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 will vary based on grade. At the GS-11 full performance level of this assignment, the clinical dietitian is responsible for independently planning, developing and directing all nutritional care activities for assigned veterans, including those with complex medical and nutritional needs. Duties will include: Nutritional Care 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, 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. Orders labs, diets, and consults per Scope of Practice / Clinical privileges. Evaluates and monitors the effectiveness and outcome of MNT interventions. Evaluates the patient's response to care based on identified, measurable outcomes and reviews the plan, as appropriate. 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. Measures outcomes through selecting indicators relevant to the nutrition diagnosis. Evaluates the effectiveness and measures progress toward outcomes of nutrition interventions by comparing current findings with previous goals and/or reference standards. Documentation supports an interdisciplinary approach and continuity of care. Nutrition Education and Coordination of Care 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. Includes information regarding budgeting, menu planning, food purchasing and preparation, food storage and sanitation. 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. Assists in planning learning experiences, teaching, and evaluating performance. Develops and prepares Healthy Teaching Kitchen presentations. Completes MDS/Care plans timely, as applicable. Participates in community projects and education. Work Schedule: Monday-Friday, 07:30am - 4:00pm Telework: Available, Approx. 3 days/pay period or up to the needs of the service. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Available Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement. 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. English Language Proficiency. Dietitian candidates must be proficient in spoken and written English in accordance with 38 U.S.C. § 7403(f). Registration: All applicants must hold the RDN credential from the Commission on Dietetic Registration (CDR) the credentialing agency of the Academy of Nutrition and Dietetics. Note: Applicants who hold the RDN credential have met the education requirement (e.g. bachelor's degree or higher) of CDR, as such this occupation is considered professional and scientific with a positive education requirement and the procedures in Part I, Chapter 4 of this Handbook will be followed when applying Veteran's preference. COPY OF REGISTRATION REQUIRED. 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. Exception for Dietitians who do not possess the RDN credential. (a) Non-credentialed Dietitians who meet the basic qualification requirements and have fulfilled the requirements below, but do not possess the RDN credential, may be given a temporary full-time appointment not to exceed one year under the authority of 38 U.S.C. § 7405(c)(2). Non-credentialed Dietitians must have fulfilled each of the following: A Earned a bachelor's or higher degree from a U.S. regionally accredited college, university or foreign equivalent (refer to ii below). 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 is located on the ACEND® website or at ACEND Accredited Programs Directory. Non-credentialed Dietitians may only be appointed at the GS-07 or GS-09 grade level and may not be promoted/converted until they obtain their RDN credential. Non-credentialed Dietitians must provide care under the supervision of a RDN at or above the full performance level. Temporary appointments of non-credentialed Dietitian will not be extended beyond one year or converted to a new temporary appointment. Failure to Obtain Registration. In all cases, Dietitians must actively pursue meeting registration requirements starting from their appointment date. At the time of appointment, servicing Human Resources (HR) staff in collaboration with the supervisor, will provide non-registered Dietitians the written requirement to obtain registration, the date by which they must acquire it and the consequences for not doing so by the deadline. Failure to obtain registration within one year from the date of appointment will result in removal from the Dietitian, GS-0630 occupation and may result in termination of employment. Loss of Credential. In collaboration with HR Office staff, management officials must immediately relieve employees who fail to maintain the required registration/certification of duties and responsibilities associated with the occupation and/or assignment, which may also result in separation from employment. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Registered Dietitian Nutritionist and Registered Dietitian: RDN and Registered Dietitian (RD) credentials are the same and both are qualifying. The difference between RDN and RD is in name only due to a change by the professional academy in 2014. In this standard, the term RDN will be used. Grade Determinations: GS-7 Dietitian (Clinical): Experience or Education. None beyond the basic requirements GS-9 Dietitian (Clinical): 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 AND Knowledge, Skills and Abilities. 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. GS-11 Dietitian (Clinical) Full Performance Level: Experience. At least one year of experience as an RDN equivalent to the next lower grade. AND Knowledge, Skills and Abilities. 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 References: VHA Handbook 5005, Part II, Appendix 20, Qualifications for Dietitians. The full performance level of this vacancy is GS-11. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-7 to GS-11. Physical Requirements: Light carrying (under 15 lbs), use of fingers, walking (1 hr), standing (6 hrs), ability to distinguish basic colors, hearing (aid may be permitted), mental and emotional stability, working closely with others, working alone.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on 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/.

Contacts

• Address VA Puget Sound Health Care System 1660 South Columbian Way Seattle, WA 98108 US
• Name: Michelle Yahne
• Phone: 503-220-8262 X53055
• Email: [email protected]