I have been in my post for more than a year and have learned a range of skills to help service users with eating disorders. Lately I’ve been working in an area that it is unfamiliar to me, being 15 miles away from where my job is based. This has involved getting lost a few times, and being rescued by sat nav.

I visit several women today, all of whom have long-term eating disorders. Their days are spent avoiding situations where they will be expected to eat so they become isolated. At lunchtime, I go for a meal with a client. Before leaving, we talk about what she will eat and how she will feel about going into a café.The client spends a considerable time choosing something and when she settles on a tuna [no mayo] sandwich she cannot face more than a few mouthfuls before she starts to change the subject, in the hope that I will not notice that she hasn’t finished her sandwich. I spend the rest of the time with her talking about strategies for coping in similar situations.

I have a meeting in a local team office about my role. People are interested in my work. Following this meeting I have an appointment with a client whoexplains how she is unable to eat anything except a few sweets and drink lots of tea. I look at plans she has agreed with her dietician, that indicate she is to have a bowl of cereal every day. We discuss what prevents her from managing this. She talks about her perception of herself as being fat and her fear of bingeing once she starts eating more. She says she would rather restrict her intake.

I spend the whole morning going around a ward finding out how the patients are managing to eat three meals a day as well as two snacks and some drinks. Joining me is a therapist and a dietician. Everyone’s input is taken into account when a patient is discussed. In the afternoon, I visit a client who spends a large part of her day bingeing and then vomiting food that she purchases every morning. I discuss with her the need for her to look at organising her day to include outside activities that do not revolve around food.

A colleague tells me how a former client of mine is managing after her long stay in a semiindependent unit. She appears to be eating well and her health is fine. I spend the afternoon on record keeping and catching up with colleagues to discuss clients. The final meeting of the day is with a client who needs to be admitted to hospital as her weight is very low. She tries to dissuade me from recommending admission and tells me how much she has eaten that week. But her weight still falls.

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