Tao T. Le, MD, MHS Assistant Clinical Professor Chief, Section of Allergy & Immunology University of Louisville Senior Edi...
Overview <ul><li>Common Ward Mistakes </li></ul><ul><li>The Team </li></ul><ul><li>A Day on the Wards </li></ul><ul><li>Th...
NRMP: Charting Outcomes in the Match
Common Mistakes <ul><li>Not understanding roles, responsibilities, expectations </li></ul><ul><li>Not seeking timely feedb...
The Team <ul><li>Attending/Chief </li></ul><ul><li>Resident </li></ul><ul><li>Intern </li></ul><ul><li>Sub-intern </li></u...
Typical Inpatient Medicine Day <ul><li>Prerounds: 7-8 am </li></ul><ul><li>Work rounds: 8-9:30 am </li></ul><ul><li>Work t...
Typical Inpatient Surgery Day <ul><li>Prerounds: 5-6 am </li></ul><ul><li>Work rounds: 6-7:30 am </li></ul><ul><li>Preop p...
Taking Call <ul><li>Overnight call </li></ul><ul><li>Short call </li></ul><ul><li>Typically Q4 </li></ul>
The Admission <ul><li>The “Call” </li></ul><ul><li>Reviewing objective data </li></ul><ul><li>Medical record review </li><...
Key Notes and Orders <ul><li>Admit orders </li></ul><ul><ul><li>A dmit to </li></ul></ul><ul><ul><li>D iagnosis </li></ul>...
Key Notes and Orders <ul><li>Admission notes </li></ul><ul><ul><li>O nset </li></ul></ul><ul><ul><li>P rogression </li></u...
Key Notes and Orders <ul><li>Progress notes </li></ul><ul><li>Procedure notes </li></ul><ul><li>Daily orders </li></ul><ul...
Documentation Tips <ul><li>Get everything co-signed </li></ul><ul><li>Date/sign all pages </li></ul><ul><li>No documentati...
Oral Presentations <ul><li>Formal presentations </li></ul><ul><ul><li>5-7 minutes (surgery: 2-3 min.) </li></ul></ul><ul><...
Daily Ward Activities <ul><li>Procedures </li></ul><ul><li>Patient/family communications </li></ul><ul><li>Consults </li><...
Survival Tips
Efficient Time and Patient Management <ul><li>Commit all tasks to a to-do list </li></ul><ul><li>Prioritize tasks </li></u...
Organizational Aids (“Peripheral Brains”) <ul><li>Clipboard </li></ul><ul><li>Binders </li></ul><ul><li>Data sheets </li><...
Evaluations <ul><li>Critical for dean’s letter </li></ul><ul><li>Know the evaluation criteria </li></ul><ul><ul><li>Clinic...
Difficult Situations <ul><li>Needlesticks </li></ul><ul><li>Abusive/inappropriate house officers </li></ul><ul><li>Inappro...
Difficult Situations (cont.) <ul><li>Difficult/violent patients </li></ul><ul><li>Difficult family members </li></ul><ul><...
Getting Off to a Fast Start
Scheduling Rotations <ul><li>Avoid most likely specialty in first/last block </li></ul><ul><li>Avoid back-to-back tough ro...
Choosing Rotation Sites <ul><li>County </li></ul><ul><li>VA </li></ul><ul><li>Academic/university center </li></ul><ul><li...
Before the Rotation <ul><li>Classmates </li></ul><ul><li>FA Wards  specialty chapter </li></ul><ul><li>FA USMLE Step 2CK  ...
Your “Secret Weapons” <ul><li>Enthusiasm/hustle </li></ul><ul><li>Time </li></ul><ul><li>Basic science knowledge </li></ul...
Upcoming SlideShare
Loading in …5
×

First Aid for the Wards Presentation with Dr. Tao Le

798 views
665 views

Published on

Published in: Education, Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
798
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • You – 3 rd year student
  • Team dependent Holding the leg/ Overnight call Short call Institution/team/dependent
  • Team dependent Holding the leg/ Overnight call Short call Institution/team/dependent
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • BE on time
  • First Aid for the Wards Presentation with Dr. Tao Le

    1. 1. Tao T. Le, MD, MHS Assistant Clinical Professor Chief, Section of Allergy & Immunology University of Louisville Senior Editor First Aid Board Series USMLERx Test Bank Series First Aid for the Wards: The Really Short Version
    2. 2. Overview <ul><li>Common Ward Mistakes </li></ul><ul><li>The Team </li></ul><ul><li>A Day on the Wards </li></ul><ul><li>The Admission </li></ul><ul><li>Key Tasks </li></ul><ul><li>Survival Tips </li></ul><ul><li>Getting Off to a Fast Start </li></ul><ul><li>Q&A </li></ul>
    3. 3. NRMP: Charting Outcomes in the Match
    4. 4. Common Mistakes <ul><li>Not understanding roles, responsibilities, expectations </li></ul><ul><li>Not seeking timely feedback </li></ul><ul><li>Not using appropriate texts and references </li></ul><ul><li>Not knowing how to be a team player </li></ul><ul><li>Inefficient organization and execution of daily work </li></ul>
    5. 5. The Team <ul><li>Attending/Chief </li></ul><ul><li>Resident </li></ul><ul><li>Intern </li></ul><ul><li>Sub-intern </li></ul><ul><li>Nurse </li></ul><ul><li>Ward clerk </li></ul><ul><li>Pharmacist </li></ul><ul><li>Other staff </li></ul><ul><li>You </li></ul>
    6. 6. Typical Inpatient Medicine Day <ul><li>Prerounds: 7-8 am </li></ul><ul><li>Work rounds: 8-9:30 am </li></ul><ul><li>Work time: 9:30-11 am </li></ul><ul><li>Attending rounds: 11-noon </li></ul><ul><li>Conference: noon-1 </li></ul><ul><li>Afternoon work: 1-? </li></ul><ul><li>Signing out </li></ul>
    7. 7. Typical Inpatient Surgery Day <ul><li>Prerounds: 5-6 am </li></ul><ul><li>Work rounds: 6-7:30 am </li></ul><ul><li>Preop prep: 7:30-8 am </li></ul><ul><li>Surgery/floor work: 8-5 </li></ul><ul><li>Conference: noon-1 </li></ul><ul><li>“ Afternoon” rounds: 4-5:30 </li></ul><ul><li>Postrounds work: 5:30+? </li></ul>
    8. 8. Taking Call <ul><li>Overnight call </li></ul><ul><li>Short call </li></ul><ul><li>Typically Q4 </li></ul>
    9. 9. The Admission <ul><li>The “Call” </li></ul><ul><li>Reviewing objective data </li></ul><ul><li>Medical record review </li></ul><ul><li>Interviewing the patient </li></ul><ul><li>Physical exam </li></ul><ul><li>Putting it all together </li></ul><ul><li>Reviewing case with the resident/intern </li></ul>
    10. 10. Key Notes and Orders <ul><li>Admit orders </li></ul><ul><ul><li>A dmit to </li></ul></ul><ul><ul><li>D iagnosis </li></ul></ul><ul><ul><li>C ondition </li></ul></ul><ul><ul><li>V itals </li></ul></ul><ul><ul><li>A llergies </li></ul></ul><ul><ul><li>A ctivity </li></ul></ul><ul><ul><li>N ursing orders </li></ul></ul><ul><ul><li>D iet </li></ul></ul><ul><ul><li>I V fluids </li></ul></ul><ul><ul><li>M edications </li></ul></ul><ul><ul><li>S pecial studies </li></ul></ul><ul><ul><li>L abs </li></ul></ul>
    11. 11. Key Notes and Orders <ul><li>Admission notes </li></ul><ul><ul><li>O nset </li></ul></ul><ul><ul><li>P rogression </li></ul></ul><ul><ul><li>P rovocation </li></ul></ul><ul><ul><li>P alliation </li></ul></ul><ul><ul><li>Q uality </li></ul></ul><ul><ul><li>R egion </li></ul></ul><ul><ul><li>R adiation </li></ul></ul><ul><ul><li>S ymptoms </li></ul></ul><ul><ul><li>S everity </li></ul></ul><ul><ul><li>T ime course </li></ul></ul>
    12. 12. Key Notes and Orders <ul><li>Progress notes </li></ul><ul><li>Procedure notes </li></ul><ul><li>Daily orders </li></ul><ul><li>Prescriptions/DC orders </li></ul>
    13. 13. Documentation Tips <ul><li>Get everything co-signed </li></ul><ul><li>Date/sign all pages </li></ul><ul><li>No documentation = no reimbursement </li></ul><ul><li>Illegibility = no documentation </li></ul><ul><li>Use only appr. abbrev. </li></ul><ul><ul><li>“ q.d.&quot; vs. “q.i.d” vs. “once daily” </li></ul></ul><ul><ul><li>To CYA, never CYOA! </li></ul></ul>
    14. 14. Oral Presentations <ul><li>Formal presentations </li></ul><ul><ul><li>5-7 minutes (surgery: 2-3 min.) </li></ul></ul><ul><ul><li>Should tell a story </li></ul></ul><ul><ul><li>CC/HPI/PE/Labs  sets the stage </li></ul></ul><ul><ul><li>A&P  delivers the climax </li></ul></ul><ul><li>Bullet presentations </li></ul><ul><ul><li>1 minute </li></ul></ul><ul><ul><li>15-20 facts </li></ul></ul>
    15. 15. Daily Ward Activities <ul><li>Procedures </li></ul><ul><li>Patient/family communications </li></ul><ul><li>Consults </li></ul><ul><li>Data collection </li></ul><ul><li>Reading up on patients </li></ul><ul><li>“ Walking supply cart” </li></ul>
    16. 16. Survival Tips
    17. 17. Efficient Time and Patient Management <ul><li>Commit all tasks to a to-do list </li></ul><ul><li>Prioritize tasks </li></ul><ul><li>Organize tasks by location </li></ul><ul><li>Maximize hospital information system </li></ul><ul><li>Keep “scut” essentials on board </li></ul><ul><li>Always be early!! </li></ul>
    18. 18. Organizational Aids (“Peripheral Brains”) <ul><li>Clipboard </li></ul><ul><li>Binders </li></ul><ul><li>Data sheets </li></ul><ul><li>Note cards </li></ul><ul><li>iPhone/iPad/Android </li></ul>
    19. 19. Evaluations <ul><li>Critical for dean’s letter </li></ul><ul><li>Know the evaluation criteria </li></ul><ul><ul><li>Clinical performance </li></ul></ul><ul><ul><li>Shelf exam? </li></ul></ul><ul><li>Know who is evaluating you </li></ul><ul><li>Clarify expectations </li></ul><ul><li>Ask for feedback early on </li></ul>
    20. 20. Difficult Situations <ul><li>Needlesticks </li></ul><ul><li>Abusive/inappropriate house officers </li></ul><ul><li>Inappropriate procedures </li></ul><ul><li>“ Gunner” classmates </li></ul><ul><li>Patient death </li></ul><ul><li>Sexual harassment </li></ul>
    21. 21. Difficult Situations (cont.) <ul><li>Difficult/violent patients </li></ul><ul><li>Difficult family members </li></ul><ul><li>“ Narcolepsy” </li></ul><ul><li>Personal/family illness </li></ul>
    22. 22. Getting Off to a Fast Start
    23. 23. Scheduling Rotations <ul><li>Avoid most likely specialty in first/last block </li></ul><ul><li>Avoid back-to-back tough rotations </li></ul><ul><li>Do easy rotation before desired specialty rotations </li></ul>
    24. 24. Choosing Rotation Sites <ul><li>County </li></ul><ul><li>VA </li></ul><ul><li>Academic/university center </li></ul><ul><li>Community/private hospital </li></ul><ul><li>Outpatient clinic </li></ul>
    25. 25. Before the Rotation <ul><li>Classmates </li></ul><ul><li>FA Wards specialty chapter </li></ul><ul><li>FA USMLE Step 2CK </li></ul><ul><li>FA Step 1 relevant content </li></ul><ul><li>FA Wards recommended pocketbooks/texts/software </li></ul>
    26. 26. Your “Secret Weapons” <ul><li>Enthusiasm/hustle </li></ul><ul><li>Time </li></ul><ul><li>Basic science knowledge </li></ul><ul><li>“ Low” expectations </li></ul>

    ×