The Junior Medical Offcer’s Guide to the Hospital  Universe JJMMOO__GGuuiiddee..iinnddbb 11 2277//1100//22002222 1111::5522 The Junior Medical Off cer’s Guide to the Hospital  Universe A Survival Manual John Shi Junior Doctor New South Wales, Australia JJMMOO__GGuuiiddee..iinnddbb 33 2277//1100//22002222 1111::5522 First edition published 2023 by CRC Press 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN and by CRC Press 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742 © 2023 John Shi CRC Press is an imprint of Informa UK Limited Te right of John Shi to be identifed as author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. Tis book contains information obtained from authentic and highly regarded sources. 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British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library ISBN: 9781032403236 (hbk) ISBN: 9781032397405 (pbk) ISBN: 9781003352501 (ebk) DOI: 10.1201/9781003352501 Typeset in Minion Pro, designed by Robert Slimbach, from Adobe Originals by Evolution Design & Digital Ltd (Kent) JJMMOO__GGuuiiddee..iinnddbb 44 2277//1100//22002222 1111::5522 For my colleagues. JJMMOO__GGuuiiddee..iinnddbb 55 2277//1100//22002222 1111::5522 Contents Author xi Glossary xiii 1 Introduction 1 How to use this book 2 Exhortation to read, and do this asap 4 For all Doctors 6 2 Before the Term 9 Tings to bring 9 Tings to do 21 People to know 23 3 The Term: Life Rounds 25 What is a Life Round? 25 An exhortation to look afer yourself: Justifcation for the Life Round 26 An exhortation against exhaustion 28 Practical tips 29 4 The Term: IT 35 Mindset 36 Lists 37 Setting up a List 37 List maintenance 40 Personalised List/Excel List 41 Rounds List 43 Handover/Multi-Patient Task List 45 Task Manager: JMO Jobs List 47 Emergency Department: When not in ED 48 Journey Board 48 Finding stuf 50 PowerNotes 50 Clinical Docs 52 Continuous Docs 54 Ofsite data 55 Other places to look 57 Home Screen (aka Patient Summary) 58 Viewing Investigations 61 Radiology 63 vii JJMMOO__GGuuiiddee..iinnddbb 77 2277//1100//22002222 1111::5522 viii Contents Ordering Investigations 65 Principles 66 Setting up your Favourites 67 Folders/categories 68 Modifcations 72 Blood rules and myths 73 eMeds 76 Ordering Medications/Fluids 76 Modifying Medications/Fluids 77 Viewing Medications/Fluids 77 Other key functions 78 Documenting 79 Templating methodology 82 Ward Rounds 85 Other documentation 91 Attaching external documentation/media 93 Emergency Department Documenting 94 External referrals 96 Discharges 98 Methodology 99 Te Template 101 Major components 105 Te Plan 110 Useful documents to attach, but painful to do so 112 No eMR 114 Benefts 115 Te Intranet 116 Rosters 116 Resources 117 Miscellaneous 118 Doctor View 120 FirstNet 121 A justifcation for automation, efciency and minimising menial tasks 122 Templates: vice or virtue? 122 On pettiness 123 On errors 124 5 The Term: Organisation 127 On the Ward Round 129 Of the Ward Round 135 Logistics of the unexpected 141 6 The Term: Human Relations 149 Introduction: how to help other people help you 149 Phone contacts 150 Numbers 151 Ad interim 155 JJMMOO__GGuuiiddee..iinnddbb 88 2277//1100//22002222 1111::5522 Contents ix Home team 157 Who? 157 Roles 157 Mindset 158 Organisation/prioritisation 159 Learning 161 Admin 161 Working hours 161 Ward staf 162 Ward Clerk 164 Nurses 165 Pharmacist 169 Allied Health 170 Consults (Other Medical Teams) 172 Who are you talking to: Hospital hierarchy 173 Before the Consult: preparation 173 Getting to the Team 178 Making the Consult 181 Afer the Consult 187 Follow-up and future Consults: smoothing access 189 Radiology 194 General rules 194 Imaging types 197 Special services 199 Getting them 199 Te process: for now and ever afer 200 Family 201 Getting in touch: contacting the family 202 NESB: contacting the patient 203 Interacting with/reassuring the family 205 7 End of the Term 209 Getting Handover 209 Giving Handover 212 Closing the Term 213 8 After Hours 215 Staying alive: Afer Hours Life Rounds 216 Organising Afer Hours: Jobs 219 Clinical Reviews 232 Deaths 241 9 COVID-19 245 General health/pressure area care 245 Hygiene 246 Protocol 247 Documenting 248 JJMMOO__GGuuiiddee..iinnddbb 99 2277//1100//22002222 1111::5522