Specialty Dietitian – Oncology

Detailed job description and main responsibilities

CLINICAL

To work as part of a team of Oncology, Haematology and Elective Surgery Specialist Dietitians and Macmillan Dietetic Support Workers, and as an integral member of multiple tumour-site specific multidisciplinary teams to ensure a holistic approach to patient care.  This involves attending oncology team meetings, dietetic department meetings and liaising with Oncologists, Specialist Nurses, Radiographers, Allied Health Professionals, Dietetic colleagues, Dietetic Assistants and GP’s regarding dietetic and nutritional support for Oncology patients in order to optimise nutritional status during treatment.

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

To assess and prioritise referrals made by members of the multidisciplinary team

To review how the dietetic service is provided along the patient pathway, in order to provide an effective use of time and resources.

Obtain and analyse relevant information from different sources including: electronic patient records, the client, staff and/or carer’s, in order to make a comprehensive assessment of the patients diagnosis, 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 cancer treatment.

Assess patients’ nutritional status by weight history, fluid balance, nutritional intake, stool 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 nutritional support for patients with side-effects of systemic anti-cancer treatment and/or radiotherapy, such as mucositis, fatigue, nausea and vomiting, diarrhoea, taste changes, poor appetite.

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, fluid balance etc.  Within the care plan this could include modified-texture diets, oral nutritional supplements, enteral tube feeds, neutropenic diet advice. 

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.

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.  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.

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

To provide specialist training and supervision of dietetic colleagues and students using skills of reflective practice.

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 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.

To provide specialist advice, teaching and training to dietetic colleagues, students or members of the multidisciplinary team, regarding the nutritional management of patients, particularly with respect to patients receiving systemic anti-cancer treatment and/or radiotherapy. 

To have a detailed understanding of different SACT treatments and their side effects. 

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.