Inpatient Rotations

Location:   Mott Hospital
Floor: 12 W

Workroom: 12-130 (across from patient room 12-52), now complete with keurig and mini-fridge!  (BYO-K-cups, or snag some from the house officer lounge by the café in the main hospital)

Workstation: One of the two computers on the right side nearest to the door (under cabinets labeled “Physicians”)

Parking:  P3 or P2 (Don’t waste time with P4)

  • Speak with one of the two chief residents for PM&R, they should add you to the list of acceptable blue passes for the month.  Then you are able to park in P3 in a “Blue/COPH” labeled spot.   This is restricted staff parking.
  • If no spots are available, use your pass to exit the top of level 3 to the patient parking area.  But you must reenter (using your pass) to leave through the same garage (do not attempt to enter P3 and exit P2).  This is a special exception for residents and fellows.
  • If you haven’t secured a parking pass by the start of your inpatient rotation, you may park in P2 and get a parking pass from the EMG lab (deep in the bowels of the main hospital).   This is considered “patient parking” and is suppose to be used as a last resort.

Bathrooms

  • There’s two “staff only”, one of them is tucked behind the nursing station near rooms 12-60s and the other is halfway down the main 12W patient hallway across from patient rooms.
  • Single stall general use bathroom located near the gyms
  • Public restrooms located near the conference rooms

Lactation Rooms:  Available on 12 (and several other floors) located across from the gym.  They have Aveda pumps, bring your own tubing and storage supplies.

Team Meetings: 

  • When: Tuesdays starting at 2:30pm
  • Where: Team conference room (near public bathrooms)
  • Structure: 
    • Weekly team meetings on all children ON PMR SERVICE (typically not consults)
    • Resident creates note for team conference (one computer in room, may bring your own laptop if you wish)
    • Typical progression (in this order): MD/DO with medical updates, Nursing and/or Vent, PT, OT, SLP, Rehab Engineering, RPN, SW, other (dietary, etc.).  All provide short updates on weekly progress. 
    • At end, discuss anticipated d/c date.

Cafeteria: There’s one in Mott on Floor 2 (main floor) and one at Main University Hospital (if you need chocolate/sweets, you have to go to the gift shop though, either at Mott or UH)  Warning: no beverages contain real sugar!!! You’ve been warned.  Oh, and we don’t get a food allowance. 
 

Inpatient Rotation:  Typical Day

Time: 8am-5pm (or later depending on admits, work, etc.) Monday-Friday
Your job:  To learn to function as an attending on an inpatient service.

  • There is always a resident on service with you, they rotate monthly but slightly off cycle from us (by 1-2 days)
  • Residents (aside from the brand new ones) are used to running services and consults on their own, provide as much independence as you can.
  • The resident typically takes all the pages/calls from nursing, consult services, etc.  They are considered “First Contact”
  • The residents take night and weekend calls, they sign out to each other via email and MiChart.  If there is something that needs to be followed up on, be sure the resident is aware to sign it out to the night/weekend person.
  • You will have patients on your service and receive consults from other teams.
  • Patients ON your service must be seen every day with notes every day.  (Consult notes vary in frequency depending on need.)
  • Be sure to talk with parents daily (if they are available) and ideally see patient working in therapy (and talk w therapists)
  • Notes:  At the beginning of the month, discuss with the resident how you would like things done.  For example, I like to split the work so that we function more as a team.  I typically start writing up the consults while they do the daily inpatient notes and we split the remainder depending on who finishes first.  (My favorite attendings always helped out with mundane things likes notes when I was swamped, while other less-favorites just watched or left me to do it myself.  Decide what you want to do and be sure the resident is aware of your expectations.)

 Your Immediate Team:

  • Attending
  • Resident
  • PT, OT, SLP
  • Rehab Neuropsychology (consult them on nearly all patients, they help with return to school)
  • Rehab Engineering (help with room controls AND can give therapists other things as well)
  • Social Work (assist with setting up outpatient therapy and everything else under the sun.  We just got a relatively new social worker so I don’t know her well yet.  Inpatient and outpatient social workers are different.)
  • Case Manager / Discharge Planner (they get most DME equipment orders written for you to sign, home care set up, etc.)
  • Nursing
  • Vent Team / Respiratory Therapist (adjust ventilators, etc.)
  • Therapeutic Recreation (consult for all inpatient rehab patients)

Survival Tips:

  • Things don’t always run very smoothly.  But if you see a problem, tell someone so it can be acknowledged and hopefully resolved.
  • When in doubt, Tammie Wiley-Rice (link to her email) has all the answers.  Email/text/call her.
  • When upset, frustrated, down, irritated, or happy, talk to Tammie. 
  • Tammie is the goddess of all.
  • Phil Stranyak (link to his email) assists the goddess of all and is doing well in the learning process of becoming somewhat godlike himself.  His number is the one on your business card so he will take (nearly) all the calls from your patient’s and/or their parents and then page you or send you an email or michart message.
  • If there’s anything you need or want or think would help out life, talk to Phil and Tammie.   They may laugh, but will also try to make things happen.  (Although I was unsuccessful in transitioning the department to glitter pens)
  • Rotation Schedules: sometimes they vary and may be changed at the last minute.  Try to stay as flexible as you can.  (The hours typically do not change)
  • If there’s a rotation, clinic, lecture, procedure, or something you would like to attend, let Ayyangar know.   She attempts to accommodate for individual interests (and dislikes) as much as possible.