Critical Care Medicine  

Resident Training

Stanford Med-Surg ICU Orientation

Before your first day
            The night before your first day in the ICU, please call your respective teams phone (Green team - 68069, Blue team - 33688) to get signout on your patients who you will need to see for rounds in the AM (the on call resident carries each team phone and will assign patients to the new incoming resident).

Morning of your first day
            The overnight residents will usually be sitting in the island of computers in front of room E-233 (when you walk into the E2-ICU main doors, bear left and they should be in front of you). If the resident for your team is not there, call the on their phone. They will give you updates on your patients from over night. They may also assign extra patients depending on how many admissions they got overnight. Prepare to arrive around 6:30-7:00 (depending on how many patients you will need to see).

AM Rounds – Start every morning promptly at 8:00 at the North ICU front desk. You will meet your team there, and see NICU patients first, and then make your was to E2.

Lectures – Start at 10:30 at the conference room outside of the entrance to D2 (Code for door is 428).   Fellows will free you up to attend these valuable teaching sessions.

Radiology Rounds – Start at 11:30 in the chest reading room in radiology. You will go over all x-rays from patients in the ICU from morning.

PM Rounds – Will start promptly at 3PM at the NICU front desk.

Rounding (AM and PM) – During rounds, the fellows (if rounding with the team and available) are to carry the team phones so that when residents are presenting, they are not interrupted.

On Call resident – Should NOT carry the team phone during his/her call day until PM rounds are over (usually around 4PM). They need to use the time they have during the day to get work done and learn the other patients on their team so they are not overwhelmed when everyone leaves after PM rounds.

Post Call resident – MUST leave by Noon post call. If they need help doing things (calling consults, procedures, etc…) the team should help him/her out to get them out on time. Post call residents at times pre-write their notes prior to rounds and then sign them after rounds to facilitate their departure. Consider morning rounds your signout to the on call resident.

Days Off – If you are NOT on call or post call on a weekend day or a holiday (Stanford hospital official holidays) you DO NOT need to be in the hospital. This includes months when the first day of the month falls on a holiday or weekend. So for example, on Jan 1, only post call and on call residents need to report for work.

All residents will get 1 day a week off averaged over 4 weeks. That does NOT mean one day off every week. There will be a week when residents will not get a day off (Sat call/Sun post call). This is made up with thursday call (“golden weekend”) when the resident will be post call on Friday and off sat/sun.

If a resident needs a specific day off, that will need to be arranged ahead of time by speaking with the teams attending and/or fellows.

Post Call resident on last day – It is expected that residents who are post call on their last day in the ICU to stay for post call rounds. (In previous years, we have had residents leave at 7AM post call to go to their new rotations which caused significant problems with handoffs. We have discussed these issues with the medicine and anesthesia chief residents, and they have agreed with us that post call residents should stay for post call rounds. If you are on call your last day and foresee a problem, it is your responsibility to bring this to the attention of your attending and fellows at the start of the rotation.

Departmental Functions – At times throughout the year, departments will have certain days when their residents need to be excused. These days are pre-arranged and are taken into consideration when making the residents schedule. That is why at times there are slight deviations from the Q4 scheduling. It is the responsibility of the resident to look at his/her schedule at the beginning of the month and if they perceive that there are any irregularities to inform their attending or fellows.

 

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