Schooling and Career

Fall Supervised Practice Reflection

Before we go much farther, I want to mention this picture is from the early days of the pandemic. It is from November 2020 when I first got hired with this organization. During my time in the job, and after vaccination became available, we lost the face shields which was nice to say the least. It’s also weird working in a healthcare facility in a pandemic. Anyway, to the actual story…

Typically in this program all of the internship hours, or supervised practice hours, as the accrediting board wants us to call them, are completed in the summers. The program itself is twenty-four months and that includes the two twelve-week summer experiences. Thankfully, the program and our program coordinators have been flexible and supported the students when they needed or wanted to complete their hours at a different time during the program. This was the case for me this past fall. At the time I was working in the kitchen of a skilled nursing facility. This was the second skilled nursing facility I had worked in, but the only one that had a full-time dietitian. At some point I had been chatting with the dietitian and she had mentioned how she missed having interns, but that the organization still had not decided when they would allow interns to return due to the pandemic. After this conversation I reached out to my internship coordinator who manages food service rotations to see if I would be able to complete my hours with the organization I was already working for. Thankfully, they let me and I was able to learn even more about the organization that I’d been working for. 

The food service rotation itself is the shortest rotation in our program. We are only required to do eighty hours of food service, and to be honest, I am glad. Food service is so important, and having more full-time dietitians in food service establishments could be beneficial, but so much of the work is managing people that I don’t think it would be a position I would enjoy long-term. But I do believe there are many people who would enjoy this type of work and therefore would be much better candidates for these types of positions. 

I’m not quite sure, but I would imagine that part of the reason this rotation is so short is because we are required to complete the Servsafe course as well as do an extensive menu modification project in the first year of the program. This program itself is considered a Future Education Model (FEM) and that means that there are many different learning techniques used to meet the required competencies. Many of the competencies are met through the supervised practice, but others are met by specific projects and assignments that students complete throughout the course of the program. 

So anyways, back in the fall I was able to complete my eighty hours of food service supervised practice with my now previous employer. Although it won’t affect my timeline too terribly, it will be nice to be able to finish a few weeks earlier than expected and hopefully take my certification exam, and get my first RD job a few weeks earlier too.  

Many of the hours I completed, I did tasks I had already been doing based on my job description as a dietary aide. This included checking temperatures of foods, and refrigerators, cleaning and sanitizing in the kitchen and the dining rooms, and interacting with the members/residents to determine their meal preferences and orders for the day. Some of the tasks I had not done before included ordering through Sysco and receiving deliveries, care plan meetings and daily interprofessional check-in meetings, sanitation reports, and menu modification. Of these tasks I enjoyed attending care plan meetings the best. Many of the tasks that the dietitian I worked with does could be completed by a food service manager. This organization just chooses to have one full-time dietitian who also does the work a food service manager would do, like scheduling. But the care plan meeting felt like the place where the dietitian could really use her nutrition knowledge the best. It also was a time for all the professionals to get together and discuss how best to support a specific resident. This was a time and space to speak with all the professionals on the healthcare team as well as the resident and their family to understand what was working well, what wasn’t working well, and what the organization could do or change to better support their members. It was nice to be a part of those dialogues and see the importance of interprofessional teams and how well they can work together. 

In each of our supervised practice rotations we have specific deliverables. These are projects that are completed to meet competencies and then presented to our preceptor to ensure all competencies were met. For the food service rotation there was one deliverable called the food supply chain evaluation. In this assignment I used the knowledge I gained from learning about ordering and receiving and working with Sysco to evaluate risks associated with the food supply chain and propose risk reduction ideas. Before the pandemic I don’t think anyone in the general population thought about the food supply chain, but this project felt very relevant during the pandemic. Similar to grocery stores, many food service establishments have struggled with the food supply chain and its many downstream impacts. I think this was a helpful project, but I am sad to say I don’t think any of my risk reduction proposals at the organization level will be implemented. Some of my proposals were related to climate change and I think that food service and organizations could do much better in terms of food waste and waste reduction. If more organizations made even small efforts towards limiting waste it could be very impactful. 

Like I mentioned before, food service is not the specialty within dietetics I would like to practice in. I’ve known that for as long as I’ve known I wanted to be a dietitian. I’ve had many jobs in food service including retail and in skilled nursing facilities and I can say I gave it a try, but it’s not for me. Despite that, I did learn more in this rotation than I had in my role as dietary aide within this organization and that was very helpful. I had opportunities to network and learn more about the other healthcare professionals like occupational therapy and physical therapy. This interdisciplary team worked so well together and each member respected the others within the team which was a great example. I am thankful for this experience, and I am also thankful that it was only eighty hours. I have since left the organization as I had some other opportunities arise that were too good to pass up. My biggest takeaway from both my experiences in skilled nursing facilities is I enjoyed getting to know the residents. I enjoyed speaking with them regularly, learning what they were up to and building rapport. Knowing that I enjoy building relationships with the people I serve makes me believe that positions I will enjoy will include regular follow up care with my patients and relationship building. I’m sure there are aspects of this in many specialties within dietetics and I’m glad that even though this wasn’t my favorite experience I did learn some about the job and about what I want in a future job. 

So now, I have completed my public health supervised practice, my advanced supervised practice and my food service supervised practice. I now have to complete my last semester of my graduate program and ten weeks of clinical supervised practice. It’s crazy to think, but in less than 6 months I will be eligible to take my registered dietitian exam. If you’re reading this and preparing for any part of your dietetic education know that it goes by so quickly. You’ll be a dietitian so soon and you’ll be a great one at that! 

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