SITE SUMMARY for: Havenwood-Heritage Heights Use for all sites (other than conferences and reading).

. Post to your portfolio within 7 days of completing work at the site. For Community sites, team leaders should submit the updated Site Book and Team Leader Report to their advisor at the same time.

Intern name: Claudia Gumina Rotation: Primary Food Service Rotation dates from: 9/24/2013 to: 10/18/2013

Date: 10/29/2013 Preceptor: Melanie Farwell Total hours: 121.5

1. Describe the projects and activities you completed during this experience. At Havenwood-Heritage Heights, I got to participate in many different activities with the staff. Because I got to spend some time working with people in different positions I understood individual jobs better. I got to participate in tray line, food assembly, recipe modification, marketing of new items and the ordering process. During my last two weeks, I did an in-service on Safe Knife Handling for the entire kitchen staff. I divided the presentation in three sections: prep, cutting and cleaning and used very simple terms. The last thing I did was my meal project in which I prepared a Halloween Themed meal. I served it in the caf and got feedback from the residents and staff that had the special food items. 2. What new knowledge was gained or new skills practiced? As I mentioned before, I got to spend some time with different staff membesr who are responsible for different parts of the foof service process. I think that in order to be a good manager, one needs to understand the labor in which your workers engage so you can understand their feelings about it and the way in which they interact. Melanie did a great job supervising and keeping the hostility at a minimun. I learned so much from the way in which she communicated with the different workers and know that I will have an easier time in a similar position because of it. 3. Identify the roll of the nutrition professional at this site and discuss your interactions with the professionals and audience members at the site. At HHH, there was only one dietitian and she was in charge of both, the food service aspect and the clinical aspect of nutrition. It seemed to me that many of the other supervisors (the other porfessionals) left many of the chores they did not know how to do to Melanie because she has a good background in nutrition and management. The residents loved Melanie and were always very receptive when I interacted with them. Because there are different levels of assistance, some residents were more engaged than others but it helped me learn a lot about interacting with people whose motor skills may be deteriorated. 4. Were there regulations or rules at this site that were related to the Scope of Practice for Nutrition and Dietetics, or the Code of Ethics? There were many regulations regarding patient autonomy that were related to the code of ethics. As dietitians, we can make recommedations, but we cannot force people to follow them. There was a patient, for example, on tube feeding, who would often confess to eating solid foods even though he had esophageal problems. As much as we tell a patient what to do, ultimately it is his choice and that concurs with principle 6: The dietetics practitioner provides sufcient information to enable clients and others to make their own informed decisions.

5. What did you learn about the audience / population group? What did you learn about yourself? I learned that sometimes elderly individuals have a hard time communicating their needs because of different difficulties and because of this, they are not heard. They are often very limited in their options, particularly if they are in a retirement community so it is important that we try to make them as comfortable as possible. I learned that I am more patient than I thought I was because I felt genuinly happy to be helping the resident find their way around and helping them order their meals. 6. Describe how you were effective with this topic or with this group. What would you do differently in the future? I was effective because, when evaluating trays and observing, I managed to always keep the needs of the population in mind. It is easy to get distracted and think about what you would like in a food, instead of what they need and for this reason, you have to focus. if I were to do something different, I would try to get more feedback from the residents in order to be able to make suggestions regarding their meal choices. 7. Summarize the ways that you applied wellness concepts and messages in this rotation. Discuss whether there were any opportunities to promote sustainable food choices or address sustainability from a food systems perspective. In this setting, it was a little hard to apply wellness concepts because so many of the meals and recipes were pre-designed and I could not just make suggestions for changes. At HHH, they actually purchased most of their produce from a local company and some of their other food items. They were efficient at utilizing leftovers and not wasting food. Many of the decisions they made were obvioulsy influenced by money so I found it difficult to make suggestions on the matter. Because it is a big facility, it is harder to make changes; particularly because of the population with which they work because they do not like changes. I did have some control over my food project which did give me the opportunity to use a variety of ingredients which I believe were nutritious and palatable. I included different vegetables and ingrdients and made healthy substitutions. After we were done, we planned to use the leftovers during the day after's lunch.