Overview: The PGY-3 will act as clinic team leader and resident educator helping to triage and supervise the care of patients by interns and students. PGY-3 will staff resident and student presentations confirming findings and assist in formulation of assessment and plans for patient. Consider yourself the attending. You should take ownership of the clinic flow and the role as an attending. Faculty is present to support you!
Schedule:
Morning conference attendance is expected on this rotation. You are expected to arrive in clinic promptly after morning report or grand rounds. The first patients are scheduled at 9 am.
The general pediatrics daytime hours are 9 am to 5 pm. Expect to stay in the afternoon until you have completed your last patient visit.
The general pediatrics evening hours are Monday and Wednesday from 5:30-8:30 pm.
Adolescent medicine evening hours are Monday, Tuesday, and Wednesday 5:30-8:30 pm.
Saturday and most Monday holidays, the clinic is open 9 am to 1 pm. Expect to stay until you have completed your last patient visit. This may be later than 1 pm if you are waiting for lab or Xray results.
Call:
Two nights of parent advice line call per week
1.5 or 2 weekends of parent advice line call per rotation
You will not have parent call past 5pm on your last night of the rotation.
HUDDLE INFO:
Huddle occurs daily @ 9:05 AM and 1:05 PM in Exam Room 8 (because of its proximity to the workroom and the hallway boards). Huddles will last no more than 10 minutes.
Prior to huddle, RN will obtain printed schedule and review if time allows. Participants include RN, attending, senior resident, MA, PAS, and social worker.
HUDDLE:
1. RN will open up schedule in EPIC and RN leads huddle.
2. Review (in order of appointment time) patient name, age and chief complaint.
a. Use Snap Shot to help assessment.
b. Identify if patients have complex medical or social needs.
c. Briefly identify resources/needs for this visit (e.g. social work, forms, outside records, possible need for ancillary or subspecialty services).
3. Any staffing concerns?
4. Any other questions or concerns?
POST HUDDLE: RN will post schedule in workroom.
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Patient Advice Line Calls:
Check Amion for when you are on call for the Parent advice line. Resident coverage is: 6 pm to 10 pm on weekdays, Saturdays: 1 pm to 10 pm; Sundays 8 am to 10 pm.
A Nurse Triage line is available to take calls from patients from 10 pm to 8 am every night (365 days per year). You will need to have your pager on and available in the event that the nurse triage line needs to contact you. The Doernbehcer General Pediatric clinic nurses will take triage calls while the clinic is open.
Calls can be busy during the winter. Patients have been informed that they will receive a call back within 30 minutes. If you are backed upon calls, or need attending advice, there is an attending on for back-up. Call the attending if you ever have questions about a call.
If you make a referral into the ER, you should call the ER at 503-494-7551 to let them know the patient is coming.
Calls should be documented with a telephone encounter in Epic. Documentation can be brief.
Calling patients back: Call through the OHSU operator (503-494-9000) in order to protect your personal phone number. You can also call with the prefix *67 to block the number you are calling from.
See educational information on telephone triage under General Pediatrics Rotation website
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Education: There will be a pre-clinic conference for the first 10-15 minutes (patient load permitting), lead by a rotation of interns, third year resident or the attending. Talks, articles and handouts can be found on the shared X drive: X:\SOM\PEDS\General Pediatric Clinic Talks. This is a resource meant to be shared and added to during your rotation.
Third year residents will be in charge of making sure topics are covered and assigning talks. In addition, the mornings can be a --time to discuss follow up of patients, interesting films, or go over a Peds in Review Case.
Procedures done in General Pediatric Clinic:
*Nebulizer treatments
*MDI Teaching
*Spirometry (in early phase)
*Vaccine administration
*PPD/TST placement
*Hemaque
*Ear irrigation
*Urethral Catheterization
*Tympanometry
* Use of fluorescein dye
* Wart treatment with liquid nitrogen
* Rapid Strep Testing
* Transcutaneous Bilirubin Testing
*Silver nitrate use
*Circumscion (Schedule per Dr. Blaschke)
Please take the opportunity as able to participate and perform procedures.