This particular client applied for an entry level graduate role as a Dietitian/Nutritionist in Queensland Health. The written application process involved the preparation of a two-page statement requiring the addressing of five competencies. My client was successful in gaining an interview, being offered the role and gladly accepting. Following are excerpts from three of the competencies.

Demonstrated base to increasing level of knowledge, expertise and skill in nutrition…

In my recent two clinical placements at the Royal Children’s Hospital (RCH) and Royal Brisbane and Women’s Hospital (RBWH), I gained a solid knowledge base on cases (basic through to complex), which I now apply to my work practices on a daily basis. These cases included high protein/high energy diets within Neurosurgery Ward and Head and Neck Cancer Outpatient Clinic at the RBWH and the Oncology wards at the RCH. More complex cases included infant feeding and failure to thrive; cerebral palsy and allergies cases at the RCH; enteral feeding cases (PEG and Nasogastric feeding) in Neurosurgery, Head and Neck Cancer Outpatient Clinic and ICU; and enteral feeding and total parental nutrition cases in Oncology at the Royal Children’s Hospital. I expanded my knowledge by conducting research on information into clinical files at the RBWH in the areas of Head and Neck Cancer and Neurosurgery in order to gain a deeper understanding of these areas. I understand the RBWH Swallowing and Nutrition Management Guidelines for patients with Head and Neck Cancer, and the processes that occur in this area. I also research treatment protocols in the Oncology ward at RCH in order to understand the treatment stages and protocols for children with cancer.

Demonstrated ability to participate effectively in a multidisciplinary team…

In my current role as a Nutrition Assistant, I work collaboratively in a team environment (up to 8 staff) on a daily basis, under the close supervision and guidance of a supervisor. I also liaise regularly with multidisciplinary teams including dietitians, speech pathologists, food service staff and nursing staff to ensure diet requirements are implemented correctly. During my clinical placement, I liaised regularly with these members of staff and with medical teams. I discuss issues with medical teams; for example, on issues surrounding patients who have been experiencing reflux from nasogastric feeds. I approach doctors with my recommendations on changing the feed to a higher density feed which would result in reducing the volume. Doctors have supported my decisions and further assisted with the reflux by authorising appropriate medication. The outcome of this collaboration results in the patients no longer experiencing reflux. In order to ensure effective management of enteral feeding for patients who are being discharged home, I discuss the discharge process with nutrition assistants to organise the necessary equipment and feeds for home enteral feeding. When dealing with patients who are continuously losing weight on the enteral feeding regimen, I liaise and consult with fellow dietitians and medical teams on whether to increase the requirements to ensure that weight loss is minimised or stabilised.

Demonstrated ability to undertake quality and service improvement activities…

During my food service management placement at The Prince Charles Hospital (TPCH), I was actively involved in the Food Service project relating to the new Queensland Health Statewide Foodservices Policy 2010. This Policy states that menu choices should be taken on the day of serving main meals to maximise patient food and nutrition intake. My role in this project involved assessing the systems and processes of the menu office and investigating the changes that needed to take place in order to implement same day menu selection. My experience as a Nutrition Assistant at the Mater assisted me to complete this task in a proficient manner. I examined and monitored the system in the menu office to determine how menus were distributed and evaluated general systems and processes. I offered recommendations on implementing more efficient ways of completing tasks by drafting new guidelines. For example, implementation of generic pre-printed meal tickets; record of phone call sheets; and the implementation of standard guidelines on ‘How to order a meal for patients’ with an attached list of diet codes for nurses stations. I also reviewed the work schedules for the menu office to meet the deadlines for same day menu selection to ensure patient meal selections were completed in a timely manner; and reviewed the methods of forecasting to reduce the heavy reliance of tally sheet within food services. I conducted an external benchmarking activity to compare processes and systems of the TPCH with other facilities to ensure those used within the menu office were efficient in order for the core business of taking meal selections with patients became the priority and the same day menu selection could be implemented. The majority of my recommendations were implemented within a seven day period; others were in the process of being considered and negotiated with relevant staff for eventual implementation. As a result, the changes contributed significantly in reducing both time wastage and the undertaking of manual tasks.

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Annie Cerone