Specialist Dietitian Nutrition Support Team

Job responsibilities

Job Summary

You will be required to provide specialist dietetic advice on the nutritional management of complex patients requiring nutrition support. You will be required to work as a team to help manage all aspects of nutritional input for these patients and manage a highly specialised caseload of patients including those requiring parenteral nutrition, and those with complex enteral feeding needs. You will work as a core member of the multidisciplinary Nutrition Support Team. The nutrition support team service includes both inpatients and outpatients.

You will act as a specialist adviser and educator to other health care professionals including dietetic colleagues regarding nutrition support.

Key Responsibilities:

Clinical

• The post holder will be an autonomous practitioner working with other members of the multi-professional team to provide a specialist dietetic service to patients, carers and health professionals by:
• Holistically assess patient suitability for artificial nutritional support including parenteral and enteral nutrition. Counsel patients/carers with regards to explanation of procedure, quality of life issues, training requirements, support available and complications associated with treatment.
• Carry out nutritional assessment to determine nutritional status and dietetic intervention.
• Provide dietetic support for complex patients discussed at any nutrition support team MDT meeting (e.g., PEG MDT).
• To act as a source of expertise on nutrition support (including parenteral and enteral feeding) and the nutritional implications of complex gastrointestinal disorders, advising and supporting other members of the multidisciplinary team and other health / care workers as appropriate, helping those who are in a position to provide nutritional advice and influence practices within the specialty, aiming to give accurate consistent nutritional messages to clients.
• Promote patient autonomy through education and support allowing the individual to make informed choices about their own care.
• To assess, develop, implement and evaluate programmes of care, co-ordinating the holistic needs of the patients.
• To provide continuity of care for ward discharges and act as a point of contact for patients.
• The post holder will work with other members of the nutrition support team undertaking regular nutrition ward rounds, as well as independent assessment of patients on parenteral or enteral feeding as required.
• Communicate complex and sensitive information to families in partnership with the multidisciplinary team regarding end-of-life artificial nutrition related issues.
• To report any untoward incidents / accidents to Lead Nutrition CNS and complete Datix incidents when required.
• To be aware of current nutrition related stock levels to ensure adequate supplies and act accordingly considering budgetary impact.
• To support with developing the Nutrition Champions network across the trust.
• Demonstrate excellent communication and interpersonal skills.
• Liaise with tertiary centres for parenteral feeding and intestinal failure to facilitate timely transfers and appropriate hand over.

Clinical Governance

• Promote best practice in health, safety and security.
• Contribute to quality improvement.
• To ensure procedures are implemented and maintained in accordance with the Policies of the Worcestershire Acute Hospitals NHS Trust.
• To ensure good standards of practice in nutrition across the trust through effective quality assurance measures such as clinical audit programmes.
• To monitor the safe and effective use of all equipment and the economic use of supplies, ordering replacement equipment together with maintenance of that equipment.
• Assist in the development, implementation and monitoring of nutrition policies and procedures ensuring that they reflect current, evidence-based practice and national guidance where relevant eg, BAPEN.
• Review incidents in relation to artificial nutrition support
• Ensure that changes in practice are shared across the trust and embedded in practice.
• Support attendance at Nutrition & Hydration Steering Group and other governance meetings when required.
• Assist in the formulation of an annual report related to the service, circulating and presenting it widely and appropriately to key stakeholders.
• Education and Development
• Train and promote safe practices, for example identifying and managing patients at risk of Refeeding syndrome.
• Provide support and training for students on placement with the nutrition support team.
• To participate in the implementation and delivery of in-house nutrition related education programmes for nurses, doctors and other members of the multidisciplinary team.
• Work alongside the team to develop evidence based written resources, policies and guidelines to promote safe effective care within the speciality.
• Maintain own professional development which reflects service needs to achieve and sustain expertise for the post.
• Reflect on own practice through clinical supervision/mentorship and to act as a clinical supervisor/mentor to others
• To attend and contribute to appropriate specialist interest groups for example BDA Specialist Groups and BAPEN.
• Ensure compliance with regard to mandatory training and HCPC requirements.

Research and Audit

• Critically analyse and evaluate research and developments within the speciality and collaborate with other members of the nutrition support team to identify areas of practice within the trust that would benefit from audit and research accordingly.
• Contribute to and develop protocols and lead individual projects as requested by the Lead Nutrition Nurse Specialist in monitoring the quality of the service.
• Develop and participate in clinical audit relevant to the speciality, comply reports and present findings to the multidisciplinary team.
• Implement changes in clinical practice to improve health outcomes.
• To be competent in the use of information technology including the formulation of databases for audit and research purposes.
• Maintain own awareness of relevant research evidence related to the speciality and work with others in applying this to practice.

Leadership

• To provide a leadership role model and demonstrate expert knowledge and high standards of clinical practice.
• Use effect prioritisation, problem solving and delegation skills to manage time and promote an effective service.
• Constructively challenge if care falls short of the standards expected or may not be in the best interest of the patient.
• To develop and maintain a network of contacts involved in the management of patients artificially fed across the trust and outside the organisation.
• Work alongside local and national networks and partnerships promoting and disseminating evidence of service development.
• Continuously assess and monitor risks to safety and quality and challenge others actions and decisions when they put patients and others at risk, taking the necessary action to escalate concerns
• Inspire colleagues to improve standards and quality, encouraging them to seek advice and solutions to problems.
• Identify gaps in service provision and discuss steps to manage any identified problem areas with the Lead Nutrition Nurse Specialist.
• To contribute to the development of strategies, protocols and policies that impact on the future service provisions and care in line with national policy.
• Contribute to the Trust agenda in the Nutrition and Hydration Steering Committee.
• Assist in establishing effective working relationships in all Divisions and with all clinical teams.
• Provide professional leadership and act as a role model within the clinical setting, demonstrating specialist knowledge and high standards of clinical practice.

Practice and Service Development

• Assist the Lead Nutritional Clinical Nurse Specialist in the development of new initiatives to improve patient experience.
• Assist the Lead Nutritional Clinical Nurse Specialist in adopting innovative clinical practices to improve patient care.
• Actively participate in local and national forums (e.g. BDA/BAPEN) and disseminate information to the Trust Nutrition and Hydration Steering Committee.
• Learn from patient feedback to improve services and reduce complaints.
• Work as part of the multidisciplinary nutrition support team and attend both the inpatient nutrition ward rounds and the nutrition support team MDTs.

Professional

• To maintain Health Care Professions Council (HCPC) registration, adhering to the Standards of Conduct Performance and Ethics.
• To maintain own competency to practice through CPD activities demonstrating awareness of new developments and their incorporation into practice as necessary.
• To work within the British Dietetic Association (BDA) code of conduct.
• To maintain a professional attitude at all times.
• To promote a positive attitude for the profession and the Trust within which you are working.
• To be aware of personal and professional development.
• To attend courses and conferences as appropriate to the service and individual development.
• To be conversant and comply with Trust Policies and regulations, and attend compulsory lectures as instructed.
• Participate in research projects where appropriate, reporting findings within a multi-disciplinary framework.
• Maintain accurate, contemporaneous, confidential and timely patient records ensuring that all patient documentation (both written and electronic) adheres to Trust Standards.
• Critically review and reflect on own clinical practice, identifying areas where new, expanded skills may be learnt to improve the patient pathway specific to the nutrition support team.

Personal Qualities

Essential

• Autonomous practitioner.
• Ability to recognise own professional limitations and when to seek advice from senior colleagues.
• Ability to remain calm & in control during busy phases
• Willing to lead change.
• Able to work single handedly.
• Excellent team player.
• Self-motivated.
• Interested in the recruitment and selection process of staff.
• Relates well to staff and patients.
• Caring attitude and empathy.
• Professional attitude to routine/non-routine tasks.
• Desire to deliver a high-quality service.

Desirable

• Ability to identify personal development needs
• Experience of handling difficult & sensitive situations well

Experience

Essential

• Significant post-graduation experience in the NHS.
• Experience of developing a clinical service
• Experience of working in specialist areas as part of a team.
• Experience of implementing evidence-based practice for continuous service improvement.
• Experience of teaching students and healthcare professionals.
• Experience in implementing clinical governance.
• Evidence of active participation in audit.

Desirable

• Participation in clinical research.
• Experience of supervising staff.
• Experience of appraising others.
• Effective team leader able to assume leadership responsibilities.

Planning & Organising Skills

Essential

• Able to prioritise workload and meet clinical needs of patients.
• Able to demonstrate excellent personal organisational skills.
• Able to act on own initiative.
• Able to work to time schedules to meet deadlines.
• Able to work effectively in a multi-professional team.
• Ability to deal with frequent interruptions through the day.

Qualifications

Essential

• Degree in Nutrition & Dietetics or equivalent qualifications in Dietetics.
• Registered Dietitian recognised by the HCPC.
• Wide range of CPD activities related to specialist area of dietetics.
• Educated to Masters level or equivalent level of knowledge and experience

Desirable

• Member of the British Dietetic Association.
• Attendance on clinical educators programme.
• Attendance on relevant accredited courses.
• Member of appropriate specialist group

Knowledge and Skills

Essential

• Sound clinical knowledge in a specialist clinical area.
• Excellent interpersonal skills including observation, listening and empathy skills.
• Evidence of excellent verbal communication skills including active listening skills.
• Evidence of dealing with sensitive communication issues and barriers to communication.
• Evidence of excellent written skills.
• Evidence of communication skills of empowerment and dealing with barriers to change.
• Evidence of clinical reasoning skills relating to working with complexities.
• Able to research evidence-based practice and apply to practice.
• Ability to train students to graduate level.
• Excellent presentation skills.
• Evidence of training professionals in formal and informal settings.
• Ability to hold group patient education sessions.
• Evidence of effective multidisciplinary team working.
• Evidence of dealing with situations when individuals show anxiety, anger, emotional distress.
• Evidence of delivering a high-quality patient-centred service.
• Highly developed problem-solving skills.
• Ability to maintain patient confidentiality.
• Excellent computer literacy skills: email, data input, internet, Microsoft Word, PowerPoint, Excel.

Analytical & Judgement Skills

Essential

• Ability to assess individuals with complex medical problems and to plan their dietetic care.
• Ability to make decision regarding change of practice based on clinical evidence and disseminate same to other health professionals.
• Ability to set, monitor and evaluate standards of dietetic care.
• Ability to interpret clinical statistics data results to plan future service needs.
• Aware of legal responsibilities.
• Ability to deal with complaints from patients.
• Ability to deal with staff capability and disciplinary issues.
• Ability to write a report.

Other Job Requirements

Essential

• Professional appearance.
• Ability to work flexibly to cover service needs.
• Ability to work occasional evenings and weekends.
• Able to travel to other hospital sites.
• Knowledge of wider NHS issues with ability to discuss and support team.

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).