Ashley Madura shares about her field experience last summer!

I completed my advanced field experience at Golden LivingCenters, a long-term care and short-term rehabilitation facility. I was located at Golden Living Walnut Creek in my hometown, Erie, Pennsylvania. My preceptor, the only registered dietitian for that facility, had only been there for about a year and a half. Previously to being hired by Golden Living, she held the same consulting job for 12 years, so being an in-patient dietitian was a new experience for her. When I began contacting my preceptor about a field experience, she was very open to it and helpful, despite being extremely busy. Contacting her became difficult at times because she is always in and out of her office, which I did not really know at the time, but being persistent really paid off! We agreed to have me come in three days a week for 8 hours, and I would spend the other two days and some weekend time working on projects and research on my own, since this arrangement was most conducive to both of our schedules. Every day that I was at the facility, I would arrive at 9:00am and get settled, and then my preceptor and I would attend about two hours of morning meetings with the executive director, director of nursing, and other members of the healthcare team. There, we would discuss the status of each resident, admissions and discharges, and any issues or problems for the day. Then my preceptor and I would return to her office and, for the first few weeks, I spent a lot of time watching her do patient assessments and trying to learn the language and format. I also had the opportunity to work with the facility’s dietary manager, who worked very closely with my preceptor.

When I started my field experience in the beginning of May, we had a few ideas outlined and I figured I would be doing some mock projects just for practice. However, I quickly found that my preceptor really wanted me to be working on real projects and solving actual problems for her. I also realized that I was expected to complete the projects by myself without much guidance or supervision from my preceptor, which I found very daunting at first. Several things that I did while at Golden Living included:

  • creating handouts on the common therapeutic diets for the nurses and Certified Nursing Assistants (CNAs) to reference
  • creating and implementing a new flow sheet for recording resident heights and weights
  • conducting sessions to educate the nurses and CNAs on the new flow sheet and how to properly take height and weight measurements
  • investigating the way resident intakes were being recorded

I also completed a food waste evaluation for the dietary manager in order to help him figure out where costs could potentially be cut. In addition to completing these larger projects, I accumulated daily and weekly tasks that became my own. I eventually began to complete resident assessments on my own, and also helped with Minimum Data Sets (MDS’s). On a weekly basis, I created a spreadsheet of all the residents’ on dietary supplements, and organized it to show how much of each supplement or fortified food was ordered. I would then send this to the dietary manager for him to tell the kitchen staff what to prepare. Another task that I completed weekly was to gather information and prepare for what they called WWFRI meetings. Several times, I presented the information at these meetings by myself. I learned how to do monthly weight reports, and did them on my own for the last two months of my field experience. At about 200 hours into my field experience, I had all of these tasks to keep me busy and often worked on my own for a good part of the day. The independence was very empowering!

My favorite part of my field experience was getting to know my preceptor and working with her. I was very lucky to have someone that I connected with on both a professional and a personal level. Being able to interact comfortably with her made my experience a very positive one, and she came to trust me with a lot of her work. However, this also meant that I was given a lot of responsibility, and became obligated to meet and exceed my preceptor’s expectations. At times, I did feel quite stressed, especially with limited time to work on projects outside of my field experience due to my part time job (and trying to spend some time enjoying the summer weather.) In the end, I had a really great sense of accomplishment and I learned far more than I thought I would. A big surprise for me came about halfway through my field experience, when I was given my own computer access. This allowed me to do virtually everything that my preceptor could do. Learning to use the software on my own and writing ADIME notes on residents was something that I was proud of because I felt that this was one of the more difficult tasks.

Overall, I would say that I had a very positive experience. Since there was not a lot of structure, this particular type of field experience would definitely be beneficial to students who are self-driven and able to quickly adapt to different situations.

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