NICU
Rotation director:
Name: Astrid Platteau
Email: platteau@ohsu.edu (preferred method of communication)
Pager: 14324
Cell Phone: 786-663-6142
NICU unit phone: 503-494-8122
Overview:
The NICU is an inpatient intensive care experience, core to pediatric residency education. Residents will learn about and care for neonates admitted to the unit for various reasons, from prematurity to congenital abnormalities.
Rotation goals and objectives:
Basic goals and objectives for interns
o Distinguish a well neonate from a sick neonate
o Become comfortable with neonatal resuscitation and attendance of deliveries
o Become familiar with resources aimed at neonatal care
o Define normal weight, feeding, and growth for term and preterm neonates
o Identify criteria for discharge readiness for a neonatal patient
Basic goals and objectives for 2nd years
o Diagnosis and management of ill neonates in conjunction with NICU team
o Nutritional management of neonates from birth to discharge
o Develop a comfortable and confident approach to interviewing and communicating with parents of a hospitalized neonate.
o Identify social and medical barriers to safe discharge of neonatal patients with chronic medical conditions.
Basic goals and objectives for 3rd years
o Diagnosis and management of critically ill neonates in conjunction with NICU team
o Discuss the influence of chronic and terminal illness on the neonate, family, physician and hospital personnel and develop strategies to facilitate effective and empathetic care for these patients.
o Discuss the ethical and emotional issues surrounding the care and delivery of severely ill infants.
o Ensure sound follow-up and understand the beginnings of outpatient management of neonates once they leave the NICU
Prior to the start of the rotation:
Obtain sign out on your patients from the resident preceding you. If this is your first time in the NICU, allow some extra time during your sign out to do some teaching on things like total fluid and calorie calculations, the expected workflow in the morning before rounds, and rounding expectations.
First day of the rotation:
Overall: Sign-out occurs at 7 am in the Advanced Practice office at the back of the unit. Be ready for rounds at 9 am in the attending office to review X-rays, followed by bedside rounds starting at 9:15 am.
1. Morning sign-out begins at 7am every day. You may need to begin pre-rounding earlier in order to be prepared for rounds, depending on the census.
2. Daily rounds start promptly at 9am in the attending office reviewing new X-rays for the day. At 9:15AM, resident team rounds will start in pod 6. Bring a computer on wheels to be able to put in orders (max of 2 computers due to space limitations). If you’re not presenting a patient, you’re expected to listen to the presentation and help put in orders with order read back at the end of the presentation.
Resident Expectations:
1. Read the resident expectations and tips page.
2. Conferences: You are encouraged to attend morning report and grand rounds as able, though please be back on the unit and ready to start at 9 am for xray rounds in the attending office. You should be able to attend a minimum of 3 noon conferences routinely while working days, with one of them being Friday Forum when that is the Friday Conference. Please notify the advanced practice team members when you will be off of the unit for conference.
3. Neonatology conferences: there are several conferences specific to the neonatology division each week that are great learning opportunities but not required for residents. You will receive an email each week listing the conferences and topics. Read here for a description of the meetings and the general schedule.
4. NICU simulations are scheduled approximately every 3 weeks between 5-6pm to allow for hands on practice of NRP and the equipment in a simulation setting. The night residents will come an hour earlier than usual in order to participate in simulations with the day residents. Dates of the simulations will be noted on the monthly google calendars which are linked in the weekly emails. You will also receive email reminders the week prior to the simulations.
5. NICU nutrition talks are scheduled close to the beginning of each first year resident's first NICU rotation. If you don't see a date scheduled for you, or you would like to have a refresher, contact the rotation director or the dietitians directly, and we'd be happy to get this set up.
General Schedule:
Note: If a resident has continuity clinic or their family medicine education afternoon, a huddle should occur during xray rounds (between 9-9:15 before rounds) to establish how and when signout of their patients will occur, and to whom. This huddle should include the fellow or attending and at least one member of the NP team to help troubleshoot.
Note: The expectation is that residents continue to be in the NICU to care for their patients, be available for new patients, and learn about neonatal medicine for the entirety of their day. If, however, the unit is slow enough and it would not negatively impact patient care, education, or the additional providers in the unit, signing out early to another resident can be considered. However, this MUST be discussed with the fellow for approval.
If you are going to be absent for all or part of a day:
1. Notify the chief residents and Mike Grubbs
2. Notify the fellow/attending on service if it is something known in advance (attending a conference, interview, etc); notify either the night or day fellow if it is an unexpected absence (illness, etc)
Resident Resources, Helpful Tips, and Further Readings: