Iatrogenic Withdrawal Protocol (updated 10/2022)
START OF CYCLE INFORMATION
You can find the PICU Orientation Packet here
We are very excited to have you all in the PICU this block! You will find that many aspects of the PICU are similar to your other floor experiences, and many are very different. The fellows and attendings are all wonderful teachers. Although the learning curve is steep, we have confidence that you will be wonderful. This is an awesome learning experience so try to soak in all the information that you can!
The schedule can be viewed on: montefiorepedsresidency.qgenda.com
The rotating residents should have received emails about your title in QGenda. Please let us know if you have issues navigating your schedules.
Note: There may be residents at varying times on an "Advanced PICU Elective." They will have different responsibilities, and will work more closely with the fellows. If you see a resident assigned for a 7:30am-4pm shift, they are on the advanced elective, and will not be carrying patients with the residents who are on the regular PICU rotation.
All rotating residents should have EPIC access following completion of Montefiore EPIC training. If your access is not working, please call the EPIC Service Desk at 718-920-4554 so they can activate it if hasn't already been activated. If you have any issues with security/badge, EPIC, or Cureatr, please contact Asia Nieves (anieves@montefiore.org) and cc pedschiefs@montefiore.org.
Important information before your first day:
The first day in the PICU can be challenging because of how complicated the patients tend to be. Please get a thorough sign out on your patients before your first day. The PICU secretary can be reached at (718) 741-2000, and you can ask to speak with a resident on whichever team you will be joining. You can also go through your patients' hand off notes which can be found in Epic under "Write Handoff" --> "Pediatric Hospital Medicine". Please familiarize yourself with this handoff format as it is based on the PCCU resident rounding templates. On your rotation, please update the handoffs regularly.
Please arrive to the PICU at 6am for am sign-out and 6pm for pm sign-out daily
Please sign into Epic as the RESPONSIBLE PROVIDER for all your patients for the correct shift start and end times. All notes need to be written while in the PEDIATRIC CRITICAL CARE context in Epic.
Please refer to the attached PICU Orientation packet for additional information regarding the daily schedule, team breakdown, sick call etc.
Educational lectures occur in the PICU daily prior to rounds from 7:45am-8:15am unless otherwise specified by the fellow or attending on service. Please have all your pre-rounding completed in time to be there for lecture. The night team will receive case-based teaching sessions at night. Potential lecture schedule is attached here.
If you work the Saturday 24hr shift, you do not need to arrive in the PICU until 7am on Monday morning. This is to comply with duty hour regulations. The resident on the Sunday 24hr shift will stay to signout to you on Monday morning, but they are not allowed to admit new patients past 6am (because they are in ‘transition time’).
While you are in the PICU, it can be very difficult to predict how busy the days will be. If things are calm, the fellows can help decide if it is appropriate for someone to have a "short call" day and sign out early to other members of their team. Please try to be as fair as possible about this, and please let us know how it is working.
For planned absences, you are expected to find your own shift coverage in advance. If you must call out sick, please notify your program - depending on your program, they must send someone to cover in your absence - and you MUST CALL THE CHAM CHIEF ON CALL. The Chief on Call (name and phone number) can be found on QGenda. Please call (call by phone, do not text) as soon as you know you are calling out.
Please try to update Transfer notes daily in the PICU. These are used for when you transfer a patient from the PICU to the floor, and it is very important to keep them updated, so that they are ready to be sent once that day comes! Please use the dot phrase .TRANSFERACCEPT to write a transfer note to the floor. These dotphrases are meant to be used in the BLANK note, not the EPIC transfer note template.
For all residents: Please let the chiefs know if you are experiencing COVID symptoms such as fever, URI symptoms, myalgias, etc. You may be required to get a COVID swab and may not be permitted to come back to work until cleared by Occupational Health, but this will be determined on a case-by-case basis. The phone number for Occupational Health at Montefiore is: 718-920-5406. Please let the CHAM chiefs know if you need to call out, and we will work with your chiefs to ensure the unit is staffed appropriately.
Again, we are extremely excited to have you with us. We know this will be a challenging but very educational experience. Please feel free to reach out to the CHAM peds chiefs (or anyone else- we are all here to help!) if you have any questions ❤️