Specialty Dietitian – Renal

Job description

Job responsibilities

CLINICAL

To work as part of a team of renal dietitians and as an integral member of the multidisciplinary team so as to ensure a holistic approach to patient care. This involves attending regular MDT HD meetings and team meetings. Liaising with Consultant Nephrologists, Transplant Surgeons, haemodialysis nursing teams, peritoneal dialysis specialist nurses, renal care managers, bone mineral specialist nurses, pre dialysis nurses, clinical renal specialist pharmacists, housekeeping and nursing staff.

Organise own workload: prioritising and balancing patient-related and professional demands and contributing to the effectiveness of the renal team.

To judge and determine the appropriateness of referrals made by members of the multidisciplinary team in order to ensure effective use of time and resources.

Assess patients diagnosis, medical care and biochemistry making decisions as to who needs dietary management.

Obtain and analyse relevant information from different sources including: clinicians medical notes, nursing notes, the client, ward staff and/or carers, in order to make a comprehensive assessment of the patients condition, prognosis and treatment plans so that a decision on the most appropriate dietetic treatment to support this can be made in the short and long term.

Interpret and monitor biochemical data generally and specifically in renal disease.

Assess patients nutritional status by calculating macro and micronutrient intake and then carry out a nutritional assessment by using tools such as Subjective Global Assessment, anthropometrics (use of dynamometer to assess handgrip strength) and physical signs of deficiency.

Calculate nutritional requirements using specific assessment tools and calculations. To remain up to date with the literature and ensure that this is an evidence based process and clinically relevant to the renal or critically ill acute renal and transplant patient group.

Advise on appropriate artificial feeding routes for renal patients with the particular complexity of renal biochemistry and fluid restrictions.

Formulate individualised patient care plans, artificial feeding regimens, taking into consideration factors which may affect requirements or help/hinder provision of nutrition support such as: prescribed drugs, biochemical derangements etc. Within the care plan this would include nutritional supplements, specialist feeds, need for added micronutrients.

Evaluate the effectiveness of nutritional goals and modify these goals and care plans as necessary based on ongoing analysis, assessment of information available and changing patient needs.

Address and monitor their changing nutritional needs over the course of their disease and advise other members of the multidisciplinary team.

Be involved in discharge planning of renal patients to other facilities e.g. nursing home, community hospital, and district general hospitals both within and outside of Oxfordshire. Advising members of staff - nursing, dietetic and catering staff on dietary modifications and how this can be achieved within the constraints of their facilities. This includes those discharged into GP and District Nurses care.

Modify dietary advice according to biochemistry, lifestyle, treatment being undertaken, drugs and associated medical conditions adding to complexity of dietetic management.

Advise on initiation and titration of certain medicines used within renal medicine for example phosphate binding agents.

Translate the science of nutrition into everyday foods within renal medical requirements.

Use communication techniques i.e. behavioural change and motivational interviewing to work with the patient to adapt their diet.

Communicate effectively and sensitively with patients, carers and other health professionals. Skills of persuasion, motivation, explanation and gaining consent may be used in a wide variety of different, sometimes sensitive, situations. It is important to be able to communicate complex information at an appropriate level. Barriers to communication may be evident e.g. loss of sight, loss of hearing, lack of English, both written and spoken, requiring the use of translators.

Deal with patients with chronic conditions and those with poor outcomes/terminal conditions.

To be sensitive to the religious and ethnic needs of patients' dietary requirements and have an understanding of foods eaten by multicultural populations and how they impact on hospital catering.

Calculate nutritional composition of convenience/social services meals and advising on suitable choices for renal medical needs.

To be actively involved with the development of evidence based, trust-wide guidelines - to be a resource to other dietitians as specialist renal practitioners, writing and compiling diet sheets, protocols and advice.

To cover for other dietitians when sickness or leave necessitates.

PROFESSIONAL

Be accountable for own actions within the professional, ethical and legal framework for dietetics set out in the Health and Care Profession Councils code of practice for Dietitians and the British Dietetic Associations professional standards for Dietitians.

To take responsibility for own continuing professional development and providing evidence for this by maintaining a CPD portfolio. CPD involves critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

Participate in annual appraisal, identifying own developmental and training needs and setting personal developmental objectives.

To participate in departmental and renal team audits in order to monitor and evaluate whether local/national/international standards are being met and make recommendations for change. To be involved with the planning of departmental clinical effectiveness and audit strategies.

Actively contribute to the dietetic student training program, facilitating the development of skills and knowledge, being involved in the assessment process and acting as a mentor to students.

To provide specialist advice, teaching and training to all members of the multidisciplinary team, regarding the nutritional management of patients, particularly renal patients. This involves participation in in-house training courses e.g. new staff nurses orientation program and advanced nursing courses. Also to participate in external training/teaching when requested.

To have a detailed understanding of medical conditions/drugs and nutritional implications.

To take the lead on corporate departmental projects.

ORGANISATIONAL

To determine priorities for own work area based on clinical need and balance patient caseload with professional demands.

To collect data as required by the department, trust and outside agencies.

To maintain accurate and up to date documentation of patient interventions on electronic records. To communicate dietetic interventions to appropriate members of the multidisciplinary team by documentation within nursing/medical notes or by means of generating a letter/report.

Person Specification

Qualifications

Essential

• Registration as a Dietitian with HCPC
• BSc (Hons) Nutrition / Dietetics degree or post graduate diploma or equivalent

Desirable

• Evidence of a range of CPD activities

Experience

Essential

• Demonstrates knowledge, skills and experience of a wide range of clinical areas
• Experience of working as part of a multidisciplinary team.

Personal Skills

Essential

• Excellent oral and written communication skills.

Desirable

• Teaching & training skills

Behavioural Skills

Essential

• Able to set priorities and manage own time.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Oxford University Hospitals NHS Foundation Trust

Address

Churchill Hospital

Old Road

Headington, Oxford

OX3 7LE

Employer's website

https://www.ouh.nhs.uk/ (Opens in a new tab)