Rotation Overview
General Information
3 West
PICU
Rotation Contact Information:
Rich Zanetti
richard.c.zanetti.mil@health.mil
PGY Level-Specific
PGY-1
PGY-2
PGY-3
PGY-1
Hours:
Weekdays: 0600 - 1700
Sunday: 0600 - 1700
Job description:
- Gather numbers and overnight events on assigned patients
- Daily patient exam
- Round on patient
- Place orders
- Call consultants
- Write patient notes
- Update discharge summaries
- Present a case daily at morning report
- SIM cases every Friday morning after morning report in the PICU
“Typical” Day:
0600: I-PASS sign out (can arrive early to start to gather numbers if needed)
0630-0735: Finish pre-rounding including seeing patients (gen peds exams can be delayed if patients are sleeping)
0745-0900: Morning report case presentation
0915: Huddle with nurses
0920-1200ish: Rounds with Peds Heme-Onc first, then General Peds
After Rounds: Place orders, call consultants, discharges
Remainder of Day: ED consults, admissions, discharges, lecture by attending or senior resident, procedures if available, work on D/C summaries if time
1630: Prepare for sign out and finalize I-PASS
1700: I-PASS sign out
Weekends:
0600: Arrive and I-PASS sign out; pre-rounding
0800: Rounds begin
-
Usually attendings (heme/onc or gen peds) will bring breakfast
After Rounds: Place orders, call consultants, write notes, discharges
Remainder of Day: Finish notes, ED consults, admissions, discharges, monitor patients, discharge summaries, update I-PASS, etc.
1700: I-PASS sign out (except for Saturday 24 hour shifts)
Words of Wisdom:
- Stay organized! Use whatever method works best for you (many people use rounding sheets)
- Start notes prior to rounding! You can do this either in a Word document and print it to have on rounds OR you can start a daily note (copy forward or start new if new patient) but always be sure if you do this to change the topic of the note to “in progress” and delete your signatures.
- Be sure to get sign out from the off going intern and give sign out to the oncoming intern at the beginning and end of the month!
- Be nice to nurses and get to know them
PGY-2
PGY-3
Huddle Teaching Point: the senior resident will provide a teaching point during morning huddle. This is meant to be very brief, think 2-3 minutes. If the census is very low and you want to do something more involved, go for it, but with the new PICU requirements, this should not be a burden on the team. For example, “ there is a patient on medication X, which we do not use frequently on our ward. This medication can cause side effect Y, therefore we monitor for these signs and symptoms…” You should not be doing a comprehensive review of everything about the medication or a disease. You can keep it short!
Resources
General
I-PASS Family-Centered Rounds
Cheatsheet
LENS Board: the ward is using a LENS board, this is a great tool for communicating (ex: teaching, safety issues, giving kudos to team members). Attached is a quick one page on how to post on the LENS board (hint: you can text to it! 202-915-7735).