Nutrition Nurse Specialist

• Act as the Trust's expert practitioner for adult enteral and parenteral nutrition.
• Independently assess, plan, implement and evaluate specialist nutritional care for adults requiring artificial nutritional support.
• Lead nurse-led nutrition clinics and participate in multidisciplinary nutrition ward rounds.
• Provide expert advice regarding enteral feeding, parenteral nutrition, intestinal failure and malnutrition.
• Assess suitability for long-term enteral feeding including gastrostomy and jejunostomy placement.
• Assess patients requiring parenteral nutrition and contribute to safe management of central venous access devices.
• Support prevention of catheter-related bloodstream infections in collaboration with Infection Prevention and Control and Critical Care teams.
• Insert and replace feeding tubes within agreed competencies and manage complex enteral access complications.
• Assist with PEG and nasogastric tube placement where appropriate.
• Assess and review patients requiring replacement feeding tubes, ensuring timely intervention in accordance with Trust policy and national guidance.
• Deliver specialist nutritional support to patients within gastroenterology, stroke, head and neck cancer, critical care, surgical and medical specialties.
• Develop expertise in supporting patients with eating disorders.
• Following appropriate training, contribute to the delivery of a nurse-led coeliac disease service.
• Support discharge planning for patients requiring home enteral or parenteral nutrition.
• Provide follow-up for patients receiving home enteral feeding and liaise with homecare providers and community teams.
• Accept referrals and make onward referrals autonomously.
• Act as a qualified non-medical nurse prescriber within the scope of professional competence, Trust policy and prescribing authority, prescribing appropriate medicines, nutritional products and other treatments as clinically indicated.
• Request, review and interpret appropriate diagnostic investigations, including blood tests and other relevant investigations, within the scope of the role and professional competence, taking appropriate clinical action and escalating abnormal or concerning results when required.
• Use clinical assessment, investigation results and specialist knowledge to inform diagnosis, treatment planning, monitoring and evaluation of patients receiving nutritional support.
• Maintain appropriate prescribing and diagnostic competencies and undertake relevant continuing professional development to ensure safe, evidence-based practice.

Essential

• Registered Nurse Level 1
• ENB 998, MSPP or equivalent
• Relevant experience in caring for this group of patients.
• Advanced Communication
• Non-Medical Prescribing qualification
• Evidence of continuing professional development (CPD) relevant to nutrition
• Evidence of recent specialist training in enteral and/or parental nutrition
• Evidence of leadership development or equivalent experience

Essential

• Significant post registration experience in adult nursing
• Experience of caring for patients receiving enteral and parenteral nutrition
• Experience of caring for patients with feeding and swallowing problems
• Experience assessing nutritional requirements and developing, implementing and reviewing individualised nutrition care plans
• Experience of managing patients with feeding and swallowing difficulties
• Experience of working within a multidisciplinary team, including dietitians, speech and language therapists, medical teams and pharmacists.
• Experience of recognising and managing complications associated with enteral and parenteral nutrition.
• Experience of clinical risk assessment and risk management.
• Experience of providing education and training to patients, carers and healthcare professionals.
• Experience of contributing to clinical governance, quality improvement and patient safety.
• Experience pf managing independently and prioritising a specialist caseload
• Experience of supporting discharge planning and continuity of nutritional care between hospital, community and home settings.

Desirable

• Experience working within a specialist nutrition support team.
• Experience of home enteral nutrition and/or home parenteral nutrition.
• Experience of managing complex gastrostomy, jejunostomy or other enteral feeding devices.
• Experience of vascular access management in patients receiving parenteral nutrition.
• Experience of standard setting, clinical audit and service evaluation.
• Experience of developing and implementing clinical guidelines, policies or patient information
• Experience of leading or contributing to service improvement projects.
• Experience of undertaking or contributing to research.
• Experience of presenting clinical/service information at local or regional meetings.
• Experience of supporting junior staff and other professionals in developing nutrition-related competencies.

Essential

• Comprehensive knowledge of the principles of nutritional assessment and nutritional support in adults.
• Knowledge of disease-related malnutrition, including identification, prevention and management.
• Specialist knowledge of enteral and parenteral nutrition.
• Knowledge of commonly used enteral and parenteral nutrition products and equipment.
• Knowledge of indications, contraindications and complications associated with enteral and parenteral nutrition
• Knowledge of safe nasogastric tube placement and confirmation processes.
• Knowledge of gastrostomy and jejunostomy care
• Understanding of refeeding syndrome and its prevention and management.
• Understanding of fluid, electrolyte and biochemical monitoring in patients receiving nutritional support
• Understanding of the nutritional needs of patients with gastrointestinal, neurological, oncology, head and neck, maxillofacial and surgical conditions
• Knowledge of infection prevention and control principles relevant to nutrition support.
• Understanding of clinical governance, patient safety, incident reporting and risk management.
• Awareness of relevant national guidance, professional standards and evidence-based practice.
• Understanding of capacity, consent and safeguarding considerations in relation to nutritional support.

Desirable

• Knowledge of home nutrition support and community-based nutrition services.
• Knowledge of nutrition support pathways across acute, community and primary care settings.
• Knowledge of current national nutrition support standards and quality frameworks.
• Knowledge of service improvement methodologies.
• Knowledge of clinical audit and research methodology.
• Awareness of the financial and resource implications of specialist nutrition support.

Essential

• Competent in the assessment and management of patients requiring nutritional support.
• Competent in passing fine-bore nasogastric tubes in accordance with local policy.
• Competent in the assessment and ongoing management of enteral feeding tubes
• Competent in gastrostomy tube care and management.
• Competent in monitoring patients receiving parenteral nutrition.
• Able to recognise and respond appropriately to complications of enteral and parenteral nutrition
• Able to interpret relevant biochemical and clinical information and escalate concerns appropriately.
• Able to undertake nutritional risk assessment and formulate appropriate nursing interventions.
• Able to develop, implement and evaluate individualised nutritional care plans.
• Able to provide practical education and competency-based training to patients, carers and healthcare professionals.
• Able to work safely within professional scope of practice and recognise when specialist or medical input is required.

Desirable

• Project management skills
• Computer skills (word processing, spreadsheet, and Powerpoint)
• Competence in gastrostomy tube insertion/ change
• Competence in managing jejunal feeding tubes.
• Experience with central venous access devices used for parenteral nutrition.
• Competence in delivering competency-based training for enteral feeding procedures.
• Experience of managing complex nutrition support in the community/home environment.

Essential

• Excellent verbal, written and interpersonal communication skills.
• Ability to establish therapeutic relationships with patients and families.
• Ability to communicate complex clinical and nutritional information clearly to patients, carers and professionals
• Ability to adapt communication to patients with communication, cognitive, sensory or language difficulties
• Ability to manage sensitive and potentially distressing conversations around nutrition, feeding and treatment decisions.
• Ability to negotiate and influence practice across professional boundaries.
• Ability to manage conflict and challenging situations professionally.
• Ability to provide clear clinical documentation and accurate written advice.
• Ability to deliver presentations and educational sessions to multidisciplinary audiences.

Desirable

• Experience of developing patient information resources
• Experience of delivering formal presentations or teaching sessions to large groups.
• Experience of facilitating multidisciplinary meetings or case discussions.

Essential

• Shows evidence of effective clinical leadership
• Autonomy, Prioritisation.
• Ability to work as a member of a team.
• Delegation and Supervision skills
• Experience in Research, Audit and Quality Improvement

Desirable

• Experience of leading a Multidisciplinary Project
• Evidence of Change Management
• Experience of presenting audit/research findings. Experience of using quality improvement methodologies such as PDSA.

Essential

• Compassionate and Patient Centred Approach.
• Flexible and Self-Motivated
• Commitment to professional development
• Self Motivated and able to work independantly.
• Positive Approach, to change and service development.