Welcome to the NICU! During your time, you will work with other residents, fellows, neonatal nurse practitioners (NNPs), and attendings as well as members of a multi-disciplinary team to provide care to premature neonates and neonates with varying illnesses. You will attend high risk deliveries and practice resuscitation skills in order to become competent in Neonatal Resuscitation (NRP).


Contacts

Before Your Rotation

  • Review the Goals and Objectives
  • The senior residents for each block should reach out to the team 1-2 months in advance to discuss scheduling, which will then be reviewed by the Chief Residents.
  • All oncoming team members must receive verbal patient sign-out from the outgoing team; you should also review the off-service notes in Epic by the outgoing interns

Scheduling

Monthly Schedule

  • PL-1 interns
    • 2-3 blocks during intern year
    • 28 hour in-house call every fifth or night
    • 4 days off per block
  • PL-2 and PL-3 senior residents
    • Your amount of time as a NICU senior will depend on your career interests and will be part of your Senior Supervisory Rotation (SSR)
    • Q4 call rotation, split between 2 seniors, NNPs, and PL-3 cross coverage
    • 4 days off per block

Daily Schedule

  • Sign-out at 7 AM
  • Pre-round until 8:30 AM
  • Round on CICN (Comer 4) at 8:30 AM
  • Attending teaching from 9:00-9:30 AM in the NICU conference room
  • Round on NICU (Comer 2) at 9:30 AM
  • Post-call intern and senior should leave by 11 AM after completion of rounds and clinical duties
  • On days when cross-covering night senior is working, senior resident should sign out at 3:30 PM
  • NNP sign-out occurs daily at 4:00 PM

Weekly Schedule

  • Radiology Rounds on Tuesdays and Fridays at 1 PM in the radiology suite
  • Social work lectures on 2nd Mondays at noon
  • Discharge Rounds on Tuesdays at 2 PM in K287 to discuss all patients’ long term and discharge planning needs. One senior resident should be present.

Roles and Responsibilities

PGY-1 Responsibilities:

  • Call intern should log into intern pager 6361
  • Pre-rounds:
    • Gather all numbers prior to rounds; if you are running behind, your senior should help you complete data gathering
    • Talk with bedside nurses and examine all patients prior to rounds
  • Present patients on rounds
  • Write daily progress notes and orders
  • Perform history and participate in the stabilization of new admissions
  • Carry code pages and attend deliveries when paged
  • Perform procedures including but not limited to: intubations, umbilical line placement, lumbar puncture, chest tubes
  • Present assigned patients on radiology rounds alongside NICU senior
  • Update EPIC-based problem list at least weekly with additional updates prior to patient care transfers. Problem lists should include pertinent details of the hospital course and should be used for off-service notes and discharge summaries.
  • Communicate with parents
    • Families should be updated in person or by phone at a minimum of twice weekly
    • In the case of emergent care or acute change in medical status, families should be updated immediately
    • As discharge approaches more frequent updates may become necessary
  • Plan discharges, facilitate follow-up appointments, and write discharge medications
  • Occasionally evaluate an infant in the mother-baby unit (newborn nursery), with appropriate supervision
  • Supervise medical students

PGY-3 Senior Resident Responsibilities:

  • Call senior should log into 6362 and 6369 pagers
  • Supervise all interns in patient care, delivery room attendance, procedures, and the completion of notes
  • Examine sick patients and be up to date on all labs prior to rounds
  • Update sign-out, put in orders, and support interns during rounds
  • Perform procedures including but not limited to: intubations, umbilical line placement, lumbar puncture, chest tubes
  • Help carry out patient care plans
  • Supervise and teach interns, sub-interns, and medical students
  • Oversee distribution of patients to NNP service
  • Conduct and oversee sign-out between resident team and NNP team
  • Carry patients as needed to maintain intern patient cap of 7 patients (total of 28 patients for the entire resident team)

Locations

The NICU is located on Comer 2nd floor – enter from hallway connecting Comer and Mitchell. Critically ill patients are admitted to Comer 2nd floor NICU, patients requiring neonatology specialty care but not critically ill are admitted to the Comer 4th floor transitional care unit.

Resources

Review common NICU topics in the NICU Handbook, written by former NICU fellows