and trayline areas provided a clear, efficient workflow for staff which made the work area safer and more productive.

Now What?

This was an excellent learning opportunity as to how it is possible for my future career could look. The knowledge I gained about the methods of learning and communication that clinical dietitians use is something that I can apply as I continue to work my way toward internship and my career. I learned that even within a single facility, there is an enormous variety in the roles that dietitians play. While I learned a few things on this visit, my time there also opened my eyes to how much I don’t know about clinical dietetics, and this encourages me to consider ways in which I can explore this side of the profession as I prepare to experience it first-hand in my internship.

What?

I’ve always wanted to get my hands on a time machine and travel to the future. Unfortunately, it’s not looking likely that that will ever happen; however, I did get to have a sneak peek into my future the other day, when I met with Jaylene and heard about her experience as a 4th-year dietetics student.

Jaylene was a great resource; her enthusiasm for the dietetics profession shone through easily as she spoke about her education and experiences. We discussed everything, from specific course material, to time management, to internship plans, to the importance of career networking.

So What?

The main lessons that Jaylene passed on to me were these:

• Use professors as a resource as much as possible.
  
  Jaylene reminded us that our professors hold not only what’s needed to fulfill the learning objectives in each course curriculum, but also valuable, varied career experience as dietitians, and the personal stories to go along with it.  She encouraged us to ask any and all questions of our professors, no matter how trivial or strange they might seem. Our professors’ help can be maximized when we…
• Take charge of your own learning, and be prepared with course material.
  
  In academic terms, this means reviewing course material from previous years enough to be able to apply it when necessary. It was helpful to hear this and remember that the content from my previous degree will be something I’ll need to draw upon in the coming years. This spurred me to look through old binders and take out notes to have on hand, and to consider planning review time into next summer in order to be ready for our 4th year clinical courses.In professional terms, this means seeking out personal growth experiences, networking opportunities, and sources of higher learning which will enhance my academic experiences and contribute to my preparedness for joining the profession. For example….
• Attend the DC National conference! 

  Jaylene spoke extremely highly of the conference that she attended last year. It was clear that the experience, for her, was worthwhile and inspiring, and that she is looking forward to attending again. I had already been considering going, but now it’s even further up on my list!

Now What?

Jaylene’s advice will be useful to apply as I continue in my journey as a dietetics student, and I’m certain that it will keep popping up in my mind as I face the challenges that come with preparing myself for a career as a dietitian. Besides the specific advice that came from it, this meeting was also a good reminder that I have people all around who have been in my shoes and can offer both a sympathetic ear and a word of advice when needed.

What?

It was hard for me not to physically wince and cringe, hard to restrain my hands from flying up to cover my face in shame, as I listened to the story of Dave Culver, the former adventure guide who sustained a life-changing spinal injury while mountain biking in Kamloops. Beyond the gruesome details of his accident and injury, it was the description of the appalling level of care he received during his time at the hospital there that left me feeling shocked and angry. Even beyond that, it was the way that this story hit so close to home – literally – that incited an emotional response from me. I grew up in Kamloops. I was born in that hospital, received care there for various ailments and emergencies over the years, and then, more recently, I went on to work there in the food and nutrition unit. Furthermore, mountain biking on the many trails in that area is a favourite activity for many of my friends and family, and a lifelong career for my brother. With all this in mind, I suppose it was inevitable that I would feel an emotional connection to the case we were presented for our inter-professional education session, and throughout the process I tried to make sure that I used this emotional connection as something that would enhance my learning.

So What?

The case gave me an opportunity to explore my view, and the views of those in my group, on what it means to provide care in a rural community. I had never before heard of a doctor keeping a patient from better care for the doctor’s own learning purposes, and it opened my eyes to the fact that these types of things happen at all, let alone in my own little hospital at home. I found that some of those in my group blamed the ‘rural setting’ for the poor quality of care that Dave received. My background in this type of setting led me to differentiate the setting from the practices, and come to the conclusion that the poor choices on behalf of the care team were the root problem, independent of the setting in which they occurred. It makes sense to provide the best care given the facility and training

Examining Dave’s story allowed me a chance to reflect on the harm that can result when a care provider allows ego to rule the decision-making process. Other members of my group were as shocked and appalled by the physician’s actions as I was. However, as much as we all vilified the doctor in the story, a small part of me wondered if I will ever be in a position where ego could get in the way of good care. It’s an undesirable thought, but it brought me to the important point of considering the actions I can take to prevent it from becoming a mistake that I make in my future practice.

More than anything, Dave’s story made it clear how crucial it is for health care team members to work collaboratively, not only with each other, but with the patient and his or her family and support network. Dave’s journey could have been made so much easier through improved collaboration between team members. I found myself wondering, for example, whether a dietitian was involved with the case; if so, there’s a good chance that he or she would have noted Dave’s irregular bowel movement patterns and linked them to the cause. Could the physiotherapist have sped up the healing process by bringing a dietitian onto the care team when he noticed Dave having difficulty with bowel movements?

Now What?

Working on this case with a team of other students who are just beginning their journey as health care professionals, as I am, was an invaluable experience that I feel has set me up for a better understanding of my responsibility to future care teams, clients and patients. The enthusiasm that I felt from other group members for solving problems in this way, and the need that was apparent for input from each educational background, made this type of collaboration seem more accessible than I’d previously thought. I would welcome more chances to work together with other human services and health care students. I appreciate having looked through the lenses of the physician, the pharmacist, the dentist and the physiotherapist from whom I learned through this experience, and I hope that I can carry them with me as I continue to learn.