Macmillan Dietetic Support Worker – Upper GI

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Clinical Responsibilities:

• To actively assist Dietitians in information gathering and performing routine measurements, such as PGSGA-SF, hand grip strength, sit to stand and dietary intake and symptoms to assess patient’s nutritional status.

• To screen and review nutritional status and oral intake of non-complex patients, raising referrals to Dietetics or other disciplines as appropriate.

• To demonstrate knowledge and expertise in the use of Oral Nutritional Supplements (ONS) for OG patients following surgery.

• To negotiate and implement appropriate nutrition support interventions, e.g. additional snacks, meals and supplements as appropriate in liaison with the dietitian.

• To action GP letters requesting ONS and enteral feed using templates under supervision of the Dietitian .

• To help with the organisation of feeding pump training, registration of patients on Nutricia MyConnex, electronic patient records (EPR), completion  of handover forms to community staff, dietetic and nursing colleagues, and to ensure that patients have supplies of enteral tube feed and/or nutritional supplements and ancillaries for safe hospital discharge and facilitate continuity of care . 

• To help with management of tube fed patients, ensuring they have adequate stock of feed and ancillaries at home. This involves liaising with Nutricia MyConnex and directing patient queries.

• To use encouragement, reassurance and sensitivity to support patients in overcoming barriers and achieve mutually agreed goals.

• To support patient’s in understanding their post-surgery diet with provision of diet literature, under guidance from the Dietitian.

• After training, to provide dietary advice for patients before and after insertion of an oesophageal stent.

• To become competent to teach patients to flush and care for feeding tubes to support the day case tube pathway. 

• To become competent to provide pump training to patients to facilitate rapid discharges and avoid discharge delays.

• After training, to triage incoming telephone calls from OG patients, relatives and carers, liaising with Upper GI MDT members as required.  For example, to liaise with the surgical team in order to organise re-suturing of jejunostomy feeding tubes or communicate feeding tube complications.

• To participate in learning and development opportunities, to develop additional skills and/or competencies required to perform role and to attend education and learning events offered by Macmillan Cancer Support. 

• To promote and provide Macmillan and local sources of patient information, including signposting to Maggies Cancer Information Centre and the Oxford patient support group (OOSO).

• To help with patient experience feedback data in order to identify OG Dietetic Service development needs  .

• To be available to arrange urgent feed deliveries from the hospital site in response to patient demand. 

Policy Awareness/Implementation:

To be aware of, adhere to, and implement relevant Trust and Departmental policies including, but not limited to:

• ‘Optimising Nutrition and Hydration Care for All Patients’ policy,

• Trust guidelines mandating maintenance of high quality, up-to-date and accurate clinical records,

• Data protection guidelines regarding safe and appropriate use and communication of patient information amongst the MDT,

• Health and Safety, Infection Control and Moving and Handling guidelines and corresponding mandatory training,

• Trust incident reporting and risk management procedures.

Personal and Service Development:

• To identify training needs and facilitate learning for personal development,

• To attend relevant education and training in order to maintain up-to-date skills including Macmillan educational events

• To work collaboratively within the MDT to evaluate current practice and care pathways with the overarching aim of improving patient care and efficacy of interventions,

• To participate in implementation of service/Trust clinical governance plan

•  To participate in clinical governance/audit activities, including collecting and analysing data, to allow the timely compilation of reports and appropriate recommendations

•  To provide peer support and cover to other Dietetic Support Workers and Dietetic Assistants

• To be involved in the induction of newly employed members of the OG and Dietetic teams and training of less experienced staff (including students), including demonstrations of daily duties and provision of practical training,

• With support, to devise a Personal Development Plan/Portfolio documenting yearly objectives orientated to reflect personal, service and Trust aims.

Freedom to act:

• To be accountable for own professional action and recognise professional boundaries, accessing supervision when required.

• To understand how and when to seek support from supervisors.

• To organise and prioritise own daily tasks with reference to priorities of the UGI and Dietetic teams. 

• To abide by relevant Standard Operating Procedures.

• To work independently on specified tasks, with supervision from a Dietitian/Ward Manager at pre-determined intervals and access to appraisal within an Individual Performance Framework.

Physical, Mental and Emotional Skills:

•  To be able to work a flexible work pattern, requiring effort and concentration over several short/long periods.

•  To work flexibly and be able to adjust to the constantly changing demands of a fast-paced ward.

•  To be competent in use of IT services, including Email, Intranet, Excel and Electronic Patient Records.

•  To utilise ‘Moving and Handling’ training to safely move feed and feeding equipment. 

•  To be sensitive to the cultural and religious needs of patients.

•  To have well-developed coping strategies to deal with distressing/challenging circumstances, for example seeing cancer patients who have received a diagnosis or upsetting information earlier that day. 

•  To be able to cope with unpleasant  working conditions (i.e. awareness of how to appropriately deal with exposure to bodily fluids as per Infection Control guidelines).