What people expect you to do

From CambridgeNotes

Pre-round

  • Update list with any new patients (use computer to do this)
  • For each patient
    • Record their bed location
    • Quickly check any new problems that developed over night, check vital signs and examine
    • Write blood results and other investigations that weren’t processed last night
    • Make a provisional assessment and plan

SHO/Reg/Consultant Round and jobs

  • Write down SHO/Reg/Consultant evaluation
  • Do any jobs such as bloods, green cards, TTOs that can be done on the round (bring folder with these items?) otherwise put them on the list for a later paper round

Special jobs

  • Pre-op list as per timetable
  • Signing investigation print-outs
  • Pre-assessment clinics as per timetable
    • History and exam
    • Order any investigations (bloods usually sent, ECG, chest X-ray)
    • Instruct patient to stop drugs as appropriate (OCPs, warfarin, aspirin)
    • Prescribe fluids (if long operation) and drugs (any current medication, pain killers, anti-emetics and further as per protocol)
    • Call anaesthetist if may not be fit for surgery
  • Foundation year teaching
  • SAU (e.g. when consultant is on-call)
    • History and exam
    • Order basic investigations (bloods usually sent, abdominak X-ray if obstruction suspected, ultrasound for gallstones, CTU for kidney stones etc.)
    • Instruct patient to stay nil by mouth for moment
    • Prescribe fluids and drugs (any current medication, pain killers, anti-emetics, antibiotics if infection etc.)
    • Senior review!!

Evening round

  • Check that days blood and investigations results for every patient and record in notes
  • Prepare next days TTO’s
  • Ensure fluids and analgesia are adequate; do patients need clexane?
  • Place blood forms for morning phlebs: any patient on fluids has daily U&E’s; post-op patients have FBC, U&E and, if applicable, INR; infected patients have FBC, CRP
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