Induction 5: Clinical Duties
Once you have handed over you are free to see patients. The consultant on shift will tell you where to start and whether there are any patients who need immediate attention.
There are 4 areas for which you may potentially be assignged: Resus, Majors, Ambulatory majors or the integrated front door (IFD)
Areas
Resus
Where our sickest patients reside:
Some of this will be fairly routine, some will be things you have never seen before
Trauma calls and managing potential C-spine injuries will become more routine, get involved early to get experience.
Procedural sedation should be supervised initially - see sedation forms on MPHED
Ask for help, again you will not be alone!
Majors
Our generally unwell cohort, often who have presented by ambulance, who are sick or immobile enough to require a bed.
IFD/ Ambulatory Majors
Where all other patients who do not fit the category of resus or majors go:
Hints and tips for working in this area!
Focus on “what is today’s problem?”
Don’t take tests you can’t follow up within the 4 hours
Learn to do simple treatments yourself as it can save the patient a lot of time.
If you think a patient is too sick for minors – tell the nurse in charge and move them to a safe area.
Do not leave patients in cubicles unnecessarily – it is important to maintain flow.
First job is to utilise our IT system Maxims to identify the patient and assign yourself to their care.
Once you have seen the patient you can order tests and review results using our Ordercomms system. Often the nursing and allied staff will have taken bloods already. Radiographers will transport all majors and resus patients to X-Ray. Minors patients whould be shown to the X-Ray waiting area.
Once you have seen them please inform the patient, the nurse looking after your patient, and the nurse in charge of your management plan. If the plan is to admit the patient please request a bed on MAXIMS. The video below will demonstrate how. This will be covered in your face-to-face IT training (if you missed this, or are a locum, please pay attention!).