UNM FAMILY MEDICINE RESIDENCY

 ROTATION INFORMATION

 PEDIATRIC INPATIENT ROTATION

Rotation name: Pediatric Inpatient Rotation

Year: R1

Rotation Contact information: 

• Pediatric Chief Coord 2-3909,hsc-pedschief@salud.unm.edu
• TIGER CONNECT ROLE: Peds Chief Resident 
• Justin Hessinger and Morgan Day (2022-2023) 

Important notes about this rotation:

Location: UNMH

Pre-requisites: NRP Certification

Description: 

Process for Calling in Sick when on Wards and Urgent Care

The Peds Leads typically check the peds chief email from 9a-5p during the weekdays and at least once a day during the weekends.

If you email us after 5pm and it will impact scheduling for the next day - we ask that you message the chief on call role on tiger connect so we can plan accordingly.

Please also cc us on your email to your program director and program coordinator.

We also ask that you have occupational health send us their return-to-work guidelines as well, if your absence is related to COVID

Last resort: If you cannot reach either peds chief, call Peds Program Director, Dr. Rebecca Craig (217-494-8054).

Schedule:

	SUN	MON	TUE	WED	THU	FRI	SAT
AM	Continuity Clinic	Pediatric Inpatient	Pediatric Inpatient	Pediatric Inpatient	Pediatric Inpatient	Pediatric Inpatient	Pediatric Inpatient
PM	Continuity Clinic	Pediatric Inpatient	Pediatric Inpatient	Resident School	Pediatric Inpatient	Pediatric Inpatient	Pediatric Inpatient

Inpatient/General Pediatrics Service:

Most pediatric patients admitted to the hospital are cared for by the General Pediatrics Service, which is managed by a team of pediatric hospitalists, with the help of pediatric and visiting residents. Some services, such as Pediatric Surgery or ENT, have their own teams, but may consult the Pediatric Team for assistance in the care of their patients. Others, such as Burn and Trauma, Orthopedics, and Family Medicine routinely have initial pediatric consults as part of the plan of care.

Pediatric patients are admitted through either the Pediatric Emergency Department, the Pediatric Urgent Care Clinic, or directly to the floor from referring physicians throughout the state. Additionally, when pediatric patients admitted to the Pediatric Intensive Care Unit who stabilize, are typically transferred to the General Pediatrics Service for continued care prior to discharge.

A wide variety of diagnoses are managed by the pediatric inpatient team, including “bread and butter” conditions such as bronchiolitis, pyelonephritis, newborn rule-out sepsis, etc. However, the inpatient service also cares for a number of children with more complicated and rare clinical conditions, often with the assistance of pediatric subspecialists, such as nephrology, infectious disease, cardiology, GI, etc.

Basic Information:

Location: The inpatient team covers patients in a number of units, all located in the Barbara and Bill Richardson Pavilion. The General Pediatrics Unit is located on the 6th floor of the Pavilion, and is where a majority of the pediatric patients are admitted. (The team “work room” is also located in this unit.) The Pediatric Specialty Care Unit is also located on the 6th floor of the Pavilion, and is next to the Pediatric Infusion Center, where children receive chemotherapy and dialysis. In general, the Specialty Care Unit is the preferred location for children who are oncology patients, renal patients, or who are immunocompromised. Periodically, teams will have patients located in the inpatient Carrie Tingley Rehabilitation Unit, which is located on the 5 th Floor of the Pavilion.

In addition to the inpatient units, the call rooms and supplemental work space are located back in the Tully Library and Conference Room, which is on the 6th Floor of the Pavilion as well.

Schedule: Your inpatient experience will be busy, but will have many learning opportunities. Two weeks of your month will be spent on service during the day, and two weeks at night.

Days: Your shift begins between 6-6:30 am. Morning sign-out is in the Tully work room at 6:30 am. In general, plan on staying to between 6 to 7 pm each day, though this may vary by patient census and clinical obligations. Typically, you will work Monday – Friday, as well as one weekend day when your team is on-call.

Nights: Your shift starts at 5:30pm Wednesday, Thursday and Sunday. However, due to morning teaching and work hour limitations your shift will start at 6pm on Friday. Most days the night shift ends at 7 am except for Friday morning due to morning teaching from 7am-7:45am. On weekends, you will be expected to stay to round with the day team until 10am on Saturday and 12pm on Sunday.

Amion shows your general schedule for the month, (as to when you are on days and nights). Go to www.amion.com, and log in using the password “unmpeds”. From this point, you can use the dropdown menu for the R1 class to find your name and view your schedule.

Contact Numbers: While on service, there are quite a few helpful numbers to have available. Most of these are included on your daily patient list for easy reference. However, a few good numbers to have handy include: Tully Library: 272-1705 Team Work Room: 272-5089 Front Desk of the General Pediatrics Unit, (GPU): 272-2704 Front Desk of the Pediatric Specialty Care Unit, (PSCU): 272-0348 Coordinators: Lanier Lopez, MD and Jorge Ganem, MD, are two of our hospitalists and are the clinical coordinators for your inpatient month. Both Dr. Lopez and Dr. Ganem will oversee your month on service, and ensure that you receive feedback and evaluations by your attendings from the rotation. They can assist you with any concerns or questions you might have while on the inpatient month. Amanda Lee, the Inpatient Chief Resident for the 2013-14 academic year, can be of assistance regarding scheduling matters. Their email addresses and pagers are as follows:

1.  Jorge Ganem: 951-1208, JGanem@salud.unm.edu  
2.  Lanier Lopez: 239-7530, LNLopez@salud.unm.edu  
3.  Amanda Lee: 951-1806, AmLee@salud.unm.edu  

Expectations:

1. Your Schedule: (See above for expected hours on service.) Please be prompt for both your day and night shifts. Sign-out is essential, and is best accomplished in a timely fashion. Every Monday and Wednesday, (while on days), you will attend Morning Report from 8:00 am to 9:00 am in the Tully Conference Room. Ward morning teaching is from 8:15 am to 9:00 am on Tuesday and Friday. Attendance is required; you must plan ahead in your pre-rounding and patient care in order to be present. Morning rounds will begin following teaching. While on nights, you will attend a Night Team Morning Report on Friday mornings, (also held on Tuesday mornings, though you will be off), between 7:00 am and 7:45 am. This will be an opportunity to discuss clinical cases and have direct teaching with the hospitalists, as well as an occasion for feedback and discussion of patient management.  
2. Professionalism and Patient Care: Due to the acuity and complexity of many of the children managed by the team, it is critical that you hold yourself to the highest standard of care while on service. We understand how busy the rotation is, and that at times, you may feel overwhelmed. In such cases, we would prefer that you ask for assistance. There are many people on your team, including your senior resident and other interns, who can help—it is much better to divide and conquer, rather than to allow important patient care duties to be neglected.  

Pediatrics is somewhat different from adult medicine in that small changes can be signs of much bigger issues. For example, a new fever in a previously afebrile child that is receiving IV antibiotics for a septic joint is a major concern, and should always warrant an evaluation by you personally, (rather than just an order for acetaminophen). A bump in creatinine in an infant from 0.2 to 0.4, (though perhaps not all that impressive for an adult), is a notable difference and should be promptly discussed with your senior resident and attending. Paying attention to and addressing such issues is essential while on service.

As with the above, should a nurse ever call you with concerns about a change in clinical status of patient, even if only mild, always personally evaluate the child. If you are busy and unable to do so, notify your senior resident or attending (if in-house), so that he or she can be certain the child is assessed.