Drs. , Ciubotaru, Stumacher, Adler, Menkel, Grantham

UPDATE: Competencies-SAM \| Advanced JCAHO Support \| JCAHO summary \| Duties in the ICU \| ICU Curriculum \| Example Schedule \| ICU Palliative Care \| Teaching \| Nutrition Documents \| ICU-Endo \| CriticalCare Topics \| ICU 4 Families \| The Bell Commission \| Orientation 2 ICU \| Res Sign-ICU duties \| For Whom The Bell Tolls \| HIPAA \| Nutrition Links \| Subclavian \| JCAHO review \| ICU Links \| ICU Protocols \| more ICU links \| Procedures & Simulation \| &Hospitalists \| Calendar \| UpdateIndex \| Help

VIEW: Home \| Competencies-SAM \| Advanced JCAHO Support \| JCAHO summary \| Duties in the ICU \| ICU Curriculum \| Example Schedule \| ICU Palliative Care \| Teaching \| Nutrition Documents \| ICU-Endo \| CriticalCare Topics \| ICU 4 Families \| The Bell Commission \| Orientation 2 ICU \| Res Sign-ICU duties \| For Whom The Bell Tolls \| HIPAA \| Nutrition Links \| Subclavian \| JCAHO review \| ICU Links \| ICU Protocols \| more ICU links \| Procedures & Simulation \| &Hospitalists \| Calendar

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Please note: You may continue to use this page type if you desire. <P class=MsoNormal style="TEXT-ALIGN: center" align=center><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 16pt">ST BARNABAS HOSPITAL ICU<SPAN style="mso-tab-count: 1"> </SPAN><o:p></o:p></SPAN></B></P> <P class=MsoNormal><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 14pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 14pt">Duties of the Intern/Resident:<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Come in between 7:00 - 7.30am Enough time to get patient assignment sign outs and <B style="mso-bidi-font-weight: normal">pre-round</B>.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Attending rounds</SPAN></B><SPAN style="FONT-SIZE: 13pt"> begin(between 8:15-8:30).<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Xray rounds</SPAN></B><SPAN style="FONT-SIZE: 13pt"> after attending rounds<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Afternoon sign out</SPAN></B><SPAN style="FONT-SIZE: 13pt"> rounds(between 3:30-3:45)<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Short call team</SPAN></I></B><SPAN style="FONT-SIZE: 13pt"> leaves 4:00 pm<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Night team</SPAN></I></B><SPAN style="FONT-SIZE: 13pt"> arrives approx 8:00 pm to receive sign out from <B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal">long call team</I></B> who leave after sign outs completed<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt"><SPAN style="mso-spacerun: yes"> </SPAN>Day 1</SPAN></B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Check the schedule to find out which district you have been assigned.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Take sign outs</SPAN></I></B><SPAN style="FONT-SIZE: 13pt"> from the night float team. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Flow sheets are to be used during the sign outs. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Obtain all details regarding the patient i.e. reason for being in the ICU, history, physical exam and lab values at admission, goals of ICU care, intervention done in the ICU and progress of all of the above during the previous shift. Any sign outs specifically regarding monitoring certain physical findings, labs and ventilator setting changes are to be noted.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Pre round</SPAN></I></B><SPAN style="FONT-SIZE: 13pt"> on the patients assigned to you. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Daily rounds consist of complete physical exam, and reviewing the following: hemodynamic parameters, ventilator parameters, EKG’s, sedation regimen, electrolytes, fluid balance, nutrition, renal function, lines, medications list and drug reactions as well as the patient’s code status. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Have the daily worksheet complete which can then be used to present at rounds. Input from the nurses is very valuable too. <o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 13pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><BR style="PAGE-BREAK-BEFORE: always; mso-special-character: line-break" clear=all></SPAN> <P class=MsoNormal style="TEXT-ALIGN: justify"> <SPAN style="FONT-SIZE: 13pt"><o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Presentation skills</SPAN></I></B><SPAN style="FONT-SIZE: 13pt"> are very important and shows how much you know about your patient. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Presenting the patient at rounds to the ICU attending in a <B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal">systematic manner</I></B> includes how the patient presented to the ICU, initial interventions done, the response and an assessment and plan for the patient for that day. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">System wise approach prevents missing out on important issues and is also easy to work with (RICHFEN)<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">R<SPAN style="mso-tab-count: 1"> </SPAN>Respiratory i.e. ventilation details, CXR changes. Aim to get patient off <SPAN style="mso-tab-count: 1"> </SPAN>toxic FiO2 i.e. <60%<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">I<SPAN style="mso-tab-count: 1"> </SPAN>ID i.e. causative organisms if known, ABx day, temperature and WBC <SPAN style="mso-tab-count: 1"> </SPAN>trend, <B style="mso-bidi-font-weight: normal"><U>all cultures and sensitivities.<o:p></o:p></U></B></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">C<SPAN style="mso-tab-count: 1"> </SPAN>Cardiovascular i.e. vasopressors, BP & HR, details of CAD, Medications.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">H<SPAN style="mso-tab-count: 1"> </SPAN>Hematology i.e. H/H, platlets, Transfusion details and goals. Coagulation <SPAN style="mso-tab-count: 1"> </SPAN>profile/ anticoagulation details.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">F<SPAN style="mso-tab-count: 1"> </SPAN>Fluids/ Electrolytes/ Nutrition i.e. I/O Chart, IVF’s, urine cc/hr, Renal <SPAN style="mso-tab-count: 1"> </SPAN>functions, monitoring and correction of lytes, feeds. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">E<SPAN style="mso-tab-count: 1"> </SPAN>Endocrine <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">N<SPAN style="mso-tab-count: 1"> </SPAN>Neurology i.e. Sedation, if on paralytics Train of<SPAN style="mso-spacerun: yes"> </SPAN>4’s, Neurocheck details, <SPAN style="mso-tab-count: 1"> </SPAN>CT scan details<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">P<SPAN style="mso-tab-count: 1"> </SPAN>Prophylaxis. GI & DVT prophylaxis.<o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 13pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><BR style="PAGE-BREAK-BEFORE: always; mso-special-character: line-break" clear=all></SPAN> <P class=MsoNormal style="TEXT-ALIGN: justify"> <SPAN style="FONT-SIZE: 13pt"><o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Any of the <B style="mso-bidi-font-weight: normal">orders</B> discussed during rounds regarding medications etc are to be <B style="mso-bidi-font-weight: normal">written immediately while on rounds</B> and the nursing staff made aware. Always flag orders.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Knowing your patient is mandatory. Always be attentive about what is happening with all the patients in your district too, as this helps you learn as well as comes in handy when on call, to deal with problems that may crop up when you cover the other patients. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">X-ray rounds</SPAN></B><SPAN style="FONT-SIZE: 13pt"> usually follow the attending rounds.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">But make it a point to call ‘Consults’ and order add on labs, drawing emergency blood work and order transfusion prior to going to X-ray rounds. <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">X rays are found in the designated shelf for ‘ICU’ in the Radiology department and are read along with the attending. Things noted on x-ray’s that should be included in the daily progress notes are changes in the pattern of findings, position of the central lines/ PA cath ( if present), ET position and NGT position.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Once back from the X-ray rounds complete all the other things that were discussed on rounds. This is a good time to re-evaluate any patient who is being weaned or whose ventilator settings were changed during the rounds.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"><SPAN style="mso-spacerun: yes"> </SPAN>Discuss with your superior and the attending regarding extubation time. Extubations done early gives you more time to asses patient stability prior to sign outs.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Take turns to go for lunch and always sign out your patients to the resident who is going to stay back regarding any problem you think may come up so that you don’t get beeped during your lunch. Let your senior be aware when you step out.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">If you do a procedure like a neck line, subclavian line or a PA cath make sure to immediately order a X ray and also call the technician at 4203 so that it gets done ASAP and rule out any complications. It is a good habit to follow up your X rays before leaving for the day. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Write a <U>procedure note</U> immediately after doing ro attempting to do the procedure.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Tests/treatments that were discussed during rounds are assumed by attendings to be followed through on.<SPAN style="mso-spacerun: yes"> </SPAN>If for any reason there appears to be a delay in getting them done notify the attending.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Order AM labs,Xrays and EKG’s before leaving for the day.<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Any acute or unexpected changes in the patient condition at any time needs to be notified immediately to the next superior following chain of commands even before or in between rounds</SPAN></B><SPAN style="FONT-SIZE: 13pt">. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">(PGY1 – > PGY2 – > PGY3 – > ICU ATTENDING). <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoBodyText>If the issue is thought to be a very serious one, the ICU attending should be made aware regarding the same at the earliest.(primary care attendings, consultants and family members should also be promptly notified)</P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><I style="mso-bidi-font-style: normal"><SPAN style="FONT-SIZE: 13pt">Finally the most important thing: Always document everything that is done. “Without documentation even a heroic effort on your part witnessed by everyone is without proof”. If something is not documented it was never done.<o:p></o:p></SPAN></I></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Additional duties for residents on call</SPAN></B><SPAN style="FONT-SIZE: 13pt">:<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">The senior most resident in the call team assigns admissions.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Do your admission orders early so that nurses can carry out the same.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Go over the admission and the orders with the 3<SUP>rd</SUP> year resident. <o:p></o:p></SPAN></P> <P class=MsoBodyText>EVERY ADMISSION MUST BE DISCUSSED WITH THE ATTENDING ON DUTY FOR THAT DISTRICT OR THE ON CALL ATTENDING. DIFFERENTIAL DIAGNOSIS, PLAN, AND ORDERS ARE TO BE REVIEWED WITH THAT ATTENDING IN A TIMELY FASHION. </P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt">THE RESIDENT/INTERN MUST DOCUMENT AT THE END OF THEIR ADMIT NOTE THAT THEY HAVE GONE OVER THE CASE/ORDERS WITH THE ICU ATTENDING.<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Any sign outs from the previous shift team should be carried out and documented. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Additional duties for residents on call during night float:<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Keep a close eye on the patients and sign outs given. Any admissions that are assigned are to be done. Around midnight you have to order X rays for all the patients who are intubated to see the position of the ET. In the non-intubated patients<SPAN style="mso-spacerun: yes"> </SPAN>X-rays are to be done only if there any specific thing is being followed by daily x-rays, e.g. infiltrates, worsening pnemothorax, pneumonia or pleural effusion.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Every patient on the ventilator also needs an ABG unless specified otherwise.<o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 13pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><BR style="PAGE-BREAK-BEFORE: always; mso-special-character: line-break" clear=all></SPAN> <P class=MsoNormal style="TEXT-ALIGN: justify"> <SPAN style="FONT-SIZE: 13pt"><o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">The intern</SPAN></B><SPAN style="FONT-SIZE: 13pt"> is responsible for his patients. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">The 2<SUP>nd</SUP> year resident</SPAN></B><SPAN style="FONT-SIZE: 13pt"> is responsible for his patients as well as his interns patients i.e. all the patients in his district. <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">The senior resident</SPAN></B><SPAN style="FONT-SIZE: 13pt"> on call is responsible for all the patients in the ICU i.e. all the three districts.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">It is imperative that you understand that as residents at all levels of<SPAN style="mso-spacerun: yes"> </SPAN>training, you make therapeutic decisions, write orders and perform procedures only if you are 110% comfortable doing so.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Any uncertainty needs to be confirmed or supervised by a senior to you.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Your role in the ICU is to learn and grow as physicians under a very well supervised setting.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><SPAN style="FONT-SIZE: 13pt">Utilize the nurses as a valuable source of knowledge as they possess many years of experience.<o:p></o:p></SPAN></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Do not write any orders that you are not confident in.<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-SIZE: 13pt">Work Hard and Enjoy.<o:p></o:p></SPAN></B></P><SPAN style="FONT-SIZE: 13pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><BR style="PAGE-BREAK-BEFORE: always" clear=all></SPAN> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt">I<SPAN style="mso-spacerun: yes"> </SPAN>DR. ___________________________ HAVE REVIEWED THE DUTIES OF THE HOUSEOFFICER ICU HANDOUT. I UNDERSTAND THEM FULLY.<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt"> <o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt">__________________<SPAN style="mso-tab-count: 1"> </SPAN><SPAN style="mso-tab-count: 2"> </SPAN><SPAN style="mso-tab-count: 1"> </SPAN>_________________________<o:p></o:p></SPAN></B></P> <P class=MsoNormal style="TEXT-ALIGN: justify"><B><SPAN style="FONT-SIZE: 13pt">DATE<SPAN style="mso-spacerun: yes"> </SPAN>SIGNATURE<o:p></o:p></SPAN></B></P> Automatically clean input to optimize for the web. 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Drs. , Ciubotaru, Stumacher, Adler, Menkel, Grantham

Res Sign-ICU duties

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