PICU

Rotation Director:

Name: Shinpei Shibata, MD

Email: shibata@ohsu.edu

Office: CDRC 1227

Phone: 503-494-4953

Pager: 16187

Additional Contact Information:

Medical Director: Laura Ibsen, MD. Pager 10473. Email: ibsenl@ohsu.edu

Nurse Practitioner: Serena Kelley CPNP-AC. Pager 15994. Email: phromsiv@ohsu.edu

Overview:

This is an intensive care unit rotation where residents will provide direct care for critically ill children.

Rotation goals and objectives:

    • Residents will experience the multifaceted challenges of patients and their families with critical illness, and be able to help coordinate their care amongst a multidisciplinary team

      • Residents will effectively evaluate and manage (under the supervision of an intensivist) patients with signs, symptoms, and conditions that present commonly to the intensive care unit

      • Residents will effectively evaluate and manage (under the supervision of an intensivist) patients with signs, symptoms, and conditions that present commonly to the intensive care unit including post-cardiac surgery patients

Prior to the start of the rotation:

    1. Obtain sign-out from preceding resident

    2. Review the resident resources and helpful tips prior to starting so unit flow and rounding structure makes sense

    3. Be ready to hear morning sign-out on your first day at 6am in the PICU

First day of the rotation:

    • The overnight resident will give you sign-out on your patients starting at 6 am. Please be ready to tell them which patients you are expecting to take care of and know that there might be new patients to hear about in the morning

    • Residents will pre-round from 6:15am-7:25am. This means that all patients have been examined and the residents are ready to present for 7:30am rounds

      • There will be two computers on rounds – one for updating sign-out and one for placing orders. This means that your notes/presentations will need to be printed out prior to the start of rounds!

    • Please note that the post-call resident will be available to provide help and answer questions until 8 am

    • Please note that if it is a Wednesday morning, the EM resident will leave prior to rounds to attend their teaching conference. You may be expected to read their presentations but will not have to pre-round on them separately (as the EM person has already pre-rounded)

Resident Expectations:

    1. Examine all your patients before pre-rounds. Please reach out to the attending early if you have any concerns about completing this task

    2. Communicate effectively with all members of the team including NPs, attendings, RNs, RTs, and PICU fellows

    3. Residents are first call on all patients and are expected to be the first line and primary caregiver to each of their patients

    4. Communicate concerns about clinical decompensation to all members of the team, including suggested next steps of action

    5. Effectively communicate with families in the setting of severe illness by providing regular updates of the child’s current status and plans for the day on a regular basis. Frequent updates may help ease anxiety and can build trust.

General Schedule:

Monday-Thursday:

7:30am: rounds start with cardiology patients

4:30pm: sign-out to the on-call resident

Teaching sessions: Thursdays 1:30-2pm

Friday:

7:30am: rounds start with medical patients

8:30am: cardiology arrives from conference -> transition to cardiology rounds

4:30pm: sign-out to the on-call resident

Sat-Sun:

7:30am-8:00am: rounds start with overnight resident rounding on 1-3 patients

9:00am: overnight resident leaves, moonlighter and on-call resident round, starting with cardiology patients

Noon: moonlighter leaves, if present

If there is not going to be a moonlighter on the weekend: The post-call resident stays to round with the team and leaves by 10:30am! Rounds will still start at 7:30am

If you are going to be absent for all or part of a day:

    • Please contact (page or text) the chief on call as soon as possible to arrange coverage. A verbal exchange must happen with the chief on call because you may need to contact other individuals

    • Jeopardy will be called for the following circumstances:

      • if the sick resident is on call that day, a jeopardy resident will arrive in time for evening sign-out (jeopardy is NOT called for weekday illness, if the resident gone is not on call that evening)

      • weekends

      • extenuating clinical circumstances in discussion with the chiefs

    • Any resident missing more than 2 days (or 4 half days) may be required to make up the difference at a future date at the discretion of the rotation director and program leadership.

Resident Resources: Helpful Tips, and Further Readings:

Pleas see this shared Box Folder

WEBSITE LINK: https://pdxpicu.wixsite.com/resident