Ward Tour

Welcome to the Surgery Ward

UHNBC has two "towers": For reference, the student lounge is on the 5th floor of one of these towers. The surgical ward is on the 3rd floor of the OTHER tower. You can get there by going down to the 1st floor (same level as the OR, LDR, ED, etc.) and either going past the ED, or by crossing to the opposite corner of the main open atrium of the hospital, and then up the elevators or stairs to the 3rd floor.

Make sure you check which part of the Surgery floor you are going to: one end is called Surgery North, the other is Surgery South. Each of these wings is broken into "Pods" (A-D). Each Pod is staffed by a few nurses, has several patient rooms, and some of these rooms have multiple patient beds. A patient's location may be written as room # + bed location (eg: 3202-A). There is a plaque outside each room that will orient you to which bed is A vs. B. If you aren't sure where your patient is located on the surgery floor, look them up on PowerChart and it will list their location.

To write your rounding note, you will need to access information from a variety of sources. The main places to look for your information are:

Vitals

These are found on the clipboards located at 1 (in the above diagram) on the surgery floor. They will be recorded on a sheet that looks like the one to the left.

NOTE: The most RECENT nursing notes are also found on this clipboard and are good to review/ chat with the patient's nurse to get an update on their status.

2. In's and Out's

These are found in the MAR binder at location 2. Different nurses have different ways of filling theses out (Eg: keeping a running tally vs. individual measurements that you will have to add up). Note the in's and out's are in the MAR on the surgery floor, but with the vitals clipboard on the internal medicine and family medicine units.

3. Medications

These are located in the MAR at location 2. This will tell you the most UPDATED medication the patient is recieving. As well, it will let you know when the patient last recieved a medication. This is helpful for things, such as pain medication and antibiotics.

4. Labs and Imaging

PowerChart can be accessed on all computers on the wards. You should be checking the patient's PowerChart every day with rounding to see if there are any new labs/ imaging.

5. Pertinent Chart Tabs

Chart Tabs

There are A LOT of tabs in the patient chart. The main ones we are concerned with for rounding are:

Progress Notes
Physician Orders

Physican Notes

This is where you will write everything in a patient chart, including:

Rounding Notes
Consult Notes
Procedure/ OR Notes

Physicians Orders

Check here to see if any orders have been done in the past day. This will give you a hint to the care the patient has recieved. Also if you need to write orders- they go here. Make sure to:

Time/date orders
Sign orders with designation (C3)
Write "discussed with Dr.___"

Other tabs in the patient chart that can be helpful include:

Nurses Notes: Older nurses notes will be found here, the most recent is found on the vitals chart.
Consults: Sometime, the dictated consult note will be printed off and put in here. This is helpful if it is a new patient to you so you can familiarize yourself as to why they are in the hospital. Note, these consult notes can also be found on PowerChart.
Allied Health Professionals: For some patients, if they are being seen by physiotherapy, occupational therapy, speech & language, they will leave their progress notes in this section (usually at the end of the chart)

Now that you've rounded, you decide to:

Go to the ED

Go to the OR

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