CHAPTER ONE

1.1. HISTORY OF SIWES

INDUSTRIAL TRAINING FUND (I.T.F)

In recognition of the shortcomings and weakness in the formation of SET graduates, particularly
with respect to acquisition of relevant production skills (RPSs), the Industrial Training Fund
(which was itself established in 1971 by decree 47) initiated the Students’ Industrial Work
experience Scheme (SIWES) in 1973.

The Student Work Experience (SIWES) is a skill development programme established by the
Industrial Training Fund (ITF) in 1973 with the aim to stimulate human performance, improve
productivity, and induce value-added production in industry and commerce. Through its SIWES
and Vocational and Apprentice Training Programmes, the Fund also builds capacity for
graduates and youth self-employment, in the context of Small Scale Industrialization, in the
economy. It affords students the opportunity to gain practical knowledge for a smooth transition
from theory to on-hand experience. Participation in this programme has become a prerequisite
for the award of certificates in various fields including; agriculture, medical sciences, applied
sciences, engineering, education, and environmental sciences.

In spite of the challenges faced by SIWES in the four decades of its existence, the Scheme has
not only raised consciousness and increased awareness about the need for training of SET
students, but has also helped in the formation of skilled and competent indigenous manpower
which has been manning and managing the technological resources and industrial sectors of the
economy. Participation in SIWES has become a necessary condition for the award of degrees
and diplomas to SET students graduating from higher institutions in Nigeria. It is therefore, not
in doubt that SIWES is a veritable means or tool for National Economic Development.

1.2. OBJECTIVES OF SIWES

The Industrial Training Fund’s policy Document No. 1 of 1973 which established SIWES
outlined the objectives of the scheme. The objectives are to:

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  Provide an avenue for students in institutions of higher learning to acquire industrial
skills and experience during their courses of study
 It prepares students for industrial work situations that they are likely to meet after
graduation.
 It also aims at exposing students to work methods and techniques in handling equipment
and machinery that may not be available in their institutions.
 Part of the objectives of SIWES is to make the transition from school to the world of
work easer and enhance students’ contacts for later job placements.
 To provide students with the opportunities to apply their educational knowledge in real
work situations, thereby bridging the gap between theory and practice.

Organizations Involved In the Management of SIWES

The following organizations and bodies are involved in the management of the programme:

The Federal Government

 To provide adequate funds to the ITF

 To make it mandatory for all ministries, government parastatals and private companies to
offer placement to students.
 To formulate policies guiding the scheme nationally.

The ITF

 To provide organizational structure to orientation programs for students.

 To provide logistics needed to administer the policies of the Federal Government
 To process placement list from institutions and supervising agencies, the Supervising
agencies such as NABTEB, NUC and NCCE.
 To ensure the establishment and accreditation of SIWES unit in institutions under their
various jurisdictions.
 To review programs for SIWES qualification.
 To participate in biennial SIWES conference and seminars in conjunction with ITF

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1.3. BRIEF INTRODUCTION TO IJAYE STATE HOSPITAL

The Ogun State Health Management Edict No. 6 of 1978 promulgated by the Military
Government in the state established the Ogun State Hospitals Management Board. The primary
objective of the Board is the provision of effective, qualitative and quantitative health care
services to the people of the State. The Board has 5 five health zones, controls and manages all
the 40 State owned secondary health facilities. The Board advises the Government through the
Commissioner upon such matters connected with medical or health services in the State. The
Board treats all personnel matters such as study courses, in-service training, appointments,
confirmation, promotions and discipline of employees. The Board considers and collates the
annual estimate and budget proposals for the hospitals and the headquarters. The Board
recommends ways, means of increasing the revenue and recommend for approval of the
commissioner, the charges or fees payable for services provided by or on behalf of the Board.
The Board carries out any other functions or general directives consistent with Government
policy in all matters relating to medical or health service.

OBJECTIVE OF IJAYE STATE HOSPITAL

The primary aim and objective of the organization is to provide safe, affordable, adequate,
equitable, effective, comprehensive, qualitative and quantitative health care services to everyone
in her capacity especially the people of the state and its surrounding area.

HISTORICAL BACKGROUND OF IJAYE STATE HOSPITAL, ABEOKUTA

The state hospital, Abeokuta was established in 1914 at Wasimi, Ake, and later moved to the
present site after the World War I. The hospital has been infrastructural development over the
years, and most of the colonial structures had been replaced except for few building which still
serves as a reminder of the past of the hospital. It is the main State government owned hospital
providing primary and secondary health care services to the inhabitants of Abeokuta, the state
capital and its environs.

The services include:

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PRIMARY CARE

 General OUT Patient Clinic

 Children OUT Patient Clinic
 Infant and Child Welfare
 Ante Natal Services
 Family Planning
 Immunization
 HIV/AIDS Related (Anti- Retroviral Therapy, ART Clinics)
 Chest Clinic- Free Tb Treatment

SECONDARY CARE

 Orthopedic/Trauma Surgery
 General Surgery
 Internal Medicine
 Ophthalmology (Eye Clinics)
 Obstetrics and Gynecology
 Physiotherapy
 Radiology
 Laboratory Services.

AIMS AND OBJECTIVES OF STATE HOSPITAL, IJAYE, ABEOKUTA.

The objectives of State Hospital, Abeokuta include the following;

 To be flagship of Ogun State Secondary Health care Services.

 To provide qualitative Secondary Health care services to the host community at an
affordable cost.
 To train and educate different cadres of healthcare professionals or providers for the
nation in particular and the world at large.

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 To carry out medical or health system research for the advancement of health system
knowledge for the overall purpose of raising health status of Nigeria and indeed the world
citizens.
 To participate in the community health promotion and to secure improvement in the
physical, mental and social wellbeing of the people.

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Figure 1: Chart Showing the Organogram of State Hospital Ijaye

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Figure 2: Front View of State Hospital Ijaye, Shokenu , Ogun State

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DESCRIPTION AND OPERATING HOURS OF STATE HOSPITAL ABEOKUTA

DESCRIPTION

The general hospital caters to everyone in her capacity. The mission of the hospital is to ensure
the provision of safe, quality, adequate, equitable and, accessible health services to all people in
Nigeria.

ADDRESS

88/90, Shokenu Road, Ijaye, Erunbe, Abeokuta South, Ogun, Nigeria

OPENING HOURS

Mon12:00 am - 12:00 am

Tue12:00 am - 12:00 am

Wed12:00 am - 12:00 am

Thur12:00 am - 12:00 am

Fri12:00 am - 12:00 am

Sat12:00 am - 12:00 am

Sun12:00 am - 12:00 am

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CHAPTER TWO

2.0. ACTIVITIES CARRIED OUT AT STATE HOSPITAL SOKENU, IJAYE.

THE NUTRITION AND DIETETICS UNIT

Nutrition and Dietetics Unit in State Hospital Shokenu provides nutritional care to patients with
various disease conditions and nutritional status. Dietitian provides nutrition education in
management or prevention of disease/infections using dietary and lifestyle modifications to
attain/maintain a healthy lifestyle or specific health-related goal. This is achieved by using DIET
THERAPY.

The department of nutrition and dietetics is responsible for ensuring dietary management of
patient and rendering of voluntary counseling on roles of nutrition to the wellbeing of individual.
The department covers the kitchen section of the hospital and procurement of food and non food
materials used in the kitchen.

The nutrition and dietetics department provide nutrition care and education in acute care,
residential and rehabilitation services throughout State, including specialized inpatient and
outpatient care in the following areas:

 Diabetes
 Hypertension
 Eating Disorders
 Elder Care
 Critical care
 Cardiac/Healthy heart
 Urban Health and HIV
 Nutrition Support, including Home Enteral/Parenteral Nutrition
 Orthopedics
 Outpatient Nutrition Counseling
 Rehabilitation
 Renal

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Also, the department works with other department such as: Children Emergency unit
(CHEW/CHER), Pediatrics ward, Male surgical ward, Female Surgical ward, Male medical
ward, Female Medical ward, Surgical Out Patients (SOP), Medical Out Patients (MOP),
Orthopedics, Gynae ward, Antenatal Care (ANC) and Voluntary Counseling Unit (VCT).

CLERKING: It involves asking series of questions from the patient, to know what is wrong and
why the patients have really come. This is an interactive session between the dietician and the
patient. This is done using SOAPI PROCESS:

Subjective, Objective, Assessment, Plan, Intervention.

SUBJECTIVE: Getting as much as possible information from the patient, these include all the
details gotten from a Patient. The patient will be asked series of questions to know what is really
wrong with the patient, why he/she came to the hospital, it entails information on the age,
occupation, hours of work, activity pattern, household members, chief complaints i.e. the major
sign seen, onset of disease, treatment since diagnosis, drugs administered, previous medical
nutrition therapy and diet order, family history of disease, nutrition history, usual dietary intake,
food aversions, intolerance and allergies, does he or she Skip meals, Food preparation, Last ate,
Last drank, Difficulty chewing/swallowing, Smoke, Alcohol, Herbal concoction, Recreational
drugs, Weight loss/gain, General appearance (skin/abdomen/neurologic).

OBJECTIVE: Height, weight, BMI, Waist circumference, waist to hip ratio, blood pressure,
pulse rate, ideal body weight, daily kilo cal, carbohydrate, CHON, Fat, Daily fluid requirement,
Daily dietary fibre, Biochemical lab values of the patient will be taken.

ASSESSMENT: This is basically assessing the previous history and information obtained from
the patient. This refers to the inference gotten from the objective.

 What does the BMI Leads to? is there any recent weight loss or gain?
 Is there any recent non-fluid weight gain?
 What does the W/H leads to? What are the risk factors to that?
 What does the BP leads to? What does it indicate?
 General appearance for nutrient deficit or excess
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  What is the percentage of body fat and the health consequences?

MNT/PLAN/INTERVENTION: This is the process done in order to achieve a particular goal,

and to prevent any further complications from happening. It is the treatment for specific problem
with scientifically based treatment.

MNT contains 3 basic things, which are:

1. What to correct

2. How to correct

3. Why to correct

Intervention: This is a set of actions and activities designed with the intent of changing
nutritional related behavior risk factors, environmental factors and aspect of physical or
physiological health or nutritional status of the patient. It may include good provision of
nutritional support, education passage, counseling, food shopping, cooking skills, social
marketing, and campaign and food availability.

Reason for questioning in the subjective part of SOAPI Process.

Occupation: To know the activity pattern of the patient, to know how much he/she uses and
consumes his energy. He could be sedentary, Active, Semi active, semi sedentary.

Hours of work: To know how much the person works, the stress level.

Household members: To know the number of Children and family members. To help the
patient not to separate his/her pot from the remaining members in case the disease is hereditary.

Chief Complaint: To know what has really happened that made the patient visit the hospital. It
also gives way to ask further questions.

Onset of disease: To know when exactly the problem started.

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Treatment since diagnosis: To know if the patient has probably visited a chemist nearby for
some drugs. To avoid poly pharmacy, using a drug over and over again.

Previous diet order: To know its effect, to know if and how it has contributed to the health.

Family history of disease: To know if the disease is hereditary.

Usual dietary intake: To know what the patient eats often and often, if it’s probably a cause of
the problem.

Food allergies: To know the type of food the patient could react to, that would also help when
giving a diet order.

Smoke: To know if it could also be a cause of the problem.

KITCHEN UNIT

Kitchen is a unit under the department of nutrition and food service establishment in the hospital.
It is a place where different variety of meals are prepared and served to the patients in the
hospital.

The kitchen has various rooms;

The store where wet and dry ingredients are kept

The store where cooking utensils are kept

The head caterers’ office

The kitchen where cooking and preparations of meals are made

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EQUIPMENTS USED IN THE KITCHEN

 Gas cooker
 Spoons and other cutleries
 Pot
 Warmers/ coolers
 Refrigerators
 Chopping boards
 Plates
 Milling machines
 Bowls
 Turning sticks

TYPES OF HOSPITAL MEALS

Normal diet: This is kind of meal prepared for in-patients whose condition does not require
dietary modification. This diet is to maintain the overall health of the patients. Normal diet
prepared is essentially of high calorie with good consistency, it contains essential nutrients and
micro nutrient in adequate quantities.

Therapeutic diet: this is a diet in which some nutrients have been added or reduced for the
management of certain disease conditions. It is used by nutritionist and other health professionals
(dietitians) responsible for management of disease conditions that requires nutrition intervention.
Therapeutic diet usually modified as part of medical nutrition therapy for the sick and needy.

For the therapeutic meals; referral is been sent to the dietetics office from the ward then the
dieticians write a diet order which contains the patient’s name, ward, bed number and type of
meal to prepare. Therapeutic meals are usually prepared with natural ingredients (soybean
powder and blended crayfish). The meals are usually weighed after serving the meals for normal
diet it is usually 300g while for therapeutic diet it is usually 250g.

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MENU TIMETABLE FOR HOSPITAL DIET (NORMAL DIET)

Breakfast Lunch Dinner

Sunday Bread + flaked fish + sauce Jollof rice + meat Eko + eforiro + meat
+ tea
Monday Moinmoin + pap Amala dudu + Ewedu + Beans + stew + bread
fish
Tuesday Yam + flaked fish sauce Wheat Amala + vegetable Moinmoin + eko
soup + fish
Wednesday Bread + stew + boiled egg Eba + ewedu + fish Rice + stew + meat
Thursday Moinmoin + pap Semovita/lafun + efo Eko + eforiro + fish
elegusi + fish
Friday Yam porridge + flaked fish Amala dudu + ewedu + Beans + rice + fish
sauce fish
Saturday Moinmoin + pap Eba + eforiro + fish Stewed beans

WEEKLY THERAPEUTIC DIET (Diabetic/Hypertension)

BREAKFAST LUNCH DINNER

Sunday Wheat bread +flaked Jollof rice + meat Unsieved eko +
fish sauce + tea eforiro + meat
Monday Unpeeled moinmoin Amala dudu + ewedu Beans + stew +
+ unsieved pap + fish wheat bread
Tuesday Yam + flaked fish Wheat Amala + Unpeeled moinmoin
sauce ewedu + fish + unsieved eko
Wednesday Wheat bread + stew Semovita + ewedu + Rice + stew + meat
+ boiled egg fish
Thursday Unpeeled moinmoin Amala dudu + ewedu Unsieved eko +
+ unsieved pap + fish eforiro + fish
Friday Yam porridge + Wheat Amala + Beans + rice + fish
flaked fish sauce eforiro + fish
Saturday Unpeeled moinmoin Semovita + Stewed beans
+ pap vegetable soup + fish

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PREPARATION OF FORTIFIED PAP

Fortified pap is usually used for malnourished children to correct deficiencies and it is always
use a restart for oral feeding for recovering patient; it is nutrient dense and rich in fat, proteins
and micronutrients. Fortified pap is being prepared for patients that can metabolize heavy foods,
and infants that lacks some essential nutrients and it is a source of energy for malnourished
children. It is a fluid diet for nasal-gastric patient (patient that cannot feed with cup and spoon).
Fortified pap is given 2 hourly to the malnourished child.

INGREDIENTS USED FOR PREPARING FORTIFIED PAP

 Soya beans powder (dehulled, roasted, and milled)

 Palm oil (4 tablespoons)
 Vegetable oil (2 tablespoons)
 Pap (corn soaked, washed, milled, and fermented)
 Grinded crayfish
 Sugar
 Pinch of salt

PROCEDURE

 In a clean pot, add one and a half cup of water and boil
 In the boiled water, add soya beans and stir consistently till lumps Disappear and cook for
10 minutes
 In a clean bowl add 2 tablespoonful of pap and mix with a little water to form a paste, set
the pap aside
 In the boiling soya beans, add 4 tablespoons of palm oil and 2 tablespoons of vegetable
oil, stir and allow to cook for another 5 minutes
 Add the pap and stir consistently to avoid lumps formation
 Add sugar and a pinch of salt and continue stirring
 If thick add water to attain a lighter pap, after 5 minutes the pap is ready and can be
served to the patient.

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IMPORTANCE OF FORTIFIED PAP RECIPE

Maize: It contains carbohydrates which gives the body energy.

Soya beans: It is a good source of protein and it also aids in body building and smooth skin.

Groundnut oil: it’s a good source of fat and oil which also twice energy as much as CHO.

Palm oil: It is rich in vitamin E which is a fat soluble vitamin which also gives the body energy.

Milk: Is an animal protein which is complete in the production of red blood cell.

Sugar: It is a source of energy.

Vitamin C: It helps in the production of antibiotic and the prevention of diseases

Figure 3: Therapeutic kitchen equipment used at State Hospital Ijaye

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PEDIATRICS WARD

Pediatrics is a branch of medicine that involves the medical care of infants, children and
adolescents. Pediatricians are medical doctors who specialize in treating children from 0-
18years.

The pediatric ward in State hospital Ijaye is in ward 3 and opposite it is the neonatal ward. The
pediatric ward is where children from 0-14years are taken care of.

EQUIPMENT USED IN PAEDIATRICS WARD

 Stethoscope
 Oxygen tank
 Cannula
 Pulse oximeter
 Thermometer
 Weighing Scale
 Heightometer

FEMALE MEDICAL WARD (WARD 4)

The female medical ward is where females from age 15years and above are been treated for
various medical conditions which include; hypertension, peptic ulcer disease, chronic heart
failure, diabetes mellitus and they are been monitored by the nurses and treated by doctors.

Referrals are written by the doctors to the Nutrition and Dietetics Department which includes the
disease condition of the patient, the anthropometric measurements are taken which are weight,
pulse rate, blood pressure and blood glucose level; because the patient is still on bed all the
necessary anthropometric measurement are not taken like height, waist and hip circumference.
These measurements are taken when the patient is discharged and the patient comes to the
department for review. After taking the subjective of the patient, two diet orders are prepared for
in-patient, one comprises of all the foods and fruit allowed for the patient to consume with the

17
measurements while the second one comprise of foods available in the hospital's kitchen, this is
taken to the kitchen and the other one is kept in the patient's file. Nutrition Education is given to
the patient and the patient is being monitored accordingly to know the improvement in the
patient condition.

OBSTETRICS AND GYNAECOLOGY WARD (WARD 6)

Obstetrics and gynaecology are medical specialties that focus on two different aspects of the
female reproductive system.

Obstetrics deals with the care of pregnant women, the unborn baby, labor and delivery and the
immediate period following child birth. The Obstetrician ensures that the mother and child get
the best prenatal care to ensure labor and delivery is accomplished without complications and
that should intervention be needed, it is done quickly and safely.

Gynaecology deals with any ailment concerning the reproductive organs; uterus, fallopian tubes,
cervix, ovaries and vagina. A gynecologist may also treat related problems in the bowel, bladder
and urinary system since these are closely related to female reproductive organs.

MALE MEDICAL WARD (WARD 7)

The male medical ward is where males from age 15years and above are been treated for various
medical conditions which include; hypertension, peptic ulcer disease, chronic heart failure,
diabetes mellitus and they are been monitored by the nurses and treated by doctors.

Referrals are written by the doctors to the Nutrition and Dietetics Department which includes
the disease condition of the patient, the anthropometric measurements are taken which are
weight, pulse rate, blood pressure and blood glucose level; because the patient is still on bed all
the necessary anthropometric measurement are not taken like height, waist and hip
circumference. These measurements are taken when the patient is discharged and the patient
comes to the department for review. After taking the subjective of the patient, two diet orders are
prepared for in-patient, one comprises of all the foods and fruit allowed for the patient to
consume with the measurements while the second one comprise of foods available in the
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hospital's kitchen, this is taken to the kitchen and the other one is kept in the patient's file.
Nutrition Education is given to the patient and the patient is being monitored accordingly to
know the improvement in the patient condition.

CHILDREN EMERGENCY AND OUT-PATIENT CLINIC

This department deals majorly with emergency case and out-patient children care. The out-
patient are patient that are not admitted to the ward but come from their homes to receive
treatment. The department treats children from age 0-14years of age. Any patient above 14years
of age is referred to the General Out-Patient Department (GOPD). This department attends to
out-patients from 8:00am-3:00pm. The patient are expected to retrieve their files from the record
unit then they bring it to the units where the nurses on duty check their vitals which include;
weight, temperature, pulse rate, MUAC (mid upper arm circumference) and saturated oxygen
level or blood oxygen level these vitals are been clerked into their case files and the files are
taken to the doctor who will assess the patients.

This department also attend to emergency cases and they provide treatments for a wide range of
illnesses and diseases, some of which requires immediate attention to help stabilize the patient
before they are then sent to the pediatrics department where the management is continued.

VITAL SIGNS

Vital signs are measurements of the body’s most basic functions; they are useful in monitoring
medical problems. The primary vital signs include; temperature, weight, height, pulse rate, blood
oxygen level or saturated oxygen level, MUAC, head and chest circumference etc.

TOOLS USED IN CHILDREN EMERGENCY WARD AND THEIR USES

1. MUAC TAPE: mid upper arm circumference tape is used to determine whether or not a child
is malnourished using a simple colored strip. It is used on children from age of 6 months up to 59
months. A measurement in the green zone means the child is properly nourished, a measurement

19
in the yellow zone means the child is at risk of malnutrition, a measurement in the red zone
means the child is malnourished.

2. THERMOMETER: thermometer is used to measure the degree of hotness or coldness of a

body. It is used to detect if someone has fever or not.

3. BATHROOM WEIGHING SCALE: bathroom weighing scale is used to measure the

weight of human being. It is used to measure the weight of grown up kids in the children
emergency ward.

4. INFANT WEIGHING SCALE: Infant weighing scale is used to measure the weight of
newly born and children up to the age of 3 years.

5. STETHOSCOPE: is an instrument used for auscultation, or listening to sounds produced by

the body, it is used primarily to listen to the lungs, heart and intestinal tract. It is also used to
listen to blood flow in peripheral vessels and heart sounds of fetus in pregnant women.

6. PULSE OXIMETER: is an instrument used to measure the pulse rate which is the number of
heart beats per minute, and it is also used to measure the oxygen level.

For children the average SpO2 (saturated oxygen level) is 94%-100%. Anything less is called
HYPOXEMIA which indicates a severe medical problem.

PULSE RATE WITH AGE

PULSE RATE BY AGE NORMAL PULSE RATE

<28days 100-205
1 month- 1year 100-109
1year-2years 98-140
2years-5years 80-120
6years-11years 75-118
12years-Adult 60-100
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COMMON DISEASES FOUND IN THE CHILDREN EMERGENCY WARD

1. MALARIA

It is a life threatening mosquito borne disease caused by plasmodium parasite. It is transmitted

through the bite of an infected anopheles mosquito.

Malaria causes fever, fatigue, vomiting, and headache. Symptoms begin 10-15 days after being
bitten by an infected mosquito.

The use of mosquito net, insect repellant, and mosquito control can be used to prevent malaria

Malaria affects about 5% of the whole population but plasmodium falcipurum causes a nearly all
the death and neurological complications. Severe malaria occurs in patient with little or no
immunity.

2. MALNUTRITION

Malnutrition is the excessive or inadequate intake of dietary energy. It encompasses both over
nutrition, associated with overweight and obesity, and under nutrition, referring to multiple
conditions including acute and chronic malnutrition and micronutrient deficiencies. Malnutrition
is a condition that results from eating a diet in which one or more nutrients are not enough or too
much such that the diet causes health problems. It may involve calories, protein, carbohydrates,
vitamins or minerals. Not enough nutrients is called under nutrition or undernourishment while
too much is called over nutrition. Malnutrition is often used to specifically refer to under
nutrition where an individual is not getting enough calories, protein, or micronutrients. If under
nutrition occurs during pregnancy, or before two years of age, it may result in permanent
problems with physical and mental development.

In the children emergency ward the most common case of malnutrition are those that involve the
lack of adequate nourishment. Malnutrition in this forms include; wasting, stunting, and
underweight. There are 2 major types of malnutrition; protein energy malnutrition/ severe acute
21
malnutrition and micronutrient deficiency. Children who are malnourished often possess the
following symptoms and sign:

 Fatigue
 Weight loss
 Failure to thrive
 Short stature
 Slow growth
 Muscle weakness
 Distended abdomen
 Edema

ANTENATAL CLINIC

Prenatal care, also known as antenatal care, is a type of preventive health care. The antenatal
clinic in the hospital is the unit where pregnant women receive care from health care
professionals before, during and after pregnancy. The antenatal clinic is majorly made up the
gynecology clinic, the antenatal, postnatal, infant welfare clinic and the crèche and these
different units’ functions on different days of the week.

In the antenatal unit, pregnant women and expectant mothers are expected to register with the
clinic in order to be able to receive antenatal care from the health care givers. They register and
are usually given a form or card which consists of their surname, names, residential address and
phone number, number of children in the past, occupation, religion, numbers of children alive
and dead. This is for the Dietitian/Clinical Nutritionist or doctor to determine if there is/are
history of miscarriage(s) or stillbirth(s) so as to discover what could have been the cause and
know what to plan nutritionally and medically to prevent such from happening again.

Activities carried out at the clinic include:

 Monday - Gynaecology clinic.

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  Tuesday - Booking of new patients to the clinic.
 Wednesday - Infant welfare clinic and preparation of complementary diet.
 Thursday - Revisit of pregnant women and heart palpitation.
 Friday - Revisit of pregnant women.

The pregnant women are also usually given laboratory form to carry some tests and are to come
back to see the doctor with the laboratory results after the tests have been conducted. During
their subsequent visits to the clinic, their medical checkups are mostly based on the following:

Examination of laboratory results - This include the fasting blood sugar level and HbA1c to be
sure gestational diabetes mellitus is not present, levels of protein in urine to be sure of
proteinuria, a clinical manifestation of pre-eclampsia is not present.

Examination of blood pressure - High blood pressure during pregnancy may indicate pre-
eclampsia. So regular check-up of blood pressure is done on every clinic visit so as to quickly
correct the condition and prevent further complications.

Physical examination - The doctors also examine some parts of the body such as the heart, with
a stethoscope if there are any abnormalities in breathing or the heart rate, the skin for presence of
moles and other skin spots and also the extremities such as the hands, feet and face if swelling
(edema) is present.

Checking of weight - This is performed using a stadiometer. On every clinic days, weights of
the expectant mothers are measured.

MONITORING BABY'S GROWTH.

There are several ways by which a baby's growth can be measured

MUAC TAPE

Mid upper arm circumference can help to monitor a baby's growth. The measurement is taken by
Firstly locating the middle of the upper arm baby; it can be taken on any of the arms. Then there
smaller part is inserted through the slit where the tape is wrapped around the baby's arm and the
23
reading is taken through the cut out on the white region of the tape. The calibrations on the tape
are divided into 3 zones.

 red zone which signifies SEVERE MALNUTRITION) (6-11cm) cm)

 Yellow zone which signifies MODERATE MALNUTRITION (12cm)
 Green zone which signifies NORMAL (13-26cm)

This MUAC tape can be used for babies between 6months to 59 months.

Figure 4: Muac tape

CHILD HEALTH CARDS

This card contains a growth monitoring graph of age plotted against weight and their
corresponding weights for different ages The baby is weighed with the aid of weighing scale and
then the chart is used to check to if the baby’s weight is corresponding with the age.

PHYSIOTHERAPY UNIT

This Unit handles patients with disabilities, and works to mitigate physical disabilities,
dependency and functional deterioration. It provides high-quality physical rehabilitation and
treatment to all patients.

INFRARED LAMP

This equipment is used at the physiotherapy unit because they are effective to warm the skin for
fast and efficient healing.

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Figure 5: Infrared lamp

2.2. WORK/ASSIGNMENT CARRIED OUT DURING SIWES

During my IT at the state hospital ijaiye, I worked at different sections of the hospital ranging
from the nutrition and dietetics unit, the kitchen unit, pediatrics unit, children emergency unit,
antenatal and postnatal unit, gynaecology and obstetrics unit, male medical unit, female medical
and surgical unit and this has broaden my knowledge about nutrition and dietetics as a whole.

AT NUTRITION AND DIETETICS UNIT

At the nutrition and dietetics unit clinical consultation, patient’s reviews, and patient’s
assessments are being carried out.

 I was orientated by the HOD and made to know the equipment used in the department
such as: Stadiometer/heightometer, sphygmomanometer, and different type of diet
sheets.
 I was taught the nutritional content and facts of food, nutritional guidelines for each diet
and also the complimentary feeds.
 I attend to patients that come for consultation or reviews of different diet related disease
by carrying out the objectives, clinical assessment of the patients such as the BMI, IBW
and other Anthropometry method.
 I gave health talk at the General out-patients clinic on “Diabetics mellitus"
 I also worked alongside other trainees when it comes to food preparation and service and
diet management.
 I retrieved cards and files for various patients at the record department
25
AT THE KITCHEN UNIT

 I assisted the cooks in preparation of food for the in-patient

 I helped the weighing of food prepared
 I prepared fortified gruel
 I was taught the different types of diets which are: ordinary diet, low salt diet, fat free
diet,low protein diet etc

AT THE PEDIATRICS UNIT:

 I did ward-rounds with the doctors

 I had a case of childhood tetanus being referred to my department.

AT THE ANTENATAL UNIT:

 I took the anthropometric measurements of pregnant women.

 I took the anthropometric measurements of infants.
 I went into the consulting room with the doctor in which I learnt on case relating to
nutrition such as pre-eclampsia,ananchephalis,iron deficiency anemia e.t.c

AT THE CHILDREN EMERGENCY WARD:

 I took the anthropometric measurement and vitals (SPO2,Pulse rate, temperature) of

children
 I also recorded the vitals and anthropometric measurement taken.
 I also went into the doctor consulting room, I learnt the procedures and diseases that
affect infant and children and also their nutritional intervention. I was enlightened on how
I can give out some treatment for the mal-nourished baby which are as follows:

 Dietary changes such as: eating foods high in energy and nutrients

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  Support for family to help manage factors affecting the child’s nutritional intake
 Treatment of any underlying medical conditions causing mal-nutrition
 I also assisted the nurses whenever emergency cases are being brought in.

AT THE GYNAECOLOGY AND OBSTETRICS UNIT:

 I went through case files at this unit to get familiar with nutritional problems related to
pregnancy i.e. gestation diabetics, Hypertension in pregnancy e.t.c.
 I followed the doctors on ward round in which I learnt so many things i.e. pre-eclampsia
and how it affects pregnancy, previous pregnancy condition and their effect/manifestation
on present pregnancy.

AT MALE MEDICAL WARD:

 I had a case of a patient who has DM with foot ulcer, consultation and reviews was done
by me.
 I went on ward round with the doctor.

AT THE FEMALE MEDICAL WARD:

 I had an interactive talk with the nurses on diabetics

 I went on ward round with the doctors.

2.2. LIST AND USES OF INSTRUMENTS/MATERIALS USED IN THE DEPARTMENT

(N.U.D)

1. STANDIOMETER: It is an instrument used for measuring the height and weight. It is

usually constructed out of a ruler and a sliding horizontal headpiece which is adjusted to rest on
the top of the head. The calibration is on 0.5m.Before measuring the height; the upper part must
be pulled up before the latter are pulled to ensure the right readings.
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Figure 6: A Stadiometer

2. SPHYGMOMANOMETER: This is an instrument used to measure/determine the blood

pressure of an individual.

Figure 7: A Sphygmomanometer

3. MUAC Tape: It is used for taking the mid upper arm circumference of children less than
5years old.

Figure 8: Muac tape

4. Measuring tape: It is used in taking waist circumference (WC), hip circumference (HC). For
children(less than 5 years old), it is used in taking head circumference (HC), chest circumference
(CC), and length.

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Figure 9: A tape rule

5. Diet sheets: It contains a list of food items and dietary lifestyle modified based on the
patient’s condition and the dietary goal the nutritionist/dietitian wants to achieve to improve the
nutrition status of the patient(s). It is written in both Yoruba and English language for patient’s
preference

6. SOAPI Sheet: It is a sheet that contains information about the patient.

7. Referral note: This is a note issued by Doctors to Dietitians indicating patient's disease
condition (both in- patients or out-patients referral)

8. Follow-up note: This is issued by the Dietitian, and to be brought to the unit by the patient on
next appointment. It is written with the diet sheet. It contains the date of next appointment.

9. Receipt: This is an indication that patient has paid and can be attended to in the unit. Patient
will be given a tag from the unit indicating the amount to be paid (500naira). Payment is made at
the accounting unit and 2receipts are issued to the patient which one will be returned to the unit.

10. The pulse rate: This refers to the number of time the hearts beats per minute.

How to read;

 Try to locate the radial artery at the wrist

 Start the stop watch
 Place your first finger or your thumb on the patient wrist
 Begin to count per seconds.

The count per seconds is the number of time the heart beats per minute.

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Figure 10: A doctor checking pulse rate of a patient

11. Daily Kilocalorie: This is decided based on the following

 A patient’s body mass index (BMI)

 The diagnosis of a patient
 Basal metabolic rate i.e. energy expenditure when at rest
 Activity level i.e. sedentary, semi-active, Active

Daily Kcal = Activity level x Ideal body weight

12. Daily fluid requirement: normal fluid requirement is 4 liters per day but during dry season,
the body needs more fluid to avoid dehydration, so therefore; 5 liters per day, except in cases of
water retention; fluid output + 1.5L

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 CHAPTER THREE

3.0. EXPERIENCE GAINED

Working at the Nutrition and Dietetics department as a student trainee at State Hospital Shokenu,
Abeokuta has given me the opportunity of getting a firsthand appreciation of Nutritional terms,
Diet management, learning its fundamentals, learning to work with various equipment used in
Nutritional Assessment and also acquiring skills in diet formulation.

I was able to apply some of the theoretical knowledge gained during my study at the university
to real work situations thereby bridging the gap between school work and actual practice. I also
gained experience in other fields of science, and diet management.

I learnt invaluable lessons on the code of conduct of big firms and it prepared me for work
scenarios I am likely to meet after graduation.

Personally, one of the most important skills I gained during the course of my SIWES was
communication skills within the establishment. At the department I also had to relate with other
senior trainees in order to gain more knowledge about what the course is all about.

My general experiences during the course of my SIWES are as follows:

 I was able to grasp adequate knowledge and understanding regarding nutritional

assessment and diet management.

31
 During the period of my SIWES I’ve been able to know what Nutrition and Dietetics is as
a course both the theory and practical aspects of the course
 I was taught the different types of diets which are: ordinary diet, low salt, fat free, low
protein.
 I learnt that variety of fiber containing foods such as: wheat, much fruits and vegetables
are prepared and recommended for diabetic patients. Intake of carbohydrate is reduced.
 I learnt that food which contains high carbohydrates increases the level of sugar in the
body which can result to diabetes. Much intake of white bread, rice, sugar sweetened
beverages etc.
 I was able to grasp knowledge concerning the dietary management of diabetes.
 I learnt how to carry out clinical assessment using anthropometry methods.
 I learnt about the nutritional facts of food, nutritional guidelines for each diet.
 I learnt how to take the vital signs of a patient e.g pulse rate, respiratory rates,SPO2 e.t.c

32
 CHAPTER FOUR

4.0. CONCLUSION

This report has been able to give account of the entire work experience gathered by me in State
Hospital, Shokenu, Ijaye, Abeokuta during my SIWES program, which is a core scheme in ITF
and which is saddled with the responsibility of strengthening the effective teaching and learning
of skill based course such as Nutrition and Dietetics. The Student Work Industrial Experience
Programme is a praiseworthy scheme which has offered me the opportunity to apply practical
experience to the theoretical knowledge I have been taught in the school.

33
I therefore conclude that SIWES is of great benefit to students in tertiary institutions. It therefore
implies that the proper and effective administration of SIWES will go a long way in boosting and
enhancing the competencies of the workforce of the country. I also concluded that SIWES is
confronted with series of challenges and this may have hindered the realization of the goals and
objectives of the scheme and it therefore needs to be given attention by all concerned
stakeholders. The relationship between catering and nutrition and dietetics is that we supervise
the preparation and service of food, develop modified diet, participate in research, and educate
individuals and groups on good nutritional habits. Also, my general relationship with people and
also work ethics has increased greatly. The knowledge acquired in the clinical settings has
greatly impacted my appreciation to the clinical world. The whole experience has been
worthwhile and beneficial.

CHALLENGES

-Long working hours

-challenges with other medical teams i.e. Nurses, Doctors e.t.c

- Financial difficulties

-Transportation difficulties

4.1. RECOMMENDATION

In view of the relevance of the SIWES program, it is important that it is sustained by the
government through the Industrial Training Fund (ITF) as it exposes the student to work tools,
facilities, and equipment that may not be available in their respective institutions in relation to
their course of study.

To this end, I recommend that the following under-listed points should be implemented:

34
  The hospital management should ensure regular maintenance and provision of all
equipment and machinery to enable student on industrial training carry out their practical
effectively.
 The ITF should partner with some companies where they will take up students for
industrial training. This will help student who find it difficult to find an attachment or
who end up in companies where they do nothing.
 It will be of great benefit if the institution can create a platform whereby student can
obtain pre-Siwes knowledge or excursion programs, before student embark for general 4
months industrial training programme.
 They should provide means of transportation and make sure they pay the industrial
training students.
 The establishment should put in place all the necessary facilities needed to enhance the
knowledge of the student in industrial attachment.
 Regular disbursement or payment of the student’s allowance to enable most students
participates effectively in all the activities of SIWES.
 The SIWES operators need to beef up their strategies to enable the program function
effectively so that the students being served can optimally gain experience of work to
enable them adjust properly to the work of paid employment.
 Lastly, Students’ Industrial Works Experience Scheme (SIWES) needs to be strengthened
by all concerned stakeholder in order for its objectives to be fully realized.

4.2. REFERENCE

Ojeleye, J. O. (1994) The Effect of Co-Operative Learning on Students Academic Achievement

in Biology in Senior Secondary Schools in Nigeria. Unpublished PhD. Thesis, Obafemi

Awolowo University Ile-IfeOlaiya .S. (1998) Training for Industrial Development in

35
 Nigeria.

Oladeji, S. (2000). An Evaluative Study of The Centre for External Studies University of Ibadan,

Ibadan Nigeria. 1988-1998. Unpublished PhD Thesis, University of Ibadan,

Ibadan.Yabani, D. (1980) “Manpower Development in Nigeria” vol 16 (5) 35.

Yusuf, T. A. (1998). Integration of Training Programmes Towards Effective Training Skills in

some Segments of the Nigerian Armed Forces. Unpublished PhD. Thesis: University of

Ibadan,Ibadan.

Dikko. M. (1978). The Needs for the Steps to Closer-cooperation between industries and higher

Institutions in Nigeria’. A paper presented at the University of Ilorin, Ilorin Workshop of

Scientific Research and Nigerian Industries’ P. 4-6.

Enemali, I. D. (2004) “Youth Empowerment in Nigeria through Technical/Technological

Education” Tradev Journal of Training and Development 5 (1) 7-11ITF (1990) Annual

Report Produced by Corporate Affairs Department, ITF, Jos P. 5-8

APPENDIX

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37
Figure 11: Pictures (a, b) showing my Health Talk at General Out-patient
Department in State Hospital Ijaye

38