NIGHTS IN CHARGE GUIDE

This guide will help you through trials and tribulations of a nocturnal existence at the mighty Maitland Hospital

Welcome to The Maitland Hospital (TMH) ED after hours guide.

The aim of this guide is to provide you with some tips and tricks to make things easier for your tired brain!

As well as looking after TMH ED you are also required to provide oversight to the other local rural emergency services. Overnight these rural sites are serviced by GP’s and NP’s of variable level of seniority and skill.

This guide covers care for your patients here in Maitland as well as information about the outlying sites to assist with your decision making. Some of the rural sites are GP led, others nurse led with no doctor cover. They may call for simple advice, medications, review of plans, acceptance of transfer or advice on alternative care/ assessment provision. Throughout the guide there some ideas on how you can provide best quality safe care to all patients and potentially avoid unnecessary transfers.

SETTING UP FOR SUCCESS

Familiarise yourself with the apps below before your shift starts.

ED WHITEBOARD:

Maitland Hospital Emergency Whiteboard. Useful for gaining (and ideally maintaining awareness) of the state of the department as a whole.

PATIENT FLOW WHITEBOARD:

Useful when wondering what is being transferred to department and what conversations have been ongoing

IPIMS

Patient Flow Management App - open via CITRIX application portal

Log in: TMHEMERG

password: Emergtmh1

HNE MEDICAL ON-CALL ROSTER INFORMATION*

Provides DECT and mobile phone info for on-call teams at JHH (avoids having to listen to JHH switch automated messages while on hold). This app is located in CITRIX application portal and is currently Live

PERIPHERAL SITES

TMH is a secondary referral site for several rural hospitals and 24hr services. Click the link below to learn more.

Documentation for consults and expected patients

Ideally, for all calls from peripheral sites a clinical consult note on CAP is created in the patient’s notes.

Record the patient details, advice given, treatment and disposition advice, the staff member you spoke to, the time/duration of call; even if you do not accept care of the patient!

This documentation is a legal requirement and will be referred to in the event of an adverse outcome. (Note you can have 2 CAP screens open at once to review patient results/ imaging on one and make the note in the other - open in a separate browser window)

peculiar equipment and where to find it: AND PUT IT BACK!!

Long IV Cannulas for US insertion - Two dedicated USS Trolleys in main department, silver, kept under bench of fishbowl on resus side

Medtronic and St Jude pacemaker check devices - Drawers next to SS computer in fishbowl

Nasoendoscopy- Storage room on west side of department (near ETZ)

Pan-otoscope- every bedside, eye shields only on some units

ENT head light- Drawers next to SS computer in fishbowl

Tonometer - ENT trolley (probes should also be on trolley, if not, FACEM office has spares)

Toolbox (of actual tools) - Staff specialist room in Activity Based work area on shelving