FSHN 492: FIELD EXPERIENCE

THE VILLAS

Lauren Ikeda

1557 Lehua Street

Honolulu, HI 96819

(808) 349-4199

FSHN 492

Suppervior: Heather Knox

2230 Liliha Street

Honolulu, HI 96817

hknox@ohanapacific.com

(808) 228-5786

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Future Plans and how my experience relates to them:

Immediately after graduating University of Hawai’i at Mānoa with a degree in Dietetics I

would hope to be accepted into a dietetic internship and successful pass the registered dietitian

exam to start practicing as a Registered Dietitian (RD). My dream plan would be to initially

work in a clinical setting with a focus in geriatric care for the first few years of practicing and

eventually practice in an outpatient setting. I would primarily like to work with the elderly

population because I would like to stay in Hawai’i and our elderly population continues to grow.

My motivation for getting into health care was when my late grandmother experienced a stroke,

sparking my interest in the different occupations with health care. Eventually, I would want to

work in an outpatient setting because I would like to work with clients who want to make

lifestyle changes by listening to my advice, instead of forcing someone to make a change who

may not be ready.

My field experience site is at The Villas that is a post acute care facility. At the Villas I

work as a dietary aide and dietary lead. As a dietary lead I work in the kitchen; by working on

the tray line, preparing snacks for the guests, stocking the nourishment rooms, preparing ready to

eat items, and sanitation. As a dietary lead I interact with the guest by taking daily meal

preferences, assessing new admissions, and acting as a manager when needed. Also at the Villas

I assist the RD’s by preparing nutrition assessments. The information I collect for the

assessments are anthropometric measurements, oral/supplement intake, fluid intake, bowel

movements, diet orders, labs, and blood glucose readings. The experience of working at the

Villas greatly relates to my future plans as a dietitian, especially since the main population at the

Villas is the elderly. Through my experience I have learned how to better communicate with the

elderly, as well as what their main nutritional concerns may be. The Villas, I would say, is an

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in-between clinical and outpatient facility, which are the two fields I would like to work in, so I

am able to get some sort of feel for both settings. And lastly, when I prepare assessments for the

RD’s it helps me get experience and understanding of what an RD may do on a daily basis. This

allows me to use the skills I learn in school to a real life situation.

A general description of the firm/establishment(s):

The goal of the Villas is to provide an innovated, short-stay, high acuity facility that

serves those who require clinical and rehabilitative care until they can safely go home or transfer

to a traditional long-term care facility. The Villas is united by their 10 core values. The 10 core

values are: our Kupuna comes first, our staff is our most valuable resource, we believe in an

empowered workforce, we emphasize teamwork, we provide our services with integrity and

compassion, we are committed to excellence in all that we do, we believe in the importance of a

positive attitude, we strive to continually improve our services, we believe in supporting,

providing leadership, and investing in our community, and we maintain a healthy financial

position in order to fulfill our mission. The Villas believe each facility will build on these core

values to enhance its community and accomplish its mission. Caring for our Ohana is our

mission. The clientele of the Villas is primarily the Kupuna (elderly) but anyone who needs

rehabilitative services is welcomed. The main service provided at the Villas is clinical and

rehabilitative care. The major sources of income is through health insurance companies and

patient co-pays to the facility. The major expenses are employee salaries and facility

maintenance. As for the physical facility, it is located on Liliha Street, which was formerly

known as St. Francis hospital. The facility includes 3 floors that at maximum capacity can hold

104 guest (private and semi-private rooms). The Villas is working on building an additional floor

to the facility. Currently the 3rd floor contains a rehabilitation gym and activity center, while the

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basement contains the kitchen and laundry room. The address to the Villas is 2230 Liliha Street,

Honolulu, HI 96817 and the phone number to the Villas is (808) 547-6000.

General Description of Personal

My supervisor at the Villas is Heather Knox. A brief history about Heather is she

completed her dietetic internship and masters at Washington State University. Shortly after her

internship she taught at Washington State and Idaho State Universities. She later moved to

California where she worked for an airline catering business and Nature Made as a consumer

educator. After gaining experience she decided to come back home to Hawaii and worked at

Wahiawa Hospital, Pali Momi, and Chinese Palolo Home as a registered dietitian. Currently,

Heather now works for Ohana Pacific as a clinical dietitian and food service director.

Heather at the Villas is the food service supervisor and Registered Dietitian (RD). To

apply for a position of a RD in the Ohana Pacific Management Company may be a good option

for new/entry level registered dietitian, as I am unable to find application requirements besides

having a RD licence. As an RD at the Villas, one must coordinate all phases of nutrition care:

nutrition assessment, care planning, monitoring, education, and counseling of clients. In addition,

the RD assumes the responsibility and accountability of implementing the food and nutrition

services. Furthermore, they develop programs and processes to focus on improving customer

service in food service operations and food delivery options to the residents. And occasionally

may need to travel between different facilities within Ohana Pacific (The Villas, Ann Pearl,

Garden Isle, Hale Kupuna, & Pu’uwai ‘O Makaha). Opportunity to advance from an RD would

to become a manager of food service or clinical nutrition manager.

Heather at the Villas is not only a RD but also the food service manager; which does have

a few application requirements: minimum of five years of restaurant/hospitality management or

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equivalent work experience, experience of special event/catering planning, and demonstrates

knowledge of industry trends and practical business application. A food service manager

facilitates administrative, event, and conference support functions; recommends appropriate

actions, develops budgets, monitors payment and ensures timely performance of contracted

services and completion of projects; identifies and escalates problems to vendors and assigned

others, tracks and ensure timely resolution; as well as perform other miscellaneous

responsibilities as manager. In terms of working at Ohana Pacific there is one position higher

than Heather, which is the Supervisor of Dietary, who works directly with the President of

Ohana Pacific (Richard Kishaba).

In 2017 I volunteered at the Villas to get a better understanding of what a RD does on a

daily basis and if I could see myself working as RD. This opportunity came about through my

father who plays in a soccer league with Heather. As a volunteer, I would prepare assessments

for the RDs by obtaining information that included: height, weight, BMI, PO intake, bowel

movements, blood glucose readings, and labs. Eventually as I started talking to the RDs they

said it would be great if I had diet aide experience, so I saw a job opening for the Villas and

applied. In January 2018, I officially started working as a diet aide at the Villas and after a few

months of working, I was asked to work as a diet lead. Currently, I am working as a diet aide &

lead at the Villas and occasionally help to prepare assessments for the RDs.

To apply to be a diet aide one must have a high school diploma, pass criminal

background, TB test, and drug screen, have excellent people and communication skills, and be

able to speak/write in English. The tasks of a diet aide are to help set up, serve, collect food

trays for the guest, prepare meals and between meal snacks, and perform a variety of

dishwashing and cleaning tasks in the food service unit. The requirements to become a diet lead

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are similar except one must also have basic computer skills, proficient in Microsoft Word/Excel

and Outlook, and have a basic understanding of nutrition and food service. A diet lead must be

able to do the same tasks as the diet aides, as well as assist in the coordinations of the menu

preference for the guests, interview guests daily to review menu selections and help with the

selection, production, and developers of those selection, production, and delivery. In Ohana

Pacific the only advancement above a diet lead is manager of dietary staff and cook.

Learning Plan

At the Villas I work as a diet aide/lead, and prepare assessment for the RDs. My learning

plan includes seven learning objectives that apply to the different positions I work. As diet

aide/lead the learning objectives I created are: to improve my leadership skills to help guide my

staff in the right direction, improve my time management skills to complete my job efficiently

and effectively, improve my communication skills with my staff, improve customer service skills

with the guest at the Villas, improve my MS Excel skills to correctly print production for the

staff, and to learn about food service for my future. In general, all of the the learning objectives

actions are basic actions one must do during the workday to properly execute the job.

For example effective communication is key, not only when communicating with the

staff about new additions or changes, but also important when speaking to the guest when taking

meal preferences to ensure the correct preferences for the next day. The actions needed for

effective time management are important to learn how to time manage not only during tray line

service but seeing all the guest for their meal preferences before my shift is over. It is especially

important for my time management to be on point on days where the census is high and more

than five admissions are confirmed.​ ​To become knowledgeable about food service and food

safety, I will learn about properly labeling and dating food/drink items, appropriate temperature

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ranges of the walk-in, freezer, and cold foods before and after tray line, and how to properly

check in and put away deliveries.

For preparing RD assessments my learning objective is to prepare RD assessments

accurately for the RDs to help them save time and use the work I prepare for them. The actions

needed to accomplish the learning objective is to learn to how properly use Vision (program with

patients’ information) and learn what information the RDs want and input that information into

Vision for RD use.

I believe that I accomplished the seven objectives I set for myself. From working as a

dietary aide, I learned about food service and how to properly execute duties such as properly

labeling food items, the appropriate food and appliance temperatures, and how to check in

properly check in delivery and put it away appropriately. From working as a dietary lead, I

learned how to improve my time management skills to ensure I complete seeing every guest in

facility in a timely fashion in order to print the production guide for the staff on time. My

communication and customer skills have gotten stronger. I can confidently say I know how to

interact with an array of people and know to appropriately act to certain situations if they do

arise. I learned communication is key not only with the guests when taking their meal

preferences but also with my staff, since miscommunication can easily happen when everyone is

not on the same page. My management skills have also improved as I am able to problem solve

situations, when no other management is present and know who I should notify if a problem did

arise. And lastly, I have learned how to properly use Vision in order to get all of the assessment

information, information the RDs need, and how to input the information I found on the

assessments for the RD’s use.

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The most rewarding experiences I have is when I work as a diet lead, where I am able to

interact with the guest directly. I truly feel a sense of pride when the guests tell me how much

they like the food at the Villas and how friendly everyone is. I especially feel the most pride

when some of the guest tell me personally that they can tell I really love the work I am doing.

This makes me the happiest because it reminds myself that I am choosing the right career.

Another rewarding experience is when guests, who prior to admission had a poor appetite, get

their appetite back and start becoming better/stronger (through therapy) and able to return to

their normal everyday life. To the guest who I start seeing them get stronger I always joke that

they need to eat all of their food, since therapy with work them hard and they can only get

stronger through eating.

With the good, I have also experienced some frustrations at work as well. One frustration

is speaking to certain guests who feel entitled or only complain about the service at the Villas. In

terms of dietary, we try our absolute best to accommodate everyone, but there was some guest

who knew that we accommodated them but still decided to complain. In these situations, I just

would keep a smile on my face and speak nicely to the guest to figure out how I can help them

more even, if I really did not want to help them. Another frustration at work is that some guests

at the Villas just do not have an appetite or refuse to participate in choosing their meals and then

get mad at us for not making an effort. For the ones without an appetite I just try my best to

make the food sound appealing to make them want to eat or ask the guest what they normally eat

and see if my kitchen can try to make that food. Usually after a lot of convincing the guest will

eventually choose something even if it is small. As for the guest who refuse to participate, I

make the same effort as the guests who do not want to eat and remind the guest that we need to

provide food to them and if they do not want to choose, they will receive the house menu. In

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these situations, I usually will have to inform my manager and see if they are able to convince

the guest since some guest do not listen to a diet lead but will listen to a RD. And the last

frustration would be speaking to guests who do not speak English or are hard of hearing. As for

the ones who do not speak English, I usually give a family member a weekly menu to help the

guest choose foods they would like to eat or if there is no family present, I try my best to speak

in super easy English or translate certain words into their language. There are a few Japanese

and Korean food words I know, so I will say those words instead of the English terms to make it

easier for the guest. The guest who are deaf are extremely hard for myself, since I naturally have

a high pitched and if I try to speak louder my voice only gets higher which is the pitch the

hearing impaired cannot hear. Usually I can speak loud enough for the guest to hear me but

sometimes I resort to writing out the options or showing my tablet and allowing the guest to see

the options since I cannot speak louder. Also, if the situation got too out of hand, I would ask

another co-worker to see the guest since they have louder and lower pitch voices then myself.

When I first got the job in 2018, I used to come into work feeling overwhelmed because

there were so many things I needed to learn, since I had no previous food service work and

immediately learned how hard food service worker work. I am glad I stuck out the hard time and

learned how to adapt quickly, because once I learned the basics and got into a rhythm at work,

the work came naturally and now I think work is quite easy and I do not stress before or after

work about work. The learning goals and objectives I set for myself were realistic, since all of

the objectives I set are needed in order to properly execute my job efficiently and effectively. As

I have now been working this job for two years, I already have accomplished these goals and

objectives I set before this assignment. But when I wrote my goals and objectives I thought of

my experience when I first started and how much things I needed to learn. When I first started in

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2018 these goals and objectives would definitely have been challenging for myself especially

since I had no prior experience but now, I can easily accomplish all of these goals and objectives.

From my whole experience the most valuable thing I learned and will take with me

forever is to stay humble, since I learned working in the kitchen is no joke and requires a lot of

physical effort with minimal pay. I hope to remember this as I become an RD since I will be

working close with the kitchen staff and I have had first-hand experience of what it is like to

work in a hospital kitchen. Before applying for this job, I did not think much of the work and

thought it would be easy and just be something that looked good on my resume. I did not expect

that I would learn so much from this experience, but it definitely will help me build a solid

foundation when I become a RD, since I will have a upper hand when put in my food service

rotation.

Personal Value & Applying Experience to the Future

From my field experience site, I learned one of my major strengths is that I am a quick

learner and able to adapt quickly. Heather has told me multiple times how she is amazed how

quickly I learn tasks that could be difficult for others to do. I also believe this is a strength since

I am able to work six out of eight positions we have at the Villas. The two positions I do not

work are the two that require you to cook. There have been multiple weeks where I worked a

different position every work day or there were also some days, where I had to work two

different positions at the same time. Time management I would say is another one of my

strengths; I am able to plan out my work day in my head before starting my shift, which allows

me to stay on time and on task. I would say I have a good record of not accumulating overtime

due to me managing my time well. And the last strength I have is that I have a positive attitude;

while working I always try to keep a smile on my face and speak friendly to all of the guest and

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staff. I always have an optimistic mindset especially since I know most of the guest do not want

to be in the facility and I just want to keep them motivated to get healthy.

Before my field experience I always thought I had good patience, but I learned that I need

to work on my patience more since sometimes I catch myself getting irritated at the guest for

taking a long time to respond to my questions, even though I know they are trying their best. In

the future I want to work with the kupuna, so it a good learning experience for me now to learn

how to best work with them and to develop more patience and empathy for them, since they are

not being slow on purpose, but it is just the nature of aging. Before starting my field experience,

I would say I was more timid and still am at times. But through working I have learned when I

should speak out in order to make an issue known or a suggestion to make work easier for

everyone. As time goes on and I become more knowledgeable about general nutrition and

nutrition of a certain disease. As such, I will develop more confidence and will be able to speak

to the guest without uncertainty and be able to answer their questions right away instead of me

referring their questions to the RDs.

A supervisor in a professional work setting has a very important job of managing a

team to work cohesively towards the same goal. From my experience the most important quality

a good supervisor needs to have is good communication skills and knowing different forms of

communication styles, since everyone communicates in a different way. Supervisors should

encourage a healthy work culture, to not only keep their employees happy but to also provide an

efficient work environment. At Villas, I really appreciated the flexibility of the schedule and

being approved for any vacations or requested days off without any questions as long as I had

paid time off hours available. When speaking to Heather (Supervisor) she said she always tries

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to give her employees their requested vacations days, since she knows everyone works hard, has

good attendance, and rarely calls in sick.

As for expectations I think it a two-way street the supervisor before hiring someone

should review all their expectations for them as an employee and also state what an employee

should expect from the supervisor as well. As positions change or if the dynamic in company

changes then these new expectations should be spoken about instead of making one figure it out

on their own. From my own experience I know what type of work environment I would like to

work in the future and how having good management is the base of a stable work environment.

In terms of a supervisor of a student I think one should first be flexible with the student work

schedule, since being a student is top priority. The supervisor should right off the bat should

express what they expect out of the student and give little push in the right direction to make the

experience valuable for the student. And lastly, I think the supervisor should allow the student to

have freedom to learn from their mistakes in order to build a stronger foundation for their future,

instead of holding their hand through every step.

Preparation for the Future

For my field experience site, the classes that benefited me the most are FSHN 181

(Chemical Nature of Food), FSHN 312 (Quantity Food and Institution purchasing), and FSHN

469 (Nutrition Counseling). FSHN 181 taught me the basics of preparing foods and what it may

be like working in food service as a dietician. FSHN 312 I learned about food safety, stocking,

FIFO (first in, first out), importance of labeling, food temperatures, and how to calculate recipes

and stock/deliveries. All of the information I learned in FSHN 312 has been tremendously

helpful as it gave me knowledge of the kitchen without prior food service experience so I would

not look incompetent. Also, I obtained my Servesafe certificate from this class which is helpful

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since all diet leads need Servesafe certification to comply with new regulations at the Villas.

FSHN 469 has helped me when interacting with guest I learned how to have better active

listening skills, reflect better, and overall learned how to interact with the guest on a more

professional basis which I can later apply to my professional career. As for when I prepare

assessments for the RDs classes such as FSHN 389 (Nutritional Assessment), FSHN 467/468

(Medical Nutrition Therapy (MNT) I & II) have been useful as I know the pertinent information,

I need to collect and able to understand the information and summarize the information I collect

the RDs.

Of all of the course FSHN 312 & 181 has helped me the most during my field

experience class, since majority of my work experience was being a diet aide and working in the

kitchen/tray line. From FSHN 181 I learned different cutting skills which I use on a regular basis

at the Villas, since I cut an assortment of fruits, vegetables, and pies. From FSHN 312 I use all

of my knowledge of food safety and ServeSafe on a daily basis. I have become mindful of cross

contamination, proper labeling, optimal food temperature and food danger zones, and how to

carefully check in deliveries. Recently I have been able to apply my MNT knowledge as a diet

lead. I am able to read through reports quickly to figure out why someone is on a certain diet or

how to best accommodate a person through the diet they are on. When I first started as lead, I

was unfamiliar with different health disparities and did not know how to accommodate these

disparities, but now I am more confident and knowledgeable and able to resolve problems

without bothering the RDs to solve the problem for me (I still let the RDs know the whole

situation since I am not an expert yet). For example, a Crohn’s Disease patient came into the

facility a little after we wrote our case study about Crohn’s Disease, I was the one to do the

initially nutrition interview. Since I had the knowledge about remission and certain trigger foods

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the patient felt comfortable that we would be able to accommodate them through their recovery,

as well as I felt proud of myself that I had enough knowledge to ease the patients concerns and

know how to best help him right away without having to wait a few days to a week for a RD to

see him or exacerbate his condition.

In my opinion the curriculum seems to be pretty solid in that it covers the basic fields of

dietetics one may be doing their field experience in (Food service, community, clinical, &

athletics). One area of dietetics that our curriculum lacks is for students who want to do research

in the future. I do not think our classes support this field and I know many of my fellow students

are doing their field experience in research, so they may not be able to apply what they learn in

class to their field experience site. Although it may be difficult to accommodate, I think we

should have two years of MNT (four semesters) classes, since there is so much information and

different conditions that require MNT. Cramming all of that information into the last year may

not prepare us to excel in our field experience site especially if it is a clinical setting since we

may lack prior knowledge. Also having MNT during “junior” year can also help people realize

faster that dietetics may not be their future career and give them more time to switch their career

path before graduating instead of just sticking it since they already invested too much time into

this major. MNT will be majority of what most of us graduates will be doing initially so taking

our time to figure out how to do it properly and build a strong foundation for our future would be

helpful and more beneficial for us the students.

Personally, my field experience has been tremendously valuable to me as I was given

opportunities most students may not be given. My supervisor and other RDs trusted and

believed in my abilities to allow me to prepare assessments for them and do work as an ISSP

intern may experience. This experience will allow an easier transition to when I do my

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internship in the future, as I will not be timid and have a good foundation/prior knowledge of

what to do. Even though future students may not be to experience the assessment prepping, my

experience as a diet aide and lead was also valuable to me and learned so much about the food

service and customer service side of dietetics. I would recommend future students to become a

diet aide as their field experience since you essentially will learn the kitchen perspective side and

become more appreciative of the kitchen help as we become RDs. Being able to learn how a

kitchen operates, learning hospital lingo, and learning how a skilled nursing facility operates will

be important for our futures. An added bonus as well of being a diet aide is that it is a paid field

experience opportunity so if someone needs a job or in financial need, being a diet aide is like

“killing two birds with one stone”. Lastly being a diet aide does allow us to apply what we learn

in school to a real-life situation which makes learning in school seem useful and not a waste of

time.

Overall, the main experience I gain at the Villas that I can apply to a future profession is

customer service, communication, and humbleness. From interacting with the guest on a daily

basis and building a rapport with them I have definitely improved my customer service skills. I

always have a smile on my face and positive attitude throughout the whole building, which the

guests notice, since they always tell me I am always so happy and nice. I now know how to

handle myself in situations when I deal with difficult people and how to approach these people. I

have also learned more about my own communication style and how it does not always match

with other people. So, once I learn how they best communicate then I can try my best to adapt to

their style and vise-versa. Communication is key when working in health care since every

department is responsible for a different aspect of the guest’s life. If we are all not on the same

page this could affect the care/well-being of the guest. From this job I am/have learned how to

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communicate with nursing/speech/therapy adequately, which could be similar to what I may do

in the future. And lastly this job has definitely humbled myself since I now know how hard the

kitchen staff (laborious) has to work for minimal pay. Before applying for this job I did not

think it was going to be hard, but I was wrong; depending on the shift you need to wake up really

early or stay at work somewhat late, washing dishes is very tiring, running trays back and forth

to the floors is very tiring, and doing tray line while trying to be 100% accurate can be difficult at

times. The next step is to get an internship, most likely University of Hawai’i at Manoa ISSP.

During my internship I will apply all of the knowledge I have obtained from school and field

experience to become the Registered Dietitian I can be. By the end of the internship I want to

build a strong foundation for my future and know which division of dietetics I want to pursue.

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