Dear Medical Student,

         (& Fellow, or Visiting Resident from another department):

 

Welcome to St. Barnabas Hospital and the Department of Medicine!

All students should sign in with Lorraine before starting any clinical rotations. 

In the Department of Medicine, students, fellows and residents visiting
from other departments should then sign in to the Medical Education

Office x6202 in room 717 (including the  Sign In Survey, below.) 

 

Students are afforded the privilege of entering areas of the Hospital where patient

care takes place only after they have become familiar with important policies and

procedures.  Please review the following:

  

   -JCAHO requirements for patient rights, patient safety, and

     quality of care as they apply to physicians.    Physician identification,

     patient confidentiality, hand washing and other procedures to reduce

     nosocomial infections are addressed.   Read it all?  Please review!

 

   -HIPAA laws also focus on patient confidentiality.  Students must guard

     against the unintentional disclosure of confidential patient information when

     talking in elevators, the cafeteria, or any public place.    In the course

     presenting a case to a teaching attending,  students sometimes want the security

     of material that must not be removed from the patient chart.    Copies of

     patient material used for teaching purposes must have any and all patient

     identifiers removed.     (Later, come back here for more HIPAA training.)

  

   -The Hospital policy on the Chain of Command.    Each patient admitted

     to the Hospital has or is designated an attending physician of record  who

     maintains the legal responsibility for the care of the patient.

 

     While the attending can designate some of the on site care of the

     patient to the interns and residents, the legal responsibility can not

     be relegated to such physicians in training.   In the eyes of the law, the

     attending physician is the “captain of the ship”.  It is the duty of the

     interns, residents and students to keep the “captain of the ship” aware

     of any significant developments in the clinical course of the patient.

 

      While students will spend much of their time with the PGY-1 residents

       on their team, it is the PGY-2 who is responsible for reviewing their

       notes and contemporaneously signing orders.  Orders must not be written

       by medical students unless there is a PGY-2 (or above) to immediately

       review and sign such orders.   A progress note written my a medical

       student may  substitute for such a note by the PGY-1 only if it is

       co-signed by the PGY-2 (or above).    Each inpatient team also includes

       a PGY-3 to whom the student can turn for advice or assistance.   The

       PGY-4 Medical Chief Residents are available at x6211 for questions

       or help, as is the Program Director.   Twenty four hours a day, including

       nights and weekends, there are always teaching attendings in the ICU

       and Emergency Room.

 

   -The Hospital policy on the use of Chaperones (a copy is attached to each

     medical resident “Basic Procedure Form”)

 

   -The Hospital policy on Performance of Procedures (medical students

     are only allowed to draw blood or start an IV, and that must be done

     under the direct, in person supervision of a PGY-2 or above who

     has been themselves credentialed to supervise.  In order to draw blood

     or start an IV on their own the medical student would require the

     written permission of the Program Director. 

 

   -When an unexpected event occurs (e.g., a patient falls, a student falls), an

     “Incident Report” must be filled out.  The medical resident or nursing

     supervisor can assist you in completing such a form if the occasion

     arises.   If a body fluid splashes onto the mucous membrane of student,

     or if a student suffers a needle stick, this is also an incident which

     requires reporting, but it also requires immediate attention in Employee

     Health or the Emergency Department.   Guard against a feeling of denial (or

     embarrassment) that may inhibit students from seeking the attention they

     need .   More importantly, follow all Hospital policies and procedures

     to avoid needle stick and body fluid exposures.

 

   -While you are rotating through our department, we must know where you

     are during duty hours.  The intern and resident members of your team

     must be aware of your schedule and you must inform them if you will

     be deviating from it.   Notify the Medical Chief Residents if you will

     not be reporting for duty because of illness or other activities.

 

  - Before you embark on your clinical experience here, (but after you

    read the information at the links above) we require that you

    complete a short on line form that indicates who you are, how to get

    in contact with you, and your acknowledgment that you understand the

    key policies meant to ensure your safety, the safety of patients, JCAHO

    requirements, HIPAA requirements, the "chain of command" and

    chaperone rules:  a Sign In Survey

 

 

  -While you are visiting our institution, we hope you will learn as much as

    possible.    We have taken the liberty of preparing some

    Educational References for Students & Residents, organized along

    the lines of the  ACGME/ABMS six general (core) competencies.   

    The material is  password protected and  by using it, you agree that it  is

    for your individual use only.  You are not  to share the material with others

    or divulge any passwords.    You are  expected to review this material

    with the PGY-2/3 on your team.   If there are any supplies or texts

    you need, one full service resource is a B&N bookstore.

    [There is an on line quiz to take before you complete your tour here. 

     -under construction...]

   

 -  Feedback.    Approach the interns and residents on your team to

   provide formative feedback to you.   Your teaching attending is also

   available for this purpose.     Mid-way through your time on the medical

   service you should complete the following Reflective Self-evaluation

   (view & print  with Adobe Acrobat) and then ask one of the residents

   who knows you  best to review it, comment on  it, and return it to you

   as confidential  "mid-rotation formative feedback".

 

   Shortly before you complete your rotation(s) in our department please

   ask a resident who has worked closely with you to fill out this on line

   Summative Evaluation of Student by Resident.   

 

   In order for our training program to improve  the experience it provides

   to medical students, we too appreciate  feedback.  Before you complete

   your tour here, we would be grateful  if you could complete an

   on line Student Feedback to SBH.   Thank you and

   Good Luck!