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Individual Placement Description
Placement Intensive Therapy Unit
Programme S2,S10
Year F2
Region South-East
Hospital(s) Royal Infirmary of Edinburgh
Main Duties of Placement

When working in the ICU, at present there is usually a large number of medics and nurse practioners. It is not uncommon to have 2 senior trainees, 3 junior trainees, 2 nurse practioners as well as 2 consultants.

The unit is divided into 2 and generally for the first 2 hours the patients are reviewed by trainees (1-3 each) and then a coffee break and then the consultant-led ward round.  There are usually minimal jobs. Normally there is anything from 0-4 admissions.

At night there is one senior trainee and either a junior or senior nurse practioner.  On weekends usually there is one senior trainee, one junior trainee and 1 or 2 nurser practioners.

HDU is usually manned by one junior doctor trainee and a consultant.  Some consultants will conduct a joint ward round, some will expect you review everyone first before doing a ward round and some split the patients and then later do a ward round together.  The turnover of patients is rapid here and most days there will be 3-5 in and outs; the majority being post-op patients (Hepatectomys, Nephrectomys, Whipples or more minor surgeries in patients with significant morbidities). Normally the consultant or ICU SpR will carry the HDU referral page but sometimes you will get the opportunity to carry this for some or all of the day and to go and review patients on the wards or in A&E.

Typical Work Pattern

FY2s (of which there are three at any one time) are in junior rota with CT1 critical trainees and senior medical trainees (ST3 upwards). There is a senior trainee rota of experienced anaesthetic/Intensive Care medicine registrars. There is also a team of 5-6 specialist nurse practitioners with their own rota though there are plans afoot to try and harmonise their rota with that of the medical trainees.

The majority of the 4 months is spent in ICU.  A normal day is 08.30-17.00 and a long day is 08.30-20.30. For about 2 weeks of the rotation you work in HDU doing 09.00-21.00 long days for either 3 or 4 day stretches. In any given month you will either do 7 ICU nights or 7 days HDU (as 3 or 4 day/night stretches).

Learning Opportunities

Juniors are expected and encouraged to learn procedures; in particular putting in arterial and central lines. There is a big emphasis on teaching; tutorials every Monday and Thursday from 08.00-08.30, a weekly journal club and a M&M meeting. The consultant-led ward rounds are teaching rounds.

Teaching

In addition to the above there is mandatory FY2 teaching 12.30-14.00 every Thursday.

Unique Selling Points

Exposure to sick patients, a range of interesting pathologies and opportunity to learn about the management of these patients. One works very closely with consultants and other senior clinicians and there are a multiple formal and informal teaching opportunities.

Relatively light workload and leisurely pace during weekday shifts.

Opportunities on HDU rota to assess sick patients potentially requiring level 2 or 3 care.

Opportunity to learn a variety of procedures, principally arterial lines and central venous line insertion.

Employer Information
It is important to note that this description is a typical example of your placement and may be subject to change.


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