The clinical dietitian is the medical nutrition expert and is responsible for planning, developing and directing all nutritional care activities for assigned Veterans, including those with complex medical and nutritional needs. The clinical dietitian supports the facility's mission and coordinates nutritional care independently within an interdisciplinary team, the Veteran, the Veteran's caregivers and the community.

Duties

Duties listed below are for full performance level GS-11, developmental grade (GS-7 and GS-9) duties will differ in complexity and oversight. Conducts a comprehensive nutrition assessment utilizing the Nutrition Care Process (NCP) for assigned patients. Develops and implements an individualized plan for Medical Nutrition Therapy (MNT) in accordance with the patient's medical program goals and objectives. Performs a Nutrition Focused Physical Exam (NFPE) during assessments to determine risk and/or degree of malnutrition. Calculates nutrient requirements (calories, protein, carbohydrates, lipids, vitamins, electrolytes and fluids) and necessary diet restrictions or food/drug interactions. Evaluates patterns and relationships among data obtained and possible root causes for nutrition problems. Tailors diet prescription to each individual patient according to physical and metabolic needs. Prioritizes the importance of nutrition problems for optimal health, recovery from illness, management of chronic disease or disease prevention. Utilizes evidenced-based nutrition practice guidelines and Whole Health Principles to develop shared goals with the patient and formulates a plan of care that is focused on the etiology of the nutrition problem. Actively supports veteran centric food service operations with a food forward approach through knowledge of computer software programs related to food service systems and through interfacing with the food service section to ensure patient satisfaction with meals, assisting in implementation of new initiatives, and acting as a liaison between clinical units/wards and the food service section, as applicable. Works cooperatively with foodservice staff to assure conformance to diet prescriptions, as applicable. Identifies patients in need of nutritional support and recommends the appropriate mode of support, including suitable route, formula, and rate of administration. Provides initial and on-going nutritional assessment of patients receiving enteral (EN) and/or Parenteral nutrition (PN). Orders labs, diets, and consults per Scope of Practice / Clinical privileges. Documents nutrition care plan in the patient's medical record, including nutrition assessment data, MNT initiated and recommendations, results of nutrition counseling, patient consents and discharge planning. Assesses educational needs and provides nutrition education/counseling for individuals and groups, incorporating a learning approach that considers the cultural, religious, educational and medical situation of the patient. Utilizes motivational interviewing techniques to evaluate patient and/or caregiver's readiness to learn and potential for changing behaviors. Evaluates achievement of learning objectives by the patient and/or family. Adapts nutrition education materials and counseling techniques to the patient's level of understanding, which frequently involves simplifying complex dietary restrictions. Identifies drug-nutrient interactions and counsels / communicates with the patient regarding the impact on nutrition status and/or nutrient utilization. Utilizes virtual care technology such as VA Video Connect (VVC) and Secure Messaging (SM) to improve access to nutrition care. Provides follow-up nutrition education/counseling in accordance with the patient's treatment goals and determines when a problem requires consultation or referral to another provider or service. Participates in planning and education of home nutrition support. Functions as a clinical preceptor for the dietetic internship program and in a teaching role for other health care professionals, patients and the community. Assists in the education and oversight of dietetic students and interns. Develops and prepares Healthy Teaching Kitchen presentations. Completes MDS/Care plans timely, as applicable. Participates in community projects and education. Maintains productivity standards. Monitors completion of consult management tasks by reviewing assigned nutrition consults. Maintains accurate record keeping of daily clinical activities and completes patient encounters utilizing the Event Capture System (ECS). Manages resources (time, materials, and staff) in a cost-effective manner. Assists in developing and revising patient education materials, clinical forms, and protocols. Assists in achieving compliance with The Joint Commission, or other accrediting agency standards to continuously improve the safety and quality of care. May assign and direct the workload of diet technicians and/or diet clerks. Participates in the orientation and training of new staff (e.g., Food Service Employees, dietetic interns, clinical dietitians, etc.) Work Schedule: Monday - Friday, 0800-1630 (Flexible) Telework: Available Virtual: This is not a virtual position. Functional Statement #: 99529S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Registered Dietitian Nutritionist (RDN) or Registered Dietitian (RD) - Must be registered with the Commission on Dietetic Registration (CDR) the credentialing branch of the Academy of Nutrition and Dietetics formerly known as the American Dietetic Association (ADA). Exception for GS-07 and GS-09 Only: Dietitians who do not possess the RDN/RD credential. Non-credentialed Dietitians who otherwise meet the basic qualification requirements and have fulfilled the requirements below, but do not possess the RDN credential, may be given a full-time temporary appointment not to exceed one year under the authority of 38 U.S.C. 7405(c)(2). May only be appointed at the GS-07 or GS-09 level and may not be promoted/converted until they obtain their RDN credential. Non-credentialed Dietitians must have fulfilled each of the following: Earned a bachelor's or higher degree from a U.S. regionally accredited college or university or foreign equivalent. Foreign Education: To be creditable, college and/or university degrees earned outside the U.S and its territories must be evaluated by ACEND and meet ACEND's International Dietitian Education standards which are designed to provide graduates with the knowledge and competencies to sit for the CDR credentialing exam. ~AND~ Completed an ACEND accredited experiential or supervised practice program and provide a verification statement from the program director that conveys eligibility to take the CDR registration exam as a prospective RDN. A list of ACEND accredited programs are located on the ACEND website or at ACEND Accredited Programs Directory. Current VHA Dietitians that qualify based on being covered by the Grandfathering Provision may not be promoted to a higher grade if they do not meet the current RDN/RD requirements. Grade Determinations: Dietitian (Clinical), GS-07. Experience or Education. None beyond the basic requirements. Dietitian (Clinical), GS-09. Experience. At least one year of experience equivalent to the next lower grade level. OR Education. Master's degree from a regionally accredited university or college. Knowledge, Skills and Abilities (KSAs). In addition to the experience or education above, the candidate must demonstrate the following KSAs: (a) Knowledge of various accrediting and regulatory requirements. (b) Knowledge of virtual technology to provide nutrition care. (c) Ability to deliver patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). (d) Ability to apply evidence-based nutrition practices to improve patient outcomes. (e) Ability to develop patient-centered goals. (f) Ability to collect data for performance improvement studies. (g) Ability to collaborate with stakeholders. Dietitian (Clinical), GS-11. Experience. At least one year of experience as an RDN equivalent to the next lower grade. Knowledge, Skills and Abilities (KSAs). In addition to the experience above, the candidate must demonstrate the following KSAs: (a) Skill in delivering patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). (b) Skill in interpreting research to apply evidence-based nutrition practices to improve patient outcomes. (c) Skill in developing patient-centered goals. (d) Skill in analyzing data for performance improvement studies. (e) Skill in collaborating with stakeholders. (f) Ability to comply with various accrediting, regulatory and agency authorities. Preferred Experience: 1-2 years of outpatient experience. References: VA Handbook 5005/154, Part II, Appendix G20, dated October 14, 2022. Physical Requirements: light carrying (under 15 lbs.), use of fingers, walking (up to 1 hr), standing (up to 6 hrs), ability to distinguish basic colors, hearing (aid may be permitted), and mental and emotional stability. Environmental factors include working closely with others, and working alone.

Education

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

ACEND accredited programs are located on the ACEND website or at ACEND Accredited Programs Directory.

Contacts

• Address VA Puget Sound Health Care System 1660 South Columbian Way Seattle, WA 98108 US
• Name: Michelle Rootes
• Phone: (907)257-3713
• Email: [email protected]