Dietitian (Clinical)

01Basic 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.

02Grade 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 (GS-7). OR Education. Master's degree from a regionally accredited university or college. 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.

Dietitian (Clinical), GS-11: Experience. At least one year of experience as an RDN equivalent to the next lower grade (GS-9). 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.

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.

03Preferred Experience

Knowledgeable in inpatient, outpatient, short-term, and long-term care Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

04Physical Requirements

The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment.

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. The incumbent supports the facility's mission and coordinates nutritional care with other health care providers, the Veteran, and their caregiver. Increasing complexity and specialization in nutrition requires that the clinical dietitian have expertise in a wide range of disease entities and treatment modalities.

The clinical dietitian's expertise is specific to diagnosing nutrition problems and the nutrition ramifications of disease entities and medical treatment modalities. Assessment methodologies such as identifying physical signs of malnutrition, drug/nutrient interactions and depletions, and assessment of intake and nutrient losses are critical skills used by clinical dietitians.

Major duties and responsibilities include (but are not limited to): 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.

With an understanding of the patient's health condition, designs the nutritional treatment plan with consideration for psychosocial, behavioral, physical activity, ethnic and cultural factors to obtain desirable outcomes and promote long term adherence to a medical nutrition care plan. 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. Assesses educational needs and provides nutrition education/counseling for individuals and groups within the interdisciplinary team Assists in achieving compliance with The Joint Commission, or other accrediting agency standards to continuously improve the safety and quality of care.

Serves as the nutrition expert for medical staff on the nutritional management of patients. 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.

• 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.
• Performs other duties as assigned to meet the needs of the service and patients to include providing support/coverage for vacancies and leave.

Work Schedule: Monday - Friday 8:00am-4:30pm with possible Saturday rotation at West Roxbury acute care every 5-6 weeks. Telework: Ad-hoc Virtual: This is not a virtual position. Functional Statement #: PD99531S, PD99530S, and PD99529S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized