Registered Dietitian- Level II, Senior, Lead Nutrition Support Dietitian

POSITION SUMMARY:

The Registered Dietitian II plays a key role in the management of complex dietary regimens, prevention and management of metabolic crises, education, coordination of care, clinical audit and research. The Registered Dietitian II is a specialty dietitian who assesses and coordinates diet therapy and nutrition education activities for patients with complex nutritional needs (such as inherited metabolic disease, renal failure, bariatric surgery, eating disorders, etc). Plans and provides nutritional care to patients by interpreting and adapting physician prescribed diets to individual needs. Evaluates and assesses patient responses to diet therapy through direct interview, calculating nutrient intake and lab values, monitoring tolerance of foods or tube feedings.

The Registered Dietitian II serves as a leader within the Clinical Nutrition department; is a mentor to other dietitians/, helps manage patients with complex nutritional needs, and assists with manager duties as needed. The Registered Dietitian II is a specialty dietitian who is an expert in nutrition support, requiring advanced certification and/or an advanced degree as well as prior experience in Nutrition Support. They act as the primary clinician formulating and managing total parenteral nutrition. They are an integral part of the multi-disciplinary care team for nutrition support patients and participate in BMC’s Multidisciplinary Nutrition Committee and Multidisciplinary Nutrition Support Team.

Position: Registered Dietitian-AFSCME: Level II, Senior, Lead Nutrition Support Dietitian       

Department: Nutritional Clinic

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Provides nutritional care when consulted for malnourished and/or critically ill patients; evaluates patient’s nutritional needs and develops nutritional care plan; determines solutions for total parenteral nutrition (TPN) and tube feedings when appropriate and submits to MD for approval and documents in the medical record. Monitors patients daily to assess nutritional status, i.e. reviews daily intake, laboratory values, assesses medication intake, coordinates with respiratory therapist for measurements of indirect calorimetry for appropriate patients, interprets results and modifies nutrition support based on results.  Prepares diet plans for patients who transition from TPN to oral diets.  
• Is a member of the Nutrition Support Team; Leads weekly rounds with Multidisciplinary Nutrition Support Team members to discuss  patient care plans, coordinate changes, and work collaboratively  to meet complex nutrition support needs during admission and arrange for close follow up after discharge.. Conducts all formal Nutrition Support consults. Formulates daily TPN orders for MD review including; manages fluid balance and electrolyte balance based on laboratory data and coordination with primary teams, manages insulin in the TPN, ability to adjust IV medication in TPN.
• Assesses nutritional status based on laboratory values, medical and nutritional history and medical/surgical condition; develops nutritional care plans based on this information in accordance with accepted (AND) standards of practice and written department protocols.  Consults with physicians regarding possible changes in diet orders and/or enteral nutrition (Tube feeding) needs based on therapeutic dietary needs, managing micronutrient deficiencies, suggesting interventions to help improve oral intake and assisting with GI-related interventions and providing appropriate.
• Develops and plans individual nutrition plans including appropriate oral nutrition supplements and/or tube feedings; monitors tube feedings for tolerance and assists MD in determining the appropriate tube feed formula, rate and regimen.  
• Instructs patients and their families regarding nutrition therapy after hospitalization; i.e., the principle of nutrition, the purpose and use of diet, food selection and preparation, and adopting food plans to individual needs. Additionally, recommends appropriate outpatient nutrition referrals as needed.
• Collaborates with Nutrition Support Team, Home TPN Manager, Primary Team, Case Management and Home Infusion Companies to ensure patients and families are educated on  the transition to Home Parenteral Nutrition Participates in the development and implementation of care plans for high-risk patients.
• Participates in weekly interdisciplinary rounds in the Surgical Intensive Care Unit (SICU) to receive information on condition, treatment, and discharge planning of patients on wards; discusses nutrition recommendations and treatment plans
• Participates in developing policies and procedures, collaborates with Nutrition Committee and Nutrition Support team to develop new QI projects and assists as needed with QI monitors, assists with developing nutrition guidelines and standards of care.
• Serves as member of the Multidisciplinary Nutrition Committee.  
• Participates in selection of enteral formulary by assessing hospital-based needs along with current clinical research
• Provides in-service education in nutrition to hospital personnel (MD’s, residents, students, nurses, dietitians); compiles and develops educational materials for use in individual and group classes.
• Attends Grand Rounds, Medical, Surgical and Pediatric conferences; attends and participates in professional meeting to share information when appropriate.  
• Provides yearly nutrition lectures on nutrition support to surgical interns, surgical residents, and bi-monthly surgical ICU-specific lectures to interns in their SICU rotation. 
• Provides nutrition support education and training to the Nutrition and Obesity Fellow.
• Performs Nutrition Focused Physical Exams (NFPE) on all patients to assess for malnutrition diagnosis and micronutrient deficiencies. Assists CNM in auditing staff on NFPE and assists with providing additional education/teaching for improvement as needed.
• Provides technical guidance to all nutrition staff and directs distribution of daily workload.  Assists with interviewing new perspective dietitians and conducts training for new employees. Assists with schedule planning of staff as needed to support CNM.
• Acts as coordinator and preceptor in the education/training of dietetic interns, pharmacy residents, medical interns, nutrition fellows; supervises the students’ practical experience and reviews assigned nutrition related projects;  
• Performs all functions of a Registered Dietitian I.
• Stays up to date on current nutrition research and collaborates with Clinical Nutrition Manager and attending physician to implement evidence-based nutrition recommendations into clinical practice.
• Utilizes hospital’s behavioral standards as the basis for decision making and to support the hospital’s mission and goals.
• Follows established hospital infection control and safety procedures.

OTHER DUTIES:

Performs related duties as needed/ as assigned

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

Required Qualifications:

• Registered Dietitian (RD)

• Licensed Dietitian Nutritionist (LDN) in Massachusetts

• Certified Nutrition Support Clinician (CNSC) Preferred ; Required if only Bachelors

Minimum of 2 years in Nutrition Support with above requirement

JOB REQUIREMENTS

EDUCATION:

Master’s degree required in Nutrition or related discipline OR Bachelor’s degree with CNSC and/or specialty certification.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Must be registered by the Academy of Nutrition and Dietetics (AND).

LDN (Licensed Dietitian/Nutritionist) preferred. 

EXPERIENCE:

Must have at least two years of experience as a Clinical Dietitian in an acute care setting.

KNOWLEDGE AND SKILLS:

• High level of clinical understanding of metabolism in relation to clinical nutrition; knowledge of food chemistry and macro/micro nutrient composition of foods.
• Requires the interpersonal skills sufficient to explain procedures to patients, alleviate apprehensions, as well as effectively interact with physicians, fellows, nursing, etc.
• Superior analytical skills to interpret laboratory data, identify and plan individual nutrition therapy programs and assess nutrition care plans and their physiologic effect.
• Ability to work in a fast paced changing environment
• Basic computer proficiency inclusive of ability to access, enter, and interpret computerized data/information.

Equal Opportunity Employer/Disabled/Veterans