Job Description for Renal Component-CMT Training, City Hospital
Campus. Nottingham University Hospital


Summary of Learni...
Locum Consultant Position (pending substantive appointment)


The Renal and Transplant Unit inpatients are spilt between 2...
Outpatient Clinics

One SHO is invited to attend the weekly new-patient clinic held on a
Wednesday afternoon. This is an e...
Achievement of Learning Objectives

To gain an understanding of the wide range of renal conditions that are
managed in sec...
To gain an understanding of prescribing for patients with impaired renal
function. The unit has a renal specialist pharmac...
Upcoming SlideShare
Loading in …5
×

12518971533_renal_ci..

264 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
264
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

12518971533_renal_ci..

  1. 1. Job Description for Renal Component-CMT Training, City Hospital Campus. Nottingham University Hospital Summary of Learning Objectives 1. To gain an appreciation of a wide range of renal conditions that are managed in secondary care 2. To gain experience in the assessment and management of patients with acute renal failure, including the indications for dialysis 3. To gain experience of the management of patients with chronic kidney disease 4. To gain experience in the management of patients requiring renal replacement therapy (including haemodialysis, peritoneal dialysis and renal transplantation). 5. To gain experience in the end of life care of patients with kidney failure. 6. To gain experience in the assessment of fluid balance in patients with renal failure. 7. To gain an understanding of prescribing for patients with impaired renal function. 8. To gain experience in the insertion of temporary jugular and femoral dialysis catheters and the use of ultrasound localisation for these procedures. The Renal and Transplant Unit Trainees working in the Renal and Transplant Unit will see the full spectrum of renal diseases, including renal transplantation. There are full diagnostic facilities including access to diagnostic and interventional radiology support and histopathology. Apart from medical staff there are Nurse Specialists in anaemia management, peritoneal dialysis, transplantation and pre-dialysis care. In-patient work is based on Carrel and Bramley wards. There are 4 general nephrology clinics, 3 modality clinics (transplant, haemodialysis and peritoneal dialysis) and a new patient clinic weekly, as well as a number of specialist clinics. The Team Consultants Dr C.E. Bebb (lead consultant for haemodialysis) Dr R.P. Burden (lead consultant for peritoneal dialysis) Dr M.J.D. Cassidy (transplantation) – part-time until Summer 2007 Dr S.D. Roe (lead consultant for haemodialysis – Kings Mill Hospital) Dr C. Byrne (transplantation)
  2. 2. Locum Consultant Position (pending substantive appointment) The Renal and Transplant Unit inpatients are spilt between 2 firms. Dr Roe and Dr Burden are responsible for one firm and Dr Bebb and Dr Byrne the other. The consultants rotate on and off the inpatient service, so that at any one time only one consultant is in charge of each team. Medical Consultant cover for the in-patient transplant service is provided on a monthly rota basis. 4 SHOs are allocated to the Renal and Transplant Unit. SHO’s are divided between the two teams. There is one Specialist Registrar covering each in- patient team. In addition there are 3 other specialist registrars covering the dialysis unit, peritoneal dialysis unit and transplantation. Inpatient beds Most of the units inpatients are on Bramley and Carrel wards. There are close links with the diabetes teams at the City hospital campus and joint patients are often cared for on Patience 1 and 2 wards.
  3. 3. Outpatient Clinics One SHO is invited to attend the weekly new-patient clinic held on a Wednesday afternoon. This is an educational requirement. All new cases should be presented to the consultant in charge of the clinic to determine management and further follow up plans. For SHO’s that are interested there are opportunities to sit in on modality clinics (haemodialysis, transplant and peritoneal dialysis) on an ad hoc basis providing service commitments allow. Teaching There is a weekly teaching programme led by the Consultant staff. There is a weekly x-ray meeting, fortnightly renal biopsy meeting and a regular programme of clinical audit meetings. Clinical Information The Department has a comprehensive handbook for the management of patients with renal disease. SHO’s attend a renal induction morning at the start of their attachment. Example Timetable AM Lunchtime PM Monday Handover meeting Ward work Registrar Ward Round Tuesday Consultant Ward Postgraduate Core curriculum Round Meeting teaching programme Wednesday Teaching X-Ray Meeting New patient clinic SHO ward round Thursday Registrar Ward Renal biopsy / Ward work Round Clinical audit meeting Friday Consultant Ward Renal Unit Grand Ward work Round Round
  4. 4. Achievement of Learning Objectives To gain an understanding of the wide range of renal conditions that are managed in secondary care. Attendance at the Wednesday afternoon new patient clinic, together with inpatient based work on the renal wards will expose the trainee to the variety of renal conditions. These would include nephrotic syndrome, acute renal failure, vasculitis and glomerulonephritis. Trainees will gain skills in the interpretation of electrolytes and arterial blood gases as well as diagnostic investigations relevant to renal medicine. To gain experience in the assessment and management of patients with acute renal failure, including the indications for dialysis. Trainees will be involved in the initial assessment and subsequent management of patients presenting with acute renal failure (including transfers from other hospitals). This will involve exposure to patients requiring acute haemodialysis and other extra-corporeal therapies, including plasma exchange. The SHO teaching programme includes sections on acute renal failure and the indications for dialysis. To gain experience of the management of patients with chronic kidney disease. Patients with chronic kidney disease are frequently admitted for investigation and management. The trainee will be involved in the admission of patients for renal biopsy and will have the opportunity to watch renal biopsies. To gain experience in the management of patients requiring renal replacement therapy (including haemodialysis, peritoneal dialysis and renal transplantation). The trainee will be involved in the assessment and management of in-patients treated with haemodialysis, peritoneal dialysis and transplantation. As well as a variety of general medical problems this will involve experience of vascular access problems, complications of peritoneal dialysis and exposure to patients undergoing renal transplantation (both deceased and live donor). The trainee will also be involved in the care of patients attending the out-patient dialysis unit. Unit based teaching around renal replacement therapies will be provided by the senior medical staff and nurse specialists. To gain experience in the end of life care of patients with kidney failure. End of life care is covered in the trainee induction programme. The unit also has a dedicated palliative care nurse practitioner. The trainee will gain experience of looking after renal patients at the end of life, including the use of end of life care pathways. To gain experience in the assessment of fluid balance in patients with renal failure. Fluid balance assessments are a vital part of the management of patients with both acute and chronic renal failure. Trainees will have ample opportunity to develop their clinical skills in fluid balance assessment throughout the attachment.
  5. 5. To gain an understanding of prescribing for patients with impaired renal function. The unit has a renal specialist pharmacist. Drug dosing in renal failure and common prescribing errors will be covered in teaching sessions by the pharmacist. The pharmacist is available on a daily basis on the in-patient wards and will discuss prescribing decisions with the trainee. To gain experience in the insertion of temporary jugular and femoral dialysis catheters and the use of ultrasound localisation for these procedures. There will be opportunities for trainees to develop their skills in the insertion of jugular and femoral lines for dialysis. Elective lines are placed under ultrasound guidance and trainees will be taught this technique in addition to the standard landmark based techniques. Other Learning Opportunities There will be opportunities for trainees to be involved in the management of patients with renal failure in a critical care setting. Trainees can attend the renal histology meetings if they wish. There is a regular audit programme (including quarterly mortality and morbidity meetings). This post forms part of the CMT training program for the Mid-Trent Deanery This job description supplements that of the CMT training program and describes the training opportunities offered by this post.

×