Job Description

Are you a registered dietitian looking for a new opportunity? Would you like to advance your career by working for and learning from one of the largest acute teaching hospital Trusts in the UK?



This is an exciting opportunity for a band 5 with experience or band 6 dietitian to develop knowledge and skills in renal dietetics, with training and support provided.



You will be welcomed into a friendly and supportive team of specialist renal dietitians working within The Oxford Kidney Unit. Based at the Churchill Hospital in Oxford we provide a regional renal service for Oxfordshire, Buckinghamshire and Swindon. You will work closely with the multi-disciplinary team who value and respect the role of the Dietitian. The caseload will be varied, gaining expertise in renal and transplant inpatients, outpatients and dialysis unit.

As a valued member of our team, you will receive:

Flexible working, including opportunities for home working Clinical supervision and support from experienced and specialist dietitians Dedicated time for professional and service development Regular appraisals and personalised development plan Access to a range of CPD opportunities, the Oxford AHPs Research & Innovation Unit, and Bodleian Library collection. Shared responsibility for the renal dietetic care of peritoneal dialysis, haemodialysis and home haemodialysis patients Low clearance and general nephrology patients in outpatient clinics Inpatients on the renal ward and transplant ward at The Churchill Hospital, Oxford Provide a renal dietetic service to a satellite unit, including dialysis unit and outpatient clinics, once individualised training has been completed in Oxford Contribute to the dietetic service for patients who have had a kidney transplant, simultaneous kidney and pancreas transplant, pancreas alone transplant or pancreatic islet transplantation Working as a member of the renal dietitian team and large renal and transplant MDTs Taking the lead on corporate departmental projects Advising and teaching medical and nursing staff on the dietary management of renal disease and nutritional support Advising and teaching patients and carers how to manipulate their diet to best achieve acceptable biochemistry and good nutrition Furthering best practice by current clinical evidence and develop departmental guidelines and standards Responsibility for providing dietetic support for other specialities as required

Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research. The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury.



Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community.



We call this Delivering Compassionate Excellence and its focus is on our values of compassion, respect, learning, delivery, improvement and excellence.



These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family. Watch how we set out to deliver compassionate excellence via the OUH YouTube channel .



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 patient's 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 carer's, 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.