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Resident Orientation Manual

Produced by Galveston Shriners Burn Hospital and
The University of Texas Medical Branch Blocker Burn Unit.
Contributors:  Sally Abston MD, Patricia Blakeney PhD, Manubhai Desai MD,
Patricia Edgar RN, CIC,John P Heggers PhD, David N Herndon MD,
Marsha Hildreth RD, Ray J Nichols Jr. MD



Out Patient Clinic:

   A weekly Burn Clinic is held on Tuesday's on the 4th floor.  In the morning 2 clinics run simultaneously, acute care on one side and recon (plastic) on the other.  Burn children return for clinic follow-up after discharge.  The recon clinic usually includes initial evaluations for newly accepted patient or follow-up for children being seen on the Recon. (Plastic) service.

Cleft Palate Clinic is held on the 1st and 3rd Wednesdays of every month.  The UTMB Cleft Palate Team comes to Shriners for this clinic.

Acute Rehab. Clinic is held on Thursday mornings for the children that are still at Shriners as outpatients.  This includes the children here for the 3 month NIDRR Comprehensive Rehab. Program.  During these rounds a chosen PA, PNP or Fellow coordinates the taped summary for the medical record.

Housing & Food for Parents & Outpatients:

   The local Shrine Temples provide the funding for the parents requiring housing and food when their child is here as a patient.  Housing is coordinated by the Outpatient office.  We utilize in-hospital(4) and outside(5) apartments, Ronald McDonald House and local hotels.  The decision for the exact housing location is made based upon the parent and child's needs and funding available.  The Associate Director for Outpatient and Perioperative Services is responsible for overall housing coordination.

Day Surgery Program:

   Patients requiring day surgery come to the clinic area and are seen the day before for their History & Physical and Anesthesia work-up.  Pre-op teaching is done by Child Life to help prepare the child and parent for the procedure.  The Day Surgery nurse also works with the family to help coordinate the process.  The morning of surgery the parent will be told where to bring the child.  Once fully recovered the child will return to the Day Surgery area until ready to leave the hospital.  Parents are reminded they can call the in-patient unit at any point with questions or concerns.

   To post AM admissions and Day Surgery cases call the Day Surgery nurse.  The Resource Nurse should be notified on weekends or holidays if Monday Day Surgery is needed.

Scheduling OR Cases:

   The OR Director or Charge Nurse carries the posting pager.  This pager is to be used to schedule cases for the next day or to modify cases that have already been scheduled.

   When scheduling a case the following information is needed:

1)  Name & room number for the child
2)  Faculty covering the procedure
3)  Procedure
4)  Estimated operating time
5)  Amount of blood & skin that has been ordered
6)  Position - whether prone, supine, lateral - different positioning devices may be required

A resident or fellow needs to be in the operating room at the time the child is induced.

General OR Information:

   Surgery starts at 07:30 on Monday, Tuesday, Thursday & Friday.  On Wednesday an 09:00 start time usually occurs due to the medical & anesthesia staff meetings at UTMB.

   Surgical scrubs are available for you to use during the time you are in the OR at Shriners.  These must be changed if you leave the building before the next surgical procedure.

   The operating rooms are kept very warm during the surgical procedures for the acute patients.  If you should become extra warm or feel faint during a procedure, please step out of the room or sit down on a stool in the room.  Gatorade, cold drinks, cheese and crackers are available for you outside the OR.  Remember this is not meant to be your breakfast or lunch, but as a supplement during the OR time.

   Recovery for patients will occur in the PACU for all patients on the 3rd floor, Day Surgery or 2 East, unless the patient is a 1:1 assignment.  Recovery usually takes about 1 hour or until they meet discharge criteria.

Parent Beepers During OR Procedures:

   Just prior to the patient going to surgery, the OR nurse will give the parent a numeric pager.  The parent will be instructed to come to the 2nd floor waiting area when the pager beeps.

   If at anytime during or following the OR procedure a physician would like to speak to the parent, the Circulating Nurse will page the parent.  The pager will be collected once the pager is no longer needed.


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