Day in the life of . . . Emma Rayment, Band 5 Dietitian

Emma Rayment Band 5 dietitian

Emma graduated from the University of Surrey in June this year. Originally from Tunbridge Wells, West Kent, Emma recently moved to start work as a graduate Band 5 dietitian at the Queen Elizabeth, The Queen Mother Hospital in Margate.

Starting out as a graduate Band 5 dietitian can be daunting. I should know, as I have been one for almost four months. I felt that now would be a good opportunity to provide an insight into my role and responsibilities, especially for those who have it all ahead as they enter into the final hectic year of their course.

Prior to starting as a graduate dietitian, I experienced all the normal worries and fears, mainly because it had been a year since having contact with patients in my last clinical placement. On my first day, however, all my concerns were instantly dismissed as I was immediately made to feel welcome by the team, with everyone being thoroughly supportive.

My first day was spent going through my induction programme with my line manager who clarified exactly what was expected of me. This included how I would be working, the training I would need to complete and how I would be progressing through my Band 5 role. For the first year, I will be on a preceptorship, which means that I have to pass several assessments on basic criteria, such as writing in the medical notes and prescribing a feeding regime. This is extremely useful as it not only provides reassurance that I am performing to the correct standard, but allows me to continually develop. It also counts towards the all important CPD!

The team made sure that I had a well-structured induction programme, which allowed me to successfully orientate myself within the department and hospital, including spending time with catering and ward staff. In addition to structured appraisals to ensure I am progressing as I should, I also have the support of weekly informal meetings with my team leader to discuss any issues or concerns that may arise. These regular meetings are a useful method of support, especially when you're feeling your way early on in your career.

So, after the initial induction, what can you expect on a day-to-day basis?

A typical day starts at 8am when I enter the office and help with my share of tasks such as clerking new referrals and making sure that I have all the latest biochemistry results for my patients. I begin my clinical work with any new patients who have been referred overnight. I usually aim to see 10 to 12 patients per day on average, formed of new and review cases. I have a case load of three wards which include elderly rehab, stroke and general medical, in addition to an outpatient day hospital, a relatively new concept that I am trying to develop. This has allowed me to see a wide variety of patients, with each set presenting different challenges. Far from being scary, I find these daily challenges hugely rewarding and exciting.

We have a weekly team meeting to review our workloads. One of my favourite parts of the job is working within a supportive team. I will always try to look for opportunities to help out the other members of the team if they have a large case load, while at the same time feel content in the knowledge that the support is there if I need to delegate any of my patients.

My job is on a rotational basis which has given me the fantastic opportunity to experience the three hugely different areas of intensive care, oncology and paediatrics. I have just started on my ITU rotation which, I admit, I was very apprehensive about. I had visions of being handed a critically ill patient needing a TPN regime on my first day! Again, my concerns were misplaced, as I started by shadowing the specialist ITU dietitian who talked me through all the machines and patient notes.

After building up my confidence, I have started to review and see new patients who present with a wide variety of problems. Working on ITU has allowed me to develop a new set of analytical skills, such as taking levels of sedation and ventilation into account, and considering if the patient is on haemofiltration. As the nursing is almost always one to one, you really get to know the staff who are fantastically skilled in dealing with different types of feeds, and I always feel happy knowing my patients are in such capable hands.

I am currently working on several projects which are all being counted towards my CPD. Firstly, I am involved with forming a clinical supervision group for the Band 5 dietitians within our team. I am also writing a short case study reflecting on a recent challenging patient with a high output ileostomy who was under my care. Lastly, I am involved in forming and presenting a talk on elderly inpatient nutrition and care. I have really enjoyed researching the topic and can’t wait to present it at a nutrition study day in the near future. Another of my responsibilities as a Band 5 dietitian is as the catering representative. My first meeting involved feeding back issues that have arisen, such as the availability of cooked breakfasts in the ward, to the catering department. This role has really made me appreciate the importance of a close relationship with the catering team - could be cut if necess.

I leave work at 4pm thoroughly contented, and knowing that I have had the best start to my career. I hope this has given some reassurance to those students who may be beginning to fret about what lies ahead after graduation. It is important to know that you will have the support of colleagues from your first day onwards and that you'll be able to put everything you've learnt into practice while continuing to learn and develop within your career. Think positive and look forward to being able to flourish and enjoy the challenges ahead.

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