Medical Student Orientation

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Medical Student Orientation

• Donna R. Davidson, RN, MSHP
• Interim Chief Nursing Officer

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CNO Role

• Budgeting, Staffing, Capital Budget,
  Patient/Physician/Staff Satisfaction
• Assure quality patient care is delivered to all
  patients
• Assist with problem resolution
• Office 449-4373

3
Unit Structure

• Staff Nurse
• Unit Shift Supervisor (Charge Nurse)
• Nurse Director
• House Supervisor (24/7)
• Chief Nursing Officer

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5200 Surgical/Trauma

• 33 beds
• General Surgical Unit
• Bariatric, Orthopedic,Thoracic, Vascular, Trauma
• Telemetry capability for 16 beds
• Nurse Director Darren Parks

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5500 Specialized Medicine

• 33 beds
• Medical Unit
• Observation for non-monitored patients
• Internal Medicine, Family Practice, Urology,
  Oncology, Renal
• Telemetry capability for 10 beds
• Nurse Director Darren Parks

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3100

• Adult Intensive Care Unit
• 25 beds
• Combined Medical-Surgical Intensive Care
• Restricted access unit
• Nurse Director - Karl Samuelson

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4100 Coronary Care Unit

• Coronary Care Unit
• 28 beds
• Intensive care unit-ventilators, intra-aortic
  balloon pumps, arterial lines, titratable drips
• Observation pts requiring monitoring
• CHF, angina, acute MI, arrhythmias
• Nurse Director Karl Samuelson

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4300 Pediatrics/PICU

• Pediatrics/Pediatric Intensive Care Unit
• 12 beds-4 PICU
• Age 1 day 18 years of age
• Restricted access unit
• Nurse Director Traci Eisele

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NICU

• Neonatal Intensive Care Unit
• 24 beds
• Level III MD/NP coverage
• Restricted Access Unit
• Nurse Director Traci Eisele

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4500 Family Birth Center

• Family Birth Center/Labor and Delivery
• 8 LDR rooms, 4 Antepartum, 2 ORs
• 14 beds mother/baby, GYN
• Restricted access unit
• Nurse Director Traci Eisele

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4600 Telemetry/ Step Down

• Telemetry Step-down Unit
• 20 beds
• Telemetry Monitoring for 10 patients
• Observation patients or short stay patients
• Nurse Director Inglish Camero

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4200

• Clinical Decision Unit
• 29 beds
• Cardiovascular,Thoracic
• Nurse Director Inglish Camero

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Emergency Department

• Level 1 Trauma Center
• Trauma days Monday, Wednesday, Thursday, Saturday
• Restricted Access area
• Nurse Director - Theresa Gregg

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Pre-op/OR/PACU

• Nursing Director - Lynn Crowley
• Location of inpatient and outpatient surgery
• Patients present day of surgery for pre-op
  preparation
• Operative suites
• OR Nursing Manger - Open
• Post Anesthesia Care Unit
• Pre-op/PACU Nursing Manager Matt Kayl

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On The Unit

• Return charts to the Nurses Station when finished
• Comply with Infection Control/Isolation
  requirements
• Wash hands between patient contact - when
  entering and leaving a room
• Assure confidentiality of patient information

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Dos

• Ask for assistance is you have questions
• Watch for learning opportunities - Code 99,
  Traumas
• Comply with the dress code -
• Shoes and socks
• No bare midriffs

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Donts

• Copy the medical record (HIPAA)
• Wake the patient before 0530 or 0600
• Obtain food/drink from the galley (patient use
  only)
• Bring food into public areas
• Leave back packs in public areas
• Leave valuables lying around

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Survivor Tips

• Demonstrate respect for patients, staff, families
  and others
• Get to know the HUC - can be your best friend
• Have a great learning experience

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WRITING ORDERS

• Must be licensed to take a verbal order per
  Medical Staff Rules and Regs.
• May write an order and have it signed by Resident
  or Staff.
• All entries must be dated and timed.
• All entries must be signed legibly.
• Standard is that someone else must be able to
  decipher the signature.

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PROGRESS NOTES

• All entries must be dated and timed.
• Must be legible
• Must be signed legibly.
• Standard is that someone else must be able to
  decipher the signature.

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ABBREVIATIONS

• List of do not use abbreviations on Order sheets,
  except those that have pre-printed orders.
• Part of National Patient Safety Goals

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ABBREVIATIONS
DO NOT DO THIS USE DO NOT DO THIS USE
U UNIT LEAVE OFF A LEADING ZERO (.5MG) USE THE LEADING ZERO (0.5MG)
Q.D. DAILY USE OF A TRAILING ZERO (1.0MG) NO TRAILING ZERO (1MG)
Q.O.D. EVERY OTHER DAY QN NIGHTLY
MS OR MSO4 MORPHINE SULFATE MGSO4 MAGNESIUM SULFATE
?G MCG AU AS AD BOTH EARS LEFT EAR RIGHT EAR
IU INTERNATIONAL UNITS OU OS OD BOTH EYES LEFT EYE RIGHT EYE
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National Patient Safety Goals

• Patient Identification - Always check armband
  before any procedure or test.
• Communication Always provide a report to an
  oncoming caregiver (SBAR).
• Medications All medications used must be
  properly labeled.
• Reduce infections Use of maximum sterile
  barriers in procedures.

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National Patient Safety Goals

• Medication Reconciliation reconcile medications
  upon admission, transfer and discharge.
• Safety Reduce falls
• Patient Involvement Include patient in
  discussions about care and condition.

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ENVIRONMENT OF CARE

• Provide a safe, functional and effective
  environment for patients, staff, and others in
  the hospital.
• This is crucial to providing quality patient care
  and achieving good outcomes.

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ENVIRONMENT OF CAREis managed by 7 Subcommittees

1. Safety Management
2. Security Management
3. Hazardous Materials Management
4. Emergency Preparedness Management
5. Life Safety Management
6. Medical Equipment Management
7. Utilities Management

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SAFETY MANAGEMENT

• General Safety
• Fire Safety
• Electrical Safety
• Disaster Preparedness
• Hazardous Materials and Waste

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SAFETY PLANSprovide for

• Specific job-related hazards
• Safety Orientation and Education
• Incident reporting process, monitoring
• Proactive hazard surveillance
• Call 4470 and report all safety related problems
• REMEMBER SAFETY IS EVERYONES JOB

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EMERGENCY PREPAREDNESS PLANS

• Define roles and responsibility during
  emergencies.
• Provide information necessary for you to function
  in the event of a disaster.
• Establish backup communication systems
• Describe how supplies and equipment are obtained
  or distributed.
• Ready References are provided by
• The Emergency Plans Manual in each department
• Emergency Response Poster posted throughout the
  hospital
• Ready Reference Badge provided with your ID Badge

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EMERGENCY PREPAREDNESS PLANS

• EMERGENCY PLANS MANUAL INCLUDE RESPONSES TO
• CODE BLUE (Bomb Threat)
• CODE 99 (Medical Emergency)
• CODE RED (Fire)
• CODE PINK (Infant Abduction)
• CODE GREEN (Medical Gas/Vacuum)
• Communication, Weather, and others

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LIFE SAFETY PLAN

• Provides for a fire-safe environment
• Designed to protect patients, visitors, and staff
• Helps control the fire, and smoke to prevent the
  spread.

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LIFE SAFETYACRONYMS

• CODE RED
• Fire Phone 4711
• R emove those in danger
• A ctivate the alarm
• C onfine (close doors)
• E xtinguish, if safe to do so

• CODE RED Extinguisher
• P ull the pin
• A im at the base of the fire
• S queeze the handle
• S weep from side to side