Job Summary:

In accordance with the Mission, Vision and Values, and strategic directions of Provincial Health Services Authority patient/resident safety is a priority and a responsibility shared by everyone at PHSA, and as such, the requirement to continuously improve quality and safety is inherent in all aspects of this position. The Dietitian working within an interprofessional environment provides advanced level clinical nutrition services to support the management of patients/residents of the eating disorders programs at BC Mental Health and Substance Use Services. Counsels, negotiates, connects, and thrives in an extremely challenging patient/resident population where there is the potential for severe physical and psychological sequelae. Eating disorders are associated with serious biological, psychological morbidity, and significant mortality. The Dietitian applies advanced knowledge and skill to assess, plan, implement and evaluate nutrition goals and care plans for children youth and young adults with eating disorders according to best practices which may include cognitive behavioural therapy (CBT) motivational enhancement therapy (MET) and food-related experiential strategies. Provides individual, family and group counselling to normalize the eating experience where commonly there is a strong drive to maintain the disordered eating/food issues and pursue unhealthy weight and shape, and the consequences of this psychopathology is increased chronicity and medical risk. Acts as a resource to community health care professionals on the appropriate nutritional management of this population group, provides teaching and develops education resources, participates in nutrition research, ongoing quality assurance and risk management programs.

Duties/Accountabilities:

1. Conducts comprehensive nutritional assessments utilizing advanced knowledge and expertise of the medical risks and psychopathology of children, adolescents and young adults with eating disorders by maintaining awareness of the significant increased risk or mortality including high suicide risks, and ensuring nutritional assessments include the history of the eating disorder such as binging, purging, starvation, and exercise patterns and physical nutritional assessments include anthropometric measurements and assessment of risk for refeeding syndrome.

2. Develops and implements individual nutrition care plans based upon comprehensive assessments, utilizing appropriate standards and guidelines, and incorporating individual patient/resident's lifecycle stages, culture, and religion to ensure nutritional requirements are met.

3. Provides comprehensive individual, family and group counselling to normalize the eating experience by methods such as determining the appropriate counselling methods including cognitive behavioral therapy to identify dysfunctional thoughts regarding food, body image and exercise to support them with the process of change; motivational enhancement therapy for eliciting behaviour change by helping patients/residents to explore and resolve ambivalence; and food related experientials such as progressive responsibility in menu choices, cooking group, and restaurant group.

4. Manages and monitors the patient/resident response to the nutritional care plan by focusing on issues of disordered thoughts and feelings around food, eating and body image utilizing an advanced understanding of the psychopathology behind the eating disorder, transference, counter-transference and boundary issues; monitoring menus to minimize dysfunctional eating behaviours and challenging patients/residents with new practices to achieve normalization of eating behaviours; and reviewing and adjusting the patient/resident menu selections in order to meet individual goals.

5. Provides patients/residents and families instruction regarding how to manage the patient/resident’s response to the nutrition care plan and their ability to meet goals as inpatients and while transitioning back to the community/home by giving information, providing resource material, answering questions on topics such as limit setting, and modeling appropriate eating behaviours for patients/residents and their parents.

6. Participates in the triage process, weekly patient/resident care rounds, and team family meetings by providing expert opinion related to the nutritional care of the patient/resident, working collaboratively within an interprofessional environment, and utilizing knowledge of the complexities of eating disorders such as co-morbid illness, medical and psychological complications and boundary issues.

7. Develops, coordinates, implements and evaluates patient/resident education and nutrition care resources, provides ongoing continuous planning and assessment of treatment protocols and acts as a clinical resource person to dietitians, physicians and health care professionals in the province by providing guidance for program delivery and the management of individual cases.

8. Identifies food service requirements for the Eating Disorders patient/resident population treatment to support with program treatment protocols by methods such as, liaising with Food Services provider with respect to day-to-day issues regarding patient/resident menus and monitoring quality and patient/resident satisfaction, and representing Eating Disorders at the monthly review meeting with Food Service provider.

9. Communicates nutrition care principles to health care professionals, colleagues, peers and students through in-service education and orientation/training sessions, and continuing education programs including training working dietitians who are new to the area of eating disorders.

10. Participates in program planning, program evaluation and program operations by attending meetings, reviewing team policies and procedures, providing input to the designated Manager.

11. Prepares and presents workshops/in-service instruction, education programs and written resources to other health care professionals including dietitians, physicians, nurses, psychologists, social workers and medical students regarding management of Eating Disorders. Participates in outreach education as required.

12. Participates in hospital, program, discipline and university programs related to teaching. Provides suggestions for dietetic intern experiences and provides students with learning opportunities.

13. Utilizes and promotes evidence-based care and integrates research findings into current practice. Participates in the development, implementation and evaluation of clinical research proposals, projects and surveys regarding the nutritional management of Eating Disorders patients/residents. Disseminates research and clinical findings through publications and presentations.

14. Provides input and feedback to discipline and/or program regarding strategic planning initiatives and effective use of resources. Collects and submits workload measurement and other data according to established guidelines.

15. Performs other related duties as assigned.

Qualifications:

Education, Training and Experience

• Graduation from an academic program in dietetics approved by the College of Dietitians of British Columbia.
• Three (3) years recent, related clinical experience working with the designated patient/resident population within the program (Adult or Child and Youth) with disordered eating plus additional eating disorders or nutrition counselling training (such as the eating disorders boot camp training workshop for professionals, counselling psychology, accredited advanced intensive nutrition counseling course) or an equivalent combination of education, training and experience.
• Full registration in the College of Dietitians of British Columbia.

Skills and Abilities

• Broad knowledge of clinical nutrition theory and practice in health and disease.
• Broad knowledge of the standards of practice and guidelines for clinical practitioners established by the College of Dietitians of B.C.
• Comprehensive knowledge of disordered eating and its effects on nutrition, body composition metabolic parameters, psychopathology, behaviour, including risks of refeeding syndrome, its prevention and treatment.
• Demonstrated ability to design, implement and monitor age appropriate therapeutic diets delivered via oral and enteral routes.
• Demonstrated ability to develop and implement nutrition standards of care, guidelines and protocols in relation to eating disorders treatment modalities.
• Comprehensive knowledge of counselling strategies such as CBT, and MET and their utilization in the Eating Disorders population.
• Demonstrated knowledge of community and professional resources in Eating Disorders.
• Broad knowledge of research process and methodology.
• Demonstrated ability to plan, implement and evaluate programs.
• Demonstrated ability to work collaboratively and effectively within an inter-professional environment.
• Demonstrated ability to plan, organize and prioritize work.
• Demonstrated ability to teach and provide effective consultation.
• Demonstrated effective verbal and written communication skills.
• Demonstrated ability to communicate with, and to deal effectively with co-workers, physicians, other health care professionals, patients/residents and their families, and external agencies.
• Demonstrated ability to operate the equipment used to perform the duties of the position.
• Physical ability to perform duties of the position.