HSS - Revision history

Oliviamsutton: Replaced content with " **"

2022-04-12T22:20:28Z

Replaced content with " **"

← Older revision		Revision as of 15:20, 12 April 2022
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	~~== General Info + Tips/Tricks: ==~~

	~~====== General expectations ======~~		**

	* ~~Call: Two calls, one weekday, one weekend~~
	* ~~Didactics: You present one journal club, 10-15 min presentation~~
	* Schedule: Expect to get your schedule ~2-4 weeks before starting your rotation. You can request specific calls by emailing the Cornell Chiefs, if need be.
	* Contacts: Mary Hargett is the coordinator for the program

	~~====== Where are the ORs? ======~~

	* There are 3 sets of ORs: 1st floor (Hand and Foot), 4th floor (Main) and 9th floor (Ambulatory).
	* Access the 9th floor only through the West elevators. The 4th floor can be accessed

	~~====== Where to keep your stuff: ======~~

	* There's a locker room associated with each set of ORs. You will not have a locker, but you can hang your coat on many racks here.
	* It's generally accepted to have a bag in the ORs. I've seen attendings bring entire backpacks and coats into the OR as well
	* If you want a safe, non-OR spot, you can put it in the call room on the 4th floor. It's just across from the East Elevators, door code 2+4 then 3.

	~~====== Where to eat: ======~~

	* ~2/3 of attendings will order you delivery for lunch every day.
	* For the 1/3 that don't, you can either go to the Belaire Cafe across the street, buy from the cart lady in the 3rd floor break room (cash only), or snack on PBJs and other free snacks they have in the break areas.

	~~====== The Apartment: ======~~

	* Your apartment is 310 E 71st St, Apt 3F. You can check in on the Sunday before your rotation starts by providing an ID to the doorman, who will then provide you the keys.
	* In the apartment is two twin beds with hospital sheets. If you want a nicer comforter/blanket, I recommend bringing one along as well as towels.
	* Dishes and cooking implements are stocked in the kitchen, which also has a toaster and electric kettle

	~~== Daily Responsibilities ==~~

	~~==== Your First Day: ====~~

	* They'll arrange for a fellow to give you a brief tour and get your Epic access and badge all set up from approximately 6:30AM - 9AM on your first day.
	* Then you'll join an attending and finish out the day working like usual!

	~~==== Pre-Opping: ====~~

	* Starting on your first day after orientation, you'll be expected to preop for the next day.

	~~====== Where to find your cases ======~~

	* After 2pm on the preceding day, if you click 'My Cases' under status board and adjust the day, you'll be able to see your assigned case and attendings
	* A spreadsheet of attendings' phone numbers will be sent to you before orientation, you can text your preop for the next day
	* You are not expected to put in a preop note until the day of surgery, as it can only be accessed once the patient checks in for surgery

	~~====== Remote access to Epic ======~~

	* Despite being told during orientation that we likely won't be able to access Epic remotely, you actually CAN. You have to call the help desk, 212-606-1446 to get set up.
	* You will also have to set up the 'VIP Access' app to get access.

	~~==== Daily Flow ====~~

	* ORs start at 8AM usually, but 8:30 on Thurs for grand rounds. Always check your case start the day before--surgeons stagger their two rooms and you'll often be in a later-start room
	* Techs: you will NOT have access to regular techs, but you can ask your circulator to contact the tech if you really need them. The rooms are usually very well stocked in the AM
	* Setup:
	** Most cases are block + sedation.
	** Premedication: most attendings like 5mg versed +/- ketamine or fentanyl. Older patients you can start with 2mg versed
	** Monitors: All of the cords STAY IN THE ROOM at all times, don't take any part of the cables to PACU and embarrass yourself like I did on my first day! EKG leads can be found in the containers on top of the anesthesia cart. Except for the leads, everything is reusable
	** Airway: usually nasal cannula, but there are LMAs and ETTs etc. in the anesthesia machine
	** Blocks: when you preop with your attending, always ask what they want in their blocks. Usually it will be 0.25% bupi + 2mg of PF decadron in a 30cc syringe for each. Connect this syringe to a regular IV extension.
	** Equipment: Bring an ultrasound to the room in the AM (found in the hallway outside the ORs) and program your patient in by ordering 'block ultrasound' in epic, and then it should autopopulate in the patient list in the ultrasound
	** Maintenance: usually propofol infusion. Set this up by using a 60cc syringe with 2 vials of propofol connected to stopcock > spaghetti tubing > another stopcock. The second stopcock will then be connected to the first sideport in the patient's IV. They run infusions in 'mL/h' rather than weight based, and a good starting point is usually 22mL/h
	** Machine: You will have to do your own machine checks
	* Expect to be relieved at 6pm, or whenever your room ends

	~~==== Common Cases: ====~~

	* TKR: Expect to do a single-shot spinal, I-PACK and adductor canal block
	~~* Hip: ***~~
	* Shoulder: Usually interscalene vs. superior trunk block, +/- LMA

	~~== Call Responsibilities: ==~~
	~~We take two calls while at HSS for a month, one weekday and one Saturday.~~

	* For your weekday, report at 4:30PM to PACU bay 1 to start rounding with the team. Weekday call ends at 8AM, start rounding in the OSCU (5th floor, connected with 'Step Down Unit' which you can follow the signs to)
	* For your weekend, report at ***.

	~~An attending will be in-house with you overnight, but they sleep in the building across the street.~~

	~~=== Signing out PACU patients ===~~

	* You will be given a phone with an app called 'PerfectServe' on it, which is similar to epic message or CORUS.
	* Every time a patient is ready to be signed out, you'll get a message from that nurse
	* You do not have to see the patient, simply go to the patient in Epic and put in the PACU discharge eval
	* The fastest way to get ahead of these messages is to go to:
	** All Status Boards (upper border menu) > All Areas PACU board > look at the two columns towards the end, Post Note and DC Order. If DC order has a checkmark, and post note has '!!' then the patient is ready for PACU discharge eval to be written.
	** From this board, right click on the patient > Post Signout > Addendum > fill out the note by clicking 'normal patient' > sign, and then your job is done!

	~~=== Covering patients ===~~

	* On Saturday, we cover 3 units: the PACU boarders, the Step-Down Unit (SDU) and the OSCU. On weekdays, we usually just cover SDU + OSCU depending on PA coverage.
	* Only write notes on patients who are new or have significant events.
	** Notes with template can be found by opening the patient's chart by clicking 'rounding' while highlighting the patient > 'rounding' tab > OSCU tab > write in NoteWriter

Oliviamsutton at 17:41, 7 April 2022

2022-04-07T17:41:13Z

@@ Line 23: / Line 23: @@
 * ~2/3 of attendings will order you delivery for lunch every day.
 * For the 1/3 that don't, you can either go to the Belaire Cafe across the street, buy from the cart lady in the 3rd floor break room (cash only), or snack on PBJs and other free snacks they have in the break areas.
 == Daily Responsibilities ==
@@ Line 28: / Line 34: @@
 ==== Your First Day: ====
 * They'll arrange for a fellow to give you a brief tour and get your Epic access and badge all set up from approximately 6:30AM - 9AM on your first day.
 * Then you'll join an attending and finish out the day working like usual!
 ==== Daily Flow ====

Oliviamsutton at 07:02, 7 April 2022

2022-04-07T07:02:05Z

@@ Line 1: / Line 1: @@
-== General Expectations: ==
+== General Info + Tips/Tricks: ==
-Didactics: You present one journal club, 10-15 min presentation
+====== General expectations ======
-Schedule: Expect to get your schedule ~2-4 weeks before starting your rotation. You can request specific calls by emailing the Cornell Chiefs, if need be.
+* Call: Two calls, one weekday, one weekend
-Contacts: Mary Hargett is the coordinator for the program
+====== Where are the ORs? ======
 == Call Responsibilities: ==

Oliviamsutton at 06:45, 7 April 2022

2022-04-07T06:45:36Z

@@ Line 1: / Line 1: @@
 == Call Responsibilities: ==
 === Signing out PACU patients ===
@@ Line 9: / Line 24: @@
 ** All Status Boards (upper border menu) > All Areas PACU board > look at the two columns towards the end, Post Note and DC Order. If DC order has a checkmark, and post note has '!!' then the patient is ready for PACU discharge eval to be written.
 ** From this board, right click on the patient > Post Signout > Addendum > fill out the note by clicking 'normal patient' > sign, and then your job is done!

Oliviamsutton: Created page with "== Call Responsibilities: == === Signing out PACU patients === * You will be given a phone with an app called 'PerfectServe' on it, which is similar to epic message or CORUS. * Every time a patient is ready to be signed out, you'll get a message from that nurse * You do not have to see the patient, simply go to the patient in Epic and put in the PACU discharge eval * The fastest way to get ahead of these messages is to go to: ** All Status Boards (upper border menu) >..."

2022-04-06T22:59:01Z

Created page with "== Call Responsibilities: == === Signing out PACU patients === * You will be given a phone with an app called 'PerfectServe' on it, which is similar to epic message or CORUS. * Every time a patient is ready to be signed out, you'll get a message from that nurse * You do not have to see the patient, simply go to the patient in Epic and put in the PACU discharge eval * The fastest way to get ahead of these messages is to go to: ** All Status Boards (upper border menu) >..."

New page

== Call Responsibilities: ==

=== Signing out PACU patients ===

* You will be given a phone with an app called 'PerfectServe' on it, which is similar to epic message or CORUS.
* Every time a patient is ready to be signed out, you'll get a message from that nurse
* You do not have to see the patient, simply go to the patient in Epic and put in the PACU discharge eval
* The fastest way to get ahead of these messages is to go to:
** All Status Boards (upper border menu) > All Areas PACU board > look at the two columns towards the end, Post Note and DC Order. If DC order has a checkmark, and post note has '!!' then the patient is ready for PACU discharge eval to be written.
** From this board, right click on the patient > Post Signout > Addendum > fill out the note by clicking 'normal patient' > sign, and then your job is done!