CNMC PICU Survival Guide

CNMC PICU Survival guide
1. PICU is on the 3rd floor, resident work room is on the way to the Heart and Kidney Unit (HKU). You should have access to the badge reader.

2. Plan to arrive at 0530 for signout… most likely you can come in at 0600 your first day if the census is OK and they don’t need you to round/see patients. Signout will give overnight events (or brief admit summary if kid was admitted overnight)

3. Login for any computer (other than the laptop) is 7east, or hemocuser, and the password is Drbear111. Any locked computer you find can be unlocked with the password Drbear111. If you want, you can try your own username and password that they emailed you.
4. Tracks is the application for inpatient, and BearTracks is the medical record system.

5. Add “PICU Care Team” as one of your patient lists, then I would make a list of your own patients and update as patients come and go.

6. To start a new daily note, go to “PowerNote” on the left hand side after opening the patient chart and click on the “+Add” button in the upper right hand of the list. Under the “existing” note tab (farthest to the left) click on the last PICU progress note to highlight, then click on “Copy to new note” with a title of PICU Progress Noteand choose Progress Note for type (at the top). If it was a new patient admitted overnight, choose the PICU History and Physical (PICU residents are in the habit of doing all H&Ps in the progress note format to make subsequent notes easier). Your vital sign ranges will automatically be imported, and you can import vent settings, I/Os, labs, into your daily note.
7. Sign and submit your note before rounds, you will basically just read your note for rounds. You can go back and change as many times as you would like, just make sure you don’t have your note open in edit mode while you are presenting (most of the attendings like to sign your note as you guys round). Feel free to go back and update with changes after rounds are done.

8. Typically Medical team starts rounding at room 300 and loops around unless someone is post call, Neuro/surgical starts rounding with the neuro team, then post-call person, then however people feel like finishing.

9. Rounds start at 0730. Have your notes as close to done as possible and be ready with either the laptop or a COW ready to start. You will break for radiology rounds at 0930, then resume rounding. On Wednesdays there is grand rounds starting at 0800.

10. Your team can decide this but typically while person A rounds, person B puts in their orders and person C updates Person A’s signout on GoogleDrive, so that when rounds are done the majority of the work is already done.
11. PAGING SYSTEM: We carry the critical care pager, which has a pin of 1939. Your virtual pager number will be linked to the ASCOM phone you carry. For example, if you carry phone 8048, your virtual pager number is 58048. To forward your virtual pager to your actual pager, go to the intranet/homepage, hover over the orange “Helpful Links” tab on the upper R side of the page, then click on “Paging and Staff Directory”. There is a User Login tab at the upper right side, your userID and password are your virtual pager number (i.e, 58048). Click on “My Profile” on the upper L side of the page, and the paging status should say “Call being taken by” and should say critical care medicine, rotating pager 1939. That means the pages will come to you. When you leave at the end of the day, make sure you change your paging status to be covered by the on-call person. Use their actual pager number not their virtual pager, if you don’t know their pager number just look them up by name and click on the box to the far right that says select, then “change” and verify. When you come in each morning, make sure you un-forward your pager.

12. ASCOM/phones: You will get a phone assigned, batteries are on the way to the nurses station, across from the supply pyxis (someone will show you when you get here). Batteries will last the whole day usually if you get a fully charged one in the morning, not so much when you’re on call. When you leave for the day you divert your phone to the ASCOM of the person taking call and un-divert in the morning when you arrive. To divert your phone, hit the middle top button on your phone (under the DIV), then choose “Set”, change the number, then Save (far left), then Change (far left), then Back (far right). You undivert the same way: hit the top middle button (DIV), then change, and then back.

13. LAPTOP: Password is scutdog. There is something wrong with the computer such that it won’t connect to the staff wireless. I’ve been connecting through BearAir (normal internet) then using the VPN of one of the residents to get into the system; for the first almost 2 weeks I just used the COW because I couldn’t get logged on. Will try to get it looked at before you come.
14: LIFE STUFF: Go to the security office (1st floor by the ED) and tell them you need access to rooms 4900 and 4223. These are rooms on the 5th floor with a fridge to put lunch. 4900 is where the call room/showers/fridge are, and 4223 is the Shiz (resident hangout spot with frigdes, microwave, couches, and giant jugs of drinking water). On the 7th floor you can get coffee/snacks/etc from 7 or 730ish until 1045pm. Gift shop on the 1st floor also has good snacks (coffee shop in front of gift shop) and 2nd floor is cafeteria.

15. WEEKEND ROUNDING: completely horrible. You round on 1/3 of the service (both surg and medical). Rounds still start as close to 730 as possible, and supposedly if you have more than 10 pts each fellows will help. Eat breakfast before rounds start, they’re LONG.