Weiler

Transition

Please scroll down or click the "upcoming block" link above. In the transition tab of the sheet, you will see who you should be getting sign-out from and reach out to that person prior to the start of your floor block (if you start on days). Typically, the outgoing resident/intern will email the incoming resident/intern with relevant information (see below) and/or do this by phone. You may agree on whichever sign out methods that works for both of you. For the interns starting on the B block (seccond half of the month), please see who is in your scheduled slot in the A block for coordination of sign out.

Night teams do not receive sign-out ahead of time. You will receive sign out from the day team when you arrive for your first shift.


Signout Principles 

Sign out should include the following information for each patient:

A tip for the signout email...

If your written handoff is updated in Epic, you can print the handoff as a PDF and send that to the oncoming intern/resident!

All discharge summaries must be updated to reflect events through the last day of the block. Outgoing interns, please ask your residents to help you with this if needed.


Scheduling Tidbits

Daily Schedule

You will notice that there are three different kinds of shifts on the Daily Schedule tab in the sheets below


NOTE: small teams alternate 8pm and 5pm days, with admitting determined based on your workload.


CAC Team

You will be on code team a few times each block (on your 8pm admit days or night shifts). Please check the "CAC" tab of the sheet below or on the chief's door at the beginning of each shift to determine whether you are on code team. You are expected to be at all "Rapid Responses" or “CACs.”


Responsibilities and Expectations

Interns

You will be first call for and write daily progress notes on all of your patients. Please see this PDF on progress notes for some guidance, if needed.


For new patient admissions/transfers, admission notes are required and will need to be presented to an attending during the next morning's rounds (or sooner if the attending prefers). Please read the oral presentation guideline for assistance, if needed.

MEDICATION RECONCILITATION MUST BE COMPLETED FOR EACH NEW ADMISSION/TRANSFER IN THE 'ADMISSIONS' TAB.

SIMPLY LISTING THE PATIENT'S OUTPATIENT MEDICATIONS IN A NOTE IS NOT SUFFICIENT 

Please ask your resident for assistance in this matter.


For discharges, an updated discharge summary and medical reconciliation is required. Your residents should guide you through this process. Be sure to use the .19dc dot-phrase at the top of all discharge summaries!


Residents

Resident/work rounds are an expectation and your time to use as you wish for teaching and to lay eyes on patients that may require your attention (gravely ill, interesting physical exam findings, slated for discharge that day, etc.) It is expected that residents will have seen all of the patients at some point each day. You are at liberty to determine a system with your team as to how you will supervise and check over the interns' work each day.

For new patient admissions, you must supervise the intern's admission and write an accompanying H&P. The point of this second H&P is to serve as testament and document that this supervision occurred. It need not be as detailed but between the intern's and resident's H&Ps, all relevant information for that admission is expected to be documented. Remember to call the ED within 20 mins of a patient being paged for handoff. Always check whether an admission has a private provider via the "Admit-To List" located on the Intranet, under "Clinical Communications." View the following Weiler Admit Protocol as well as the Patient Allocation Manual for more guidance.

New transfers to the floor must also be supervised but do not require a separate note.

Weekend Coverage


Other Reminders


 

Conferences and Food

We have lectures (...and lunch!) at noon conference every day and an afternoon educational activity on some days. Please check out the chief’s door to see the schedule. The chief will be text-paging and/or texting you about these. Please be on time! Please also let the chief know if your attending rounds or other activities are preventing you from being there on time.


Useful Information

SW Directors' and Nurse Managers' contact info

Alleyne Hall is the Nurse Manager of 9S

 

Lydia Valez is the Nurse Manager of 8N

 

Rob Davis is leaving as nurse manager of 8S. There will be a new nurse manager starting 7/1/2022

Appointments Scheduling Assistance

Email Jeremy Lagoa a list of patients on your team you anticipate may be discharged soon (the sooner, the better!). Include:

NOTE: For medicine subspecialties consulted on a patient's care, those services are expected to make their own outpatient follow-up appointments.

Access Codes


Scrub Machine

Located on 7N. After exiting the visitor elevators, walk through the doors to 7N and go straight ahead, through the door labeled "Authorized Personnel Only." The scrub machine is there and should work with ID access


Ultrasound

The Ultrasound is located in the 2nd floor medicine office coat closet (see door access codes above). Please remember to sign out and sign in the ultrasound before and after use. Clean the Ultrasound after each patient interaction using the Grey Sani-Cloth wipes ONLY (Purple wipes will damage the probes!). For issues with the ultrasound, please email Dr. Benjamin Galen.

Wound Care Consults

Wound care as a specialty is no longer a consult service at Weiler as of July 2022.

You may also contact Dr. Harris Kaplan and Dr. Eric Walter  at their office (347-577-4547) and via email

Consult – “Inpatient Consult to RN Wound Care Nurse” 

Cell – 347-899-1012

PPE AND RADIATION EXPOSURE

Enhanced pandemic PPE means that in addition to masks, eye protection be used throughout all inpatient clinical units. This applies to patient rooms as well as the hallways and nursing stations of clinical units.

 

Remember SURGICAL MASK + EYE PROTECTION (GOGGLES or FACE SHIELDS) must be worn for all patient interactions unless the patient requires additional isolation/PPE precautions. This equipment can be found in the clean supply room on each floor (code is 2+4 together, then 3).

 

You should be wearing N95 + EYE PROTECTION + GOWN + GLOVES for all RAPIDS AND CACs (assume you are at risk of being exposed to an aerosol generating procedure or that the pt has recently had something aerosolizing done to them within the last 90 min)

 

For all AEROSOL GENERATING PROCEDURES (AGPs), you must wear N95 + EYE PROTECTION + GOWN + GLOVES ​​regardless of COVID status.


For any CACs or rapids called to IR or cath lab suites, PLEASE PUT ON A LEAD GOWN AND THYROID SHIELD BEFORE ENTERING THE LAB. Radiology and cath lab are expected to provide these for all members of the CAC team in the event of an emergency.

Schedules

Current Block

Weiler Block 13 2022-2023.xlsx

Upcoming Block

For Issues...

Please do not hesitate to contact the chiefs, Dr. Kejo, and Dr. Lezama. Letting us know of issues in real time allow us to better address them and find solutions