Scripps Mercy ED

Rotation Onboarding:

8 weeks prior: Submit Rotation paperwork (see below)

by 6 weeks prior: Finish your schedule requests on the Mercy scheduling request form below 

4 weeks prior: Email Rotation Director and Rotation Coordinator 

Rotation POC (AY 24-25)

Rotation Directors

David Bruner, MD

dibruner@yahoo.com

757-773-8209

Cara Bergamo, MD

cara.bergamo.md@gmail.com

(Dr Bergamo on maternity leave summer 2024)

Jeremy Pierce

GME Coordinator - Visiting Rotations

Scripps Mercy Hospital

E: pierce.jeremy@scrippshealth.org

Ph: 619-260-7220

Check In

Check in at GME which  is located in basement of the main hospital building, down the hall from the auditorium.  Set up a time to sign your paperwork and get your badge BEFORE your first shift. She will send you a link for online training required for your computer access. Melissa will send over most required documents for you (current TB, medical license, TAD orders).

You should start making your schedule at least 2 months in advance. 

You will work 16 shifts during the block.

Respond to all the Code Trauma’s.  One of the staff on in the ED will be designated to respond (usually D pod staff).  Once the primary survey is done jump in with the US for the FAST exam.  If it is a patient that may need intubation be ready as the ED resident you get to manage the airway with the ED staff.  You get first dibs before the ER resident on Trauma but of course can share if you like.

Respond to all code blue’s in the hospital.  A staff and you will grab the airway box, med box, and bougie go to the room.  Good emergent airways in code situations.  Tube and leave.

DOCUMENTATION:  Be prepared to dictate all encounters. Make sure you review the dictation go-by for Mercy which is below. There are several specific things they would like which are not intuitive. There is also a template for dictating procedures and ultrasounds that you will want handy (just keep a printed copy in your pocket). The staff will almost always dictate the code trauma patients for you. For all other patients you dictate a full note and then place on “pause” for the staff to add their addendum. A few will just prefer you to close out your dictation and they will dictate their own separate note, just ask what they prefer at the beginning of the shift. All dictations are under your corporate ID number and #70 for the work type (ED note). There are some staff that will sometimes dictate the entire note for you if you are busy doing a procedure/resus. Then there are others who have you dictate everything and even wait to go home for you to finish your dictation so they can tack on their addendum.

It is very important to sign your dictations within a few days max. You will see that most are ready for signing by the end of your shift and if you are not going to be going back to Mercy the following day, it is very easy to log in remotely from home to sign them.

For efficiency, some prefer to dictate the chart in two parts with an initial H&P after you see them and then the 2nd half prior to discharge/admission. 

ORDERS: Once you write orders on paper chart on clipboard, give to the unit secretary to enter (labs/rads). Also pull the EKG tag on the chart and NURSE tag on the chart if needed (for medications/nursing orders).

ADMISSIONS: Which attending’s the patients are admitted to is confusing at first, your staff will help based on their insurance. If going to the teaching service on the ward, only the resident needs to be called if at NIGHT. During the day call the staff and resident.  Call teaching staff and resident day OR night if it is an ICU patient.

Lots and lots of procedures.  Jump on them even if the staff was already seeing the patient first.  Most of the time they will come get you to do procedures especially central lines, LP’s, lacs and I&D’s because it saves them time.  Keep your ears open because you may miss an opportunity to run a code or intubate because you’re doing an I&D on the other side of the ED.

You can wear your own scrubs or acquire from the OR. Your badge will open the doctors lounge by the cafeteria where you can get free food and drinks.