F2F
FACE TO FACE Ursula meets: Ursula Arens Writer; Nutrition & Dietetics Ursula has a degree in dietetics, and currently works as a freelance nutrition writer. She has been a columnist on nutrition for more than 30 years.
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Ursula meets amazing people who influence nutrition policies and practices in the UK.
DR ANGELA MADDEN Dietitian and Academic Nutrition and Dietetics Lead, University of Hertfordshire Co-author/editor: Oxford Handbook of Nutrition and Dietetics
Angela picks me up from Hatfield Station and we find a quiet café (except it is not: the music throbs; but as we are the only customers, our grumpy request for less volume is served, along with tea). Angela has had a dietetic career spanning many years in clinical practice, research and higher education: who better to interview for a cool and calm assessment of our profession? Young Angela was very sciency, achieving A-levels in Biology, Chemistry and Physics, but developing her interest in food at home. “My mother was, and still is, an amazing cook, but I didn’t really appreciate it at the time. Eating at a friend’s house when a ready-meal was served made me aware of how lucky I was.” Angela graduated in dietetics in 1982 from the University of Surrey. She had really enjoyed her student placement at Addenbrooke’s Hospital in Cambridge, as well as a nutrition placement at the MRC Epidemiology Unit in Cardiff. “I was surrounded by great researchers but didn’t realise it at the time. Professor Archie Cochrane was one of many experts who worked in the unit while I was there.” Her first job was at the Hammersmith Hospital in London. Although she was, of course, a basic-grade dietitian, it seemed like being thrown into the deep end of the profession. “The hospital had a postgraduate medical school, so many cases
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seemed complex, and many of the staff were academics. There was no Manual of Dietetic Practice or PubMed, so we often made clinical decisions about what to do on the basis of discussion between dietitians. But I enjoyed the challenges of work and living in London.” After two years, Angela wanted a change, which a maternity cover post in Saudi Arabia promised and delivered. The hospital was very different from NHS models of care, but very modern and well-funded. “I was wide-eyed and very interested in the different cultures and procedures, so I learnt a huge amount in a short time,” said Angela. Electronic patient records were in place decades before their use in the NHS. Her next job was at the Royal Free Hospital in North London as a specialist dietitian in the liver unit. In addition to lots of clinical care, she was closely involved with many research projects and while sitting on an interview panel to find a PhD candidate, the other panellists realised that the best candidate was not the one sitting across the table, but the woman sat on the panel with them! The post offered gains, of course, but also much hard work and long hours of effort. After much perspiration and a little inspiration, Angela completed her doctorate on the assessment of nutritional status and body composition in patients with chronic liver disease in 1998.
A friend suggested becoming a lecturer for the Dietetics course at what was then the University of North London (now the London Metropolitan University). “I was nervous, but on the first day of my first lecture, a student gave me the biggest smile and then I knew I had made the right decision,” said Angela. The diverse students at North London were often feisty, but it was their enthusiasm and support that Angela enjoyed most. In 2006, the University of Hertfordshire advertised for someone to set up an undergraduate Dietetics programme commissioned by the NHS in the East of England. Angela’s enjoyment of the challenges of living in London had waned. Travel hassle and high house prices exceeded the metropolitan magic and leafy Hertfordshire became more appealing, so she took the plunge and applied for the job at Herts. The HCPC approved the three-year Dietetic course and Angela became the Subject and Lead for Nutrition and Dietetics, which now includes two BSc courses and related research activity. There are currently about 60 students per year registered in Nutrition and Dietetics at Herts. These are interesting times for student recruitment, as changes in the demographic pool of 18-year-olds, withdrawal of NHS funding and Brexit, are all having an impact on the number of applications. The University of Hertfordshire was awarded ‘silver’ in the recent Teaching Excellence Framework (TEF) rankings, but Angela and her colleagues will be pedalling hard to achieve a better gold score in the next assessments. We talk about students. Entry criteria for the Dietetics course are higher for dietetic students than those studying nutrition and require them to be well qualified in science and to demonstrate interpersonal skills suitable to work with patients. Angela is concerned that the subject of Dietetics is still female-dominated and might benefit from more diversity (note our
discussion is between two white, middle-aged females!). A minority of her dietetic students are male and/or come from other ethnic groups and she occasionally wonders whether we make them feel as welcome as possible within our profession. I ask her in contrary spirit, whether this matters - patients want competent professionals; does it matter what gender or race they are? Angela is so thoughtful and tactful and allows that we cannot fully answer that question. But she feels that the dietetic profession might be sometimes held back by an excess of modesty and caution, and some greater diversity of thought and temperament could bring many benefits to propel the whole profession forward. Dietetics, like all professions, has changed over the years with digital tools and fixes. There are so many benefits that none of us would do without. But some blindness can creep in with constant online link-clicking, and information overload is a threat to being able to discern important and significant developments. Angela clearly loves the research side of Dietetics and how this relates to practice. She is co-editor of the Oxford Handbook of Nutrition and Dietetics and constantly contributes to a wide diversity of publications on nutrition science. But she is concerned that all dietitians should be critical thinkers and not just implementers of guidelines (NICE or otherwise). “Dietetics is not a pure science and the skill of the profession is understanding the many shades of grey between food intake and health,” says Angela. “The best way to develop better understanding and support better professional practice, is to encourage open debate. But this is something that many dietitians tend to shy away from.” For once, my argumentative side could not disagree. I was happy to think that future Dietetics graduates from the University of Hertfordshire would be combat-ready to fight for a better nutrition world.
If you would like to suggest a F2F date
(someone who is a ‘shaker and mover’ in UK nutrition) for Ursula, please contact:
info@networkhealthgroup.co.uk www.NHDmag.com August/September 2017 - Issue 127
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