Detailed job description and main responsibilities

CLINICAL

To work as part of a team of oncology dietitians and as an integral member of multidisciplinary teams to ensure a holistic approach to patient care.  This involves liaising with oncologists, haematologists, nursing teams, specialist nurses, AHP’s, Macmillan Dietetic Support Workers and Dietetic Assistants.

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

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

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

Obtain and analyse relevant information from different sources including electronic patient records, the patient, family/ carers and ward staff, 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 relation to patients receiving oncology treatment.

Assess patients’ nutritional status by diet and weight history, nutritional intake, losses such as drain outputs, stool or stoma output, vomiting and physical signs of deficiency. 

Estimate 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 oncology patients.

Advise on appropriate artificial feeding routes for patients taking into account their diagnosis, tumour site and treatment side-effects (such as dysphagia, mucositis, Graft versus host disease, newly acquired Diabetes Mellitus, pancreatic insufficiency, stoma formation, malabsorption).

Formulate individualised patient care plans taking into consideration factors which may affect requirements or help/hinder provision of nutrition support such as prescribed drugs, biochemical derangements, fluid balance etc.  The care plan could include modified-texture diets, low carbohydrate/ high protein diet, low residue diet, oral nutritional supplements, enteral tube feeding regimes or parenteral nutrition.

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 patients e.g. acute hospitals outside Oxfordshire, community hospitals, district general hospitals, nursing homes, or to their own home, and advising members of staff or family members accordingly. 

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

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.  Barriers to communication may include loss of sight, loss of hearing and limited English 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.

To cover for 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.

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

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

To participate in departmental audits and initiate audit within own work area 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.

 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 dietetic interventions on electronic records and to appropriate members of the multidisciplinary team.