IMG working patterns and information

Board Rounds

Whatever specialty you work for, you will be expected to attend the Board Round meetings or Huddles that consist of the Consultants, Nursing staff, Physiotherapists, Occupational therapists, Ward manager, and Onward care manager.

This may be a new concept for many IMGs. Board Rounds are usually held early on in the day and in these meetings, each patient on the ward under your team is discussed, important jobs are assigned, their fitness to leave the hospital is confirmed, documented and shared with the site team and the discharge pathway is shared.

This ensures that the entire team is aware of the patient pathway and so is the Trust bed management team. This enables them to plan for any emergency admissions that are awaiting a bed in the Emergency Department.

Bleep Systems

You are contactable via your bleep which has a unique number. Therefore it's your responsibility to pick up the appropriate one at the start of each shift. Be prepared to respond to bleeps as soon as possible. Nurses have an escalation policy should the bleep not get answered. You certainly don’t want your consultant to be called in case you fail to respond!

You can bleep another colleague by dialing 8080 or using the bleep function on the ward desk phone. Be prepared to try again should you not get a response in 10 minutes. It is good practice to document any failed attempts to contact a colleague for advice.

Referrals

It is common for a multi-professional team to manage patients jointly. It will be your responsibility to make a prompt, concise, appropriate, and polite referral. You may also receive referrals from other specialties during on-call shifts. It is advisable to seek your registrar’s help in these situations before you gain enough experience and knowledge of local practices.

On-call shifts

On calls may feel busy or disorganised at first. It is better to be prepared with the knowledge that you are not alone. Keep a meticulous list of handover lists, referrals, and bleeps, and tick them off as you go. Introduce yourself, and alert the team that you are new to post and that it will take time to do the jobs.

If you are uncertain, it is safe to acknowledge this and let your team know. Seek help early. Any unfinished tasks should be handed over. Equally, ask the previous teams if they wish to hand over any tasks to you.

Every shift is a learning opportunity and you should look upon any missed opportunities as a chance to improve yourself on the next shift.

Resources

Induction App

The purpose of the Induction app is to provide you with the contact details, bleep numbers, and extension of the hospital staff around you so that you may contact them in case of any need or emergency. The app is available to both IOS and Android users. Follow the link below to gain access and download Induction, BMJ, Toxbase, BMJ Best Practice and Resuscitation council App. Links to useful resources

Microguide App

The Microguide App ensures that SHO doctors have the treatment details all together in one place and accessible from anywhere in one click. It consists of the treatment doses of antibiotics and also outlines the way where one can switch from IV to Oral dosing. If you are unsure about antibiotics, doctors in training can contact the microbiology team for expert advice. You can find more about this app on the staff Intranet. You can also contact the ward pharmacist, Medicines Information, or refer to the BNF.

Shift patterns

This is an example of a shift pattern for a Doctor working in Trauma and Orthopaedics, which is commonly known here as T&O.

Ward duty: 08:00- 17:00 (Monday-Friday)

Thorough ward rounds of all inpatients and completion of jobs that arise as a result. Help is available from seniors within your own team. You may wish to liaise with other departments after liaising with your own seniors. It is common practice to escalate issues to seniors within your own team before referring patients to other teams.

You can seek help via the intranet, switchboard via 1000, or Contact lists on Induction App. (see more about this app below)

Outliers: 08:00- 17:00 (Monday-Friday)

Very often there are no beds in wards to care for admitted patients and they have to be managed in other wards and are referred to as outliers. Jobs and responsibilities remain the same as detailed above.

On-call Day:

You are assigned to receive referrals from Emergency Department and other specialties.

Admit, clerk, and initiate a management plan for those admitted. Present and assess patients with admitting Registrar and Consultant. Registrars and middle grades are available for advice but might be busy in theatres.

Weekends and Bank Holidays Ward cover

There is a skeleton staff on weekends. You will be expected to work through and assess patients on the handover list. Registrars and middle grades are available for advice but they may be busy in theatres.