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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



 Daily Rounds
   Daily rounds with the attendings occur at 7:00a.m. on weekdays and at arranged times on weekends.  All wounds should be down (i.e. without dressing) as appropriate for inspection.
Pre-rounding to resolve patient care issues is at the discretion of the fellow.  The senior resident and fellow are responsible for everything on every patient, everyday.  Students and interns who accidentally withhold vital information from their senior resident and fellow may not survive their rotation.  Good communication is the key to outstanding patient care.  Morning rounds are usually presented by the students or intern.  The format should be similar to the daily progress note.  By recording this information on a 'cheat sheet' (available on the ward), the student can make his/her presentation smoother and the job of writing progress notes easier.  Good students are early students.  Afternoon rounds are less formal, and generally a summary of pertinent events of the day.  Afternoon rounds are completed prior to the off-call resident going home.

Discharge Planning
   Discharge planning rounds are a multidisciplinary conference which occur at the Shriners Burns Hospital every Wednesday afternoon at 3:00p.m.  The Reconstructive Service presents first, then the Acute Service.  Late-comers are flogged.  The senior resident/fellow gives a basic presentation on every acute inpatient, which includes a very brief summary of the hospital course, status and current needs, followed by input from the other disciplines.  Please do not sit at the central table if you are not anticipating that you will be invited to speak.

   Discharge rounds at the Blocker Burn Unit are weekly.  Nurses review the current treatment regimen and all members of the multidisciplinary team are expected to state any problems or concern they have for the patient.  The plan of care to address those problems is then discussed.

Rehabilitation Rounds
   Multidisciplinary rehab rounds at the Shriners Burns Hospital begin at 7:00a.m. every Thursday.  Rounds includes Dr. McCauley, Dr. Huang, and Dr. Williams (Plastic Surgery), and a supporting cast of hundreds.
Daily patient rounds are usually incorporated into these rounds with a brief patient presentation, but the focus is on the rehabilitation and reconstructive needs of the patients.  Each patient from both acute and reconstructive services is examined and discussed. A majority of the discussion will be conducted outside of the patient's room, and patients & families should be warned of the large group coming into their room.


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