A "Typical" Day

My grandmother asked me this weekend to describe a typical day of my internship. This is a nearly impossible task, as I switch rotations often and locations even more frequently.

Today, however, I've excerpted a section from my foodservice management journal that represents a fairly typical day. I was at a long-term care facility for four weeks and one of my assignments was to describe each day's activities, challenges, etc. For this excerpt, I have changed names and certain details to protect privacy.

Day 6: Daily Activities

Caroline (foodservice director and my preceptor) and I attended the morning meeting, finally. It happens every morning at 9am, but Caroline had been too busy to attend last week. Odds and ends today:

• Read through “Food Service Director Responsibilities,” which cover HR, accounting, costing, production, education, communication, operations, purchasing, quality, and programs, and “Dietary Services Standards.”
• Observed Nicholas (dietary aide) and Grace (AM cook) serving brunch.
• Discussed garnishing and portion control with Caroline.
• Updated last month's inventory list in preparation for taking inventory at the end of the month.
• Reviewed QA forms with Sandy, the RD, and scheduled a time to go with her on an inspection (next Friday, hopefully).
• Nailed a poster about Employee Rights to the wall in the chemical room.

Challenges Observed

The staffing crisis continues: Tara, a cook, is in the hospital, and Chelsey, a dietary aide, is out to be with a family member (also an employee here), who is in the hospital as well. Caroline and I will work for Grace the next two mornings so that she can cover the weekend.

Interactions Had/Observed

As I walked away from observing brunch, I heard someone say, “Who was that lady?”

“No idea,” her companion replied. Some people thought I was from the state, even though I don't have a clipboard. It's about time I hit the floor and made my presence known! I was cooped up in the kitchen with catering all last week.

Progress Made

Made some progress on the in-service insofar as I read through the material with which Caroline furnished me on garnishing and controlling costs, and I pinned down more precisely what Caroline wants from the staff in in terms of garnishes and portion sizes. Observing brunch helped me understand the limitations on staff to garnish plates – Nicholas frequently had nursing assistants and volunteers waiting for him to dish up another plate, for instance. From Sandy, I learned that starches are most frequently over-portioned.

Spider sauce plating design by thehoneybunny.
Takes way too much time and product
when you're plating 90 desserts.

Revelation #6: The dietary aides do not have the time to make garnishes as elaborate as the ones Caroline showed me.

 

Different Strokes for Different Folks

Another product of cleaning out my in-box: a webinar hosted by the America Farmland Trust, an organization working to save farm and ranch land across the county.

farmland.org

This event was the second in a series entitled Planning for Food and Agriculture: Taking a Systems Approach that highlights success stories from which others can learn. The first webinar focused on the state and region level, and the one I attended looked at community and county activities.

The four speakers each presented a wealth of information specific to their communities (Sacremento, Iowa Corridor, King County in Washington, Multnomah County in Portland). A couple items stuck out to me, which reinforced how one size does not fit all when it comes to local food systems.

First, from Sacramento, the urban-rural edge. This is where farmland abuts city land. The "softer" the edge - that is, the more urban and rural land is mixed together - the more likely the farmland is to lay fallow. The likelihood increases because that field is closer to traffic, pets, invasive plants, and vandalism or theft. And the urbanites might not be too chuffed about the farm next door because of spraying, dust, noise, and odor. Furthermore, land near developments is ripe to be developed itself; so, farmers may find the land more valuable sold than farmed.

Ways to address these potential points of conflict include buffer zones, Right-to-Farm laws, and ag parks.

Wait - what parks?

The Sunol AgPark in San Fransisco

Ag parks! According to the Sacremento Region Rural-Urbans Connections Strategy, an ag park is "a combination of a working farm and a municipal park that is located at the urban edge;" Sunol Water Temple AgPark is the model. Given an ag park's modest acreage and proximity to the city, it can be a good option for small farmers looking for a bit of land.

So that was the first item that stuck out to me. The second was King County's drainage and floodplain issues. Did you know that the ditches draining agricultural areas are often swum by endangered salmon? Neither did I! Maintenance of these ditches is understandably highly regulated to protect the fish and the water quality.

Also, farms in Washington's floodplains are liable to, well, flood. Did you know that some farmers build "farm pads" or "critter pads" to elevate their livestock above Base Flood Elevation? Me neither! The pads require permitting to ensure negligible impact on the floodplain, and can also be used to elevate houses.

Always something new to learn.

Eating Alaska

As part of my independent study week, I watched the documentary Eating Alaska, by Ellen Frankenstein.

"What happens to a vegetarian who moves to Alaska and marries a commercial fisherman and deer hunter?" Frankentstein Productions

Ellen explores Alaskan modes of "extracting resources," from stalking caribou to diving for sea cucumbers to chasing mountain goats and getting stranded for four days. She never manages to pull the trigger, but is adept at cleaning, packing, and eating venison.

The movie features a varied cast of characters. The founder of an Alaskan vegetarian group who would give up meat before processed food believing there is a basic value in not exploiting animals and the earth. A teacher guiding sixth graders through a grocery store, comparing labels and reading ingredients list. A Yupik woman on St. Lawrence island, former site of a military base, describing the toxins embedded in her indigenous diet.

Eating Alaska drives home the point that one size does not fit all when it comes to eating "correctly." It depends on who you are, where you live, and how well you understand the complexities of that environment.

Minnesota Sunset Act

Catching up on email, I finally read the Minnesota Dietetic Association's educational document on licensure and learned about an intriguing act passed at the end of the the 2011 Legislative Session. But first...

What does licensure mean for dietitians?
Public safety. While the Commission on Dietetic Registration gives RDs that "R," it is not a legal authority and cannot restrict RDs who may harm the public. The Licensure Board does have legal authority and so can tell unlicensed practitioners to cease and desist, etc. In addition, being licensed conveys greater credibility to those insurers from whom we'd like reimbursement.


What is the Minnesota Sunset Act?

A MN sunset, courtesy of D. Bjorn

This act established an Advisory Commission to review the merits of departments, agencies, and other government entities to make sure they are

• efficient and effective,
• meeting their goals and objectives,
• complying with federal and state laws,
• addressing complaints in a timely manner, and
• not duplicating or overlapping with other agencies,

among other criteria. The law places agencies into six groups, each with a scheduled review date and possible expiration date.

Who's up first?
The first batch is set to expire June 30th, 2013:

• the Amateur Sports and Combative Sports Commissions
• Capitol Area Architectural and Planning Board
• the Councils on Asian-Pacific Minnesotans, Black Minnesotans, Affairs of Chicano/Latino People, Indian Affairs, and Disabilities
• all health-related licensing boards
• all advisory groups associated with these agencies

You can see that the Minnesota Board of Dietetics and Nutrition Practice falls neatly under that fourth bullet point.

What does this all mean?
As far as I can tell, the Minnesota Sunset Act is a means to shrink government and save money.  Whether it will do so and how it will affect RDs remains to be seen.

Internship Update and Homegrown Minneapolis

Last Wednesday marked the midpoint of this UMN-TEP dietetic internship. I have passed the eight-week eating disorders rotation, visited half of the community sites, dabbled in school foodservice, and made it through four weeks of foodservice in a long-term care facility.

And now, right before a two-week vacation, I'm enjoying my Independent Study week. Besides sitting in on an intensive outpatient program at The Emily Program, I am taking advantage some local food events.

Homegrown Minneapolis is an initiative started in December 2008 geared toward strengthening the city's local food system. They've knocked off some impressive items off their to-do list, the most exciting of which to me are:

• Completed a community kitchen inventory of more than 50 commercial and noncommercial kitchens
• Established a food council beginning this January
• Made it possible to use Electronic Benefits Transfer at farmers markets, aka "circulating federal food support into the local economy"

Cleaning out my in-box, I found an email about the initiative's community meeting from Healthy Food, Healthy Lives listserv. Hey, that's tonight! I thought. It was a sign - that and the fact that I heard it mentioned on MPR on my way over.

After a program introduced by Mayor R.T. Rybak that outlined the efforts and successes of Homegrown, we settled in for hosted table conversations. Our hosts for the evening wanted to know what we thought was the most significant progress made thus far and what should be the focus of the food council as it moved forward.   

Homegrown Minneapolis

Our table agreed that connecting the dots between growers, processors, distributors, eaters, and composters signified the greatest progress. And in my opinion, the future focus should be on increasing food availability and access, which is to say, eliminating food deserts.

Also, they should get a facebook page, or something with their logo on it.