The Junior Medical Officer's Guide to the Hospital Universe: A Survival Manual

322 Pages·2022·5.044 MB·English

by  John Shi

The Junior Medical
Offcer’s Guide to
the Hospital  Universe
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The Junior Medical
Off cer’s Guide to
the Hospital  Universe
A Survival Manual
John Shi
Junior Doctor
New South Wales, Australia
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First edition published 2023
by CRC Press
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
and by CRC Press
6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742
© 2023 John Shi
CRC Press is an imprint of Informa UK Limited
Te right of John Shi to be identifed as author of this work has been asserted in accordance with sections 77 and 78 of the Copyright,
Designs and Patents Act 1988.
Tis book contains information obtained from authentic and highly regarded sources. While all reasonable eforts have been made to
publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors
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strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant
manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any
information or advice on dosages, procedures or diagnoses should be independently verifed. Te reader is strongly urged to consult the
relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their
websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. Tis book does not indicate
whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical
professional to make his or her own professional judgements, so as to advise and treat patients appropriately. Tis book is not intended
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
ISBN: 9781032403236 (hbk)
ISBN: 9781032397405 (pbk)
ISBN: 9781003352501 (ebk)
DOI: 10.1201/9781003352501
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For my colleagues.
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Contents
Author xi
Glossary xiii
1 Introduction 1
How to use this book 2
Exhortation to read, and do this asap 4
For all Doctors 6
2 Before the Term 9
Tings to bring 9
Tings to do 21
People to know 23
3 The Term: Life Rounds 25
What is a Life Round? 25
An exhortation to look afer yourself: Justifcation for the
Life Round 26
An exhortation against exhaustion 28
Practical tips 29
4 The Term: IT 35
Mindset 36
Lists 37
Setting up a List 37
List maintenance 40
Personalised List/Excel List 41
Rounds List 43
Handover/Multi-Patient Task List 45
Task Manager: JMO Jobs List 47
Emergency Department: When not in ED 48
Journey Board 48
Finding stuf 50
PowerNotes 50
Clinical Docs 52
Continuous Docs 54
Ofsite data 55
Other places to look 57
Home Screen (aka Patient Summary) 58
Viewing Investigations 61
Radiology 63
vii
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viii Contents
Ordering Investigations 65
Principles 66
Setting up your Favourites 67
Folders/categories 68
Modifcations 72
Blood rules and myths 73
eMeds 76
Ordering Medications/Fluids 76
Modifying Medications/Fluids 77
Viewing Medications/Fluids 77
Other key functions 78
Documenting 79
Templating methodology 82
Ward Rounds 85
Other documentation 91
Attaching external documentation/media 93
Emergency Department Documenting 94
External referrals 96
Discharges 98
Methodology 99
Te Template 101
Major components 105
Te Plan 110
Useful documents to attach, but painful to do so 112
No eMR 114
Benefts 115
Te Intranet 116
Rosters 116
Resources 117
Miscellaneous 118
Doctor View 120
FirstNet 121
A justifcation for automation, efciency and minimising menial tasks 122
Templates: vice or virtue? 122
On pettiness 123
On errors 124
5 The Term: Organisation 127
On the Ward Round 129
Of the Ward Round 135
Logistics of the unexpected 141
6 The Term: Human Relations 149
Introduction: how to help other people help you 149
Phone contacts 150
Numbers 151
Ad interim 155
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Contents ix
Home team 157
Who? 157
Roles 157
Mindset 158
Organisation/prioritisation 159
Learning 161
Admin 161
Working hours 161
Ward staf 162
Ward Clerk 164
Nurses 165
Pharmacist 169
Allied Health 170
Consults (Other Medical Teams) 172
Who are you talking to: Hospital hierarchy 173
Before the Consult: preparation 173
Getting to the Team 178
Making the Consult 181
Afer the Consult 187
Follow-up and future Consults: smoothing access 189
Radiology 194
General rules 194
Imaging types 197
Special services 199
Getting them 199
Te process: for now and ever afer 200
Family 201
Getting in touch: contacting the family 202
NESB: contacting the patient 203
Interacting with/reassuring the family 205
7 End of the Term 209
Getting Handover 209
Giving Handover 212
Closing the Term 213
8 After Hours 215
Staying alive: Afer Hours Life Rounds 216
Organising Afer Hours: Jobs 219
Clinical Reviews 232
Deaths 241
9 COVID-19 245
General health/pressure area care 245
Hygiene 246
Protocol 247
Documenting 248
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