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GEneral Information

 

Useful Cedars Nursery Phone Numbers:

 

310-423-xxxx

310-248-xxxx

 

Voalte Phones:

NSY Intern:  

  • Login: nurseryres1  Password:  11111

  • x87280, (310) 248 - 7280

  • p1493

​

NSY Senior:

  • Login: nurseryres2   Password: 11111

  • x86986, (310) 248 - 6986

  • p0531

 

People:

 

Day NSY Hospitalist:  77599

Night NICU Hosp/NNP:  38371

NICU Attending (24h):  38369

NICU Charge RN:  38238

​

NSY Social work:  37836

​

Ward Senior:  73556 (310-384-0244)

 

Places:

 

Obs NSY:  33351

3NE (30xx):  34301

3NW (31xx):  34305

3S NSY:  34242

NICU: 34451

L&D:  33601

L&D fax: 30109

​

Lab STAT:  35431

Lab Mico:  34777

Pharmacy 4NE:  35633

​

Radiology: 37273

Radiology Reading room: 35720

Echo: 34861

​

Interpreter: 35353

 

Nursery Days

 

General Clinical Expectations:

  1. Read and familiarize yourself with the website. We know this is a lot, but this is the baseline information we need every nursery resident to know or at least be able to quickly reference

  2. Attend deliveries throughout the day with a respiratory therapist, nursery hospitalist, and/or neonatologist to participate in the resuscitations. Write delivery notes for deliveries you attend.

  3. Round on and write daily progress notes (SOAP notes) on Housestaff (HS) newborns and newborns in the observation nursery who are yellow or red in the sepsis calculator.

  4. Promptly evaluate all medical problems of newborns when called by nursing staff.  

    1. Remember:  ALL babies are our babies. There is no teaching/non-teaching service distinction. If there is any abnormality/concern, the residents are first call.

    2. Document in CS-Link every time you are called to evaluate a patient. This includes non-housestaff patients. This helps immensely with communication, teaching, tracking events. Include which PMD office service you communicated with

  5. Communicate with the nursery charge RN daily

    1. Set time in the AM (10-11am before/after safety rounds at ~11a)​

    2. Set time in the PM (10-11pm before/after safety rounds  at ~11p)

  6. Notify the private pediatrician when there is a change in the clinical status of a newborn or when admitting to “observation” status or to the NICU.​​

​

Signout

  • Nursery day intern and senior both arrive at 7am to receive signout from the night team.​​

  • Day intern and senior sign out to the night intern and senior at 7pm. 

    • EXCEPT: INTERN AND SENIOR SHOULD ARRIVE at 6:30AM ON INTERN'S FIRST DAY. ​

      • Seniors should orient the intern to the warmer and review NRP prior to 7am sign out on the intern's first day.​

      • The night team should continue to hold the pager from 6:30AM to 7AM, they are NOT to signout early

​

Rounding Logistics

  • Weekdays: Rounds will occur at earliest 8:00 am with the NSY attending

    • Senior resident should contact nursery charge nurse after morning rounds and at 10 pm (overnight senior) regarding potential discharges or any complicated/OBS babies

    • Senior resident should contact attending to confirm start time and location of rounds

  • Weekends

    • ​On weekends, rounding will be completed by either the day or night team, determined on a daily basis.

      • The night team should contact the overnight hospitalist or neonatologist to determine who will round​

    • Suggested workflow to determine weekend rounding time:

      • Call prospective attending at 4pm or after (this is the attending signout time) to find out when NSY rounds will occur for the following day

      • Call NICU hospitalist (Volte: nicunightfirst) at x38371 as first call

      • If no NICU hospitalist available or no answer, call NEO (Volte: dr attending) at x38369 as second call

      • If all else fails, there should always be a NEO available at x38369 who can tell you with who/when rounds will occur

  • On all days:​ safety rounds with nursery charge nurse are daily at 11:30a and 11:30p, after L&D safety rounds. The residents meet the nursery charge RN and discuss all active issues, including rule-outs, phototherapy, pending studies, etc.

​

Lectures & Conferences

 

  • Morning Report: Monday through Friday from 8:00 - 9:00am in the resident lounge (except on Thursdays when Grand Rounds/Case Conferences are scheduled). The emphasis will be on pediatric ward patients but the nursery team is encouraged but not obligated to attend.

  • Grand Rounds/Case Conferences: occur Thursdays from 8:00 - 9:00 am in the Harvey Morse Auditorium (ask a senior to show you how to get there if you’ve never been).  Attendance is mandatory.

  • Noon Conference: Didactic lectures occur Monday through Friday from 12:15 - 1:15 pm in the 4NE pediatric conference room, Room 4243. 

  • NICU Mock Codes on 4th Tuesday of every month from 12:30-1:30. Nursery senior and intern MUST attend and run the code. The nursery hospitalist will cover the delivery pagers during the code.​

 

Patient Coverage Responsibilities

​

  • We categorize all of the babies in the nursery into 3 classes: 

    • Housestaff, Observation, FYI

  • Every baby is your baby

    • Nurses often call you to evalu​ate infants you do not know

    • It is your responsibility to evaluate any baby in the newborn nursery at the request of the PMD or nursing staff, especially if there are acute issues (such as temperature instability, respiratory distress, or hypoglycemia), and document the encounter in CS-Link​​

​

Housestaff (HS) baby FAQ

​​

  • Who is a Housestaff baby?

    • Babies without PMDs or PMDs who don’t have Cedars privileges have a HS attending (hospitalist or neonatologist)

      • We occasionally provide coverage for certain PMDs (covering schedule is on the wall near the nursery computers in the peds lounge); ask the chief if you are unsure of the PMDs you're covering

    • We formally round and write progress notes on all HS babies daily​

​

  • Who is the HS attending?

    • The nursery hospitalist is the attending for these newborns and will supervise their care

      • A neonatologists will be assigned to cover the nursery if there is no nursery hospitalist for the day

    • Check amion.com using login: cspeds to see who is on service 

​

  • What notes do I need to write for HS babies?

    • H&Ps should be completed on the day of birth, unless the baby is born late at night (after 10 pm).

      • If the H&P is completed after the hospitalist has left for the day (i.e. 4pm-10pm), the H&P should still be signed by the admitting team, even if you have not formally staffed with an attending yet, and the cosigner should be the next day’s hospitalist (available in amion using the login: cspeds)

      • If the baby is born after 10PM, the night team should defer the H&P to the day team.
        For medico-legal reasons, one person should complete the H&P and sign it, as opposed to the night team prepping and the day team signing it.  

      • Please make sure the note is UTD when you sign it - update the time stamp, and refresh the VS. 

    • Progress notes should be completed daily

    • The discharge summary should be completed on the day of discharge. Please use the "Route" feature to send the d/c summary to the PMD at discharge. Change from Mail to Fax option if applicable.  

      • If there is additional information to add to a discharge summary after the original author has signed it, an addendum can be added with that information.

      • All notes should be written and signed by the person who saw the patient and documented the exam, assessment and plan.

​

  • What needs to be done before sending a baby home?

    • When discharging babies, make sure to complete the discharge order set in full.  The discharge summary must be completed within 48 hours after discharge, BUT ideally should be completed prior to discharge so that copy can be routed electronically or faxed to their PMD. 

    • Complete mommy talks on all housestaff newborns prior to discharge.

      • Typically, we hold off on doing the mommy talk the day the baby is born. The parent(s) will likely be paying attention to their bundle-of-joy rather than anything we have to say, plus mothers may still be groggy/uncomfortable. 

    • Ensure that all housestaff newborns have follow-up with a pediatrician in 2-3 days from discharge.  This is especially important for first-time moms.  The nursery has a list of clinics in the LA area that provide pediatric care for uninsured and/or MediCal patients available to the parents.  Don’t forget, you can always refer them to PCC/Simms-Mann/Rose.

​

Observation nursery baby FAQ

​

  • Who is added to this list?​

    • ALL infants born to mothers diagnosed with chorioamnionitis, including those getting routine vitals (per sepsis calculator). Obs even if green on the sepsis calculator

    • Infants with other sepsis risk factors (such as maternal fever, prolonged ROM, inadequate prophylaxis of GBS) without diagnosis of maternal chorioamnionitis, if they require more than routine vitals (i.e., yellow or red pathways)

    • Infants undergoing sepsis rule-outs for signs/symptoms suggestive of sepsis; Infants with BCx pending; Infants on antibiotics.

  • How long do we follow?

    • 48 hours (if clinically stable) OR until clinically stable/ruled-out/cultures negative (if applicable)

    • After 48 hours, the baby can be downgraded to “FYI” status (but leave them on the list in case there are issues later in the hospitalization)

  • Documentation​

    • Initial nursery sepsis evaluation note, then daily sepsis monitoring notes (problem-focused notes), to be sent to the PMD

    • H&P and Discharge Summaries are the responsibility of the PMD

  • Who do I staff Obs babies with?

    • You should discuss your plan of care with and send your notes to the primary pediatrician. Please call/leave an urgent message for PMDs about ALL chorio babies, even if they are green on the Kaiser sepsis calculator. 

    • You should always discuss the plan of care with the nursery attending if you feel uncomfortable with the primary pediatrician's plan

  • What if the PMD can't be reached?

    • Try paging again after 15-20 min, and tell operator it is your second attempt. If an urgent concern, you can staff with the nursery hospitalist or neonatologist on call

    • Always ​DOCUMENT in your note the date and time at which an urgent voicemail was left

 

FYI Baby FAQ

​

  • These babies are on the list "for your information" in the event that you are called to assess them

    • Who: All other infants who require close attention including, but not limited to:

      • VS abnormalities (e.g. temp drops)

      • Abnormal exam findings (e.g. sacral dimple)

      • Respiratory symptoms

      • Murmurs

      • Infants on phototherapy

      • ABO incompatibility

      • Abnormal lab studies (such as polycythemia, hypoglycemia)

      • Transfers from NICU

    • ​How long do we follow? 

      • Leave the patient on the list until discharge​​

    • Documentation: Event note at time of evaluation should include

      • reason for evaluation​

      • clinical findings

      • plan

      • Event note should be sent to the person with whom the plan was discussed (typically the PMD, though occasionally the hospitalist or neonatologist if it is urgent or the PMD can’t be reached)

    • FYI babies do not need routine notes or exams however, these infants should remain on your sign out and require daily chart review

    • The nursery attending should provide daily teaching regarding FYI babies

​

  • Tips for a few FYI Diagnoses

    • IDM/LGA/Sustained perinatal stress (3+ mec)/post-term >42 wks GA

      • Use "Neo IP Nursery hypoglycemia" order set x12 hours​

    • SGA and/or 36+1-36+6 wk GA

      • Use "Neo IP Nursery Hypoglycemia" order set x 24 hours​

    • Suspected ABO incompatibility 

      • If MBT O-​, automatic cord blood T&C is sent

      • If MBT O+

        • >37 weeks a Tc bili at 12 HOL​

          • if <6, Tc bili is repeated at 24 hours​

          • if >6, Ts bili is sent

            • if Ts bili is HIR or HR, cord blood and cord T&C are sent​

        • <37 weeks a cord T&C​​ and Tc bili are done at 12 HOL

          • if <6, Tc bili is repeated at 24 hours​

          • if >6, Ts bili is sent

    • Inadequately treated GBS or GBS unknown

      • Plug into Kaiser sepsis calculator

        • if Q4H vitals are recommended, this should be be on the OBS list​

        • if routine care is recommended, this infant can remain on the FYI list

    • Cleft Lip/Palate Workflow

      • MD/NNP evaluates suspected cleft lip/palate; assesses medical stability of patient

      • Identify feeding plan (breast, bottle or both)

      • Initiate pumping for mother

      • MD orders a clinical swallow evaluation. Pt to be evaluated by SLP by 24 HOL.

      • Pending SLP evaluation, breast feeding may be initiated with support from lactation consultant and RN

      • If formula feeding is indicated and SLP is NOT available, lactation will evaluate feeding and recommend appropriate feeding system

      • If formula feeding is indicated and neither SLP nor LC are available, RN may initiate feeding with a Dr. Brown’s specialty feeding system, pending LC or SLP availability (this would typically only occur in the very early morning hours when there is a gap in LC staffing). The cleft lip/palate resource box includes several different feeding systems.

      • You may refer to the cleft lip/palate resource binder in the nursery or resident work room for details.

      • Please let Allison Henry know if you have any questions or concerns.

​​

Chorioamnionitis

  • As of May 25, 2018: All babies born to mothers diagnosed with chorioamnionitis/III should be managed according to the Kaiser sepsis calculator

  • Link to Kaiser Sepsis Calculator

​

OF NOTE: Prior AAP GUIDELINES (what will be tested on boards, NOT used here anymore!)

  • Classic management of infant exposed to chorioamnionitis​
    • Mother and baby may bond for up to 1 hour unless baby is unstable
    • Blood culture, ampicillin, and gentamicin within 2 hours of birth​
    • CBC with manual differential and CRP at 6 hours of life. Again, NOT being done at Cedars anymore. 
    • Q4H vitals​
       

Communicating with PMDs​​

  • All interventions (eg: starting phototherapy, antibiotics, drawing blood) or urgent examination findings (eg: ambiguous genitals, respiratory distress, hypoxia, fever) should be discussed PMDs and/or NICU team in real time​. Every time you call a PMD, please document in your note the time you left a message, and that it was on the urgent line. 

    • During the day you should call the clinic to be connected to the PMD

    • At night, leave a message on the urgent line or answering service

    • What if the PMD does not call back?​

      • If you are unsure about management, you can run clinical questions by the nursery hospitalist or neonatology attending.

      • If it is a straightforward decision, document when you left the message(s), # of attempts, and that you left a message regarding the plan for the PMD. 

    • The exceptions include starting formula and cord T&C (see section "FYI baby" under subsection "Suspected ABO Incompatibility")

      • In the future these orders will be automatic conditional orders that the resident or PMD ​will not have to place into CS Link

  • Non-urgent labs (positive cord T&C) or examination findings (ear pit, sacral dimple, transitional murmur) should also be communicated to the PMD

    • Check documentation to see if PMD is aware. If PMD is not aware:

      • During the day you should call the clinic and notify the provider

      • During the night you may ​leave a message on the non-urgent line​​​​


Daily Work Responsibilities:

 

  • Pre-rounding

    • Check each morning for any housestaff babies born overnight.

    • Senior and intern divide and round on babies in the nursery.

    • Although the night team may prep vitals and I/Os for the day team, this should not be a substitute for reviewing the baby's chart yourself to obtain complete information that may not be noted in signout.

  • Rounding

    • When you enter a patient’s room to round, push the “MD in Room” button on the electronic keypad inside the room. This will alert the postpartum nurse that you are rounding so he/she can join you and participate in developing the plan of care.

    • Present your patients and plans on daily rounds

    • Patients must be examined within 24hrs of admission and d/c. 

  • Notes

    • Write comprehensive daily progress notes on all housestaff patients.

    • Please do not prep and pend a note for a different resident to sign later. Notes should be started and signed by the same provider for best practice. 

    • Babies need an H&P within 24 hours of life. 

    • Babies in “Obs” need a note every 24hrs.

    • See below for more information on notes

  • Labs

    • Follow-up maternal prenatal labs (from her OB) if not available at the delivery. This is especially important, e.g. Hepatitis B status. If maternal Hep B status is unknown, newborns will need the Hep B vaccine within 12 hours of life.

    • Additional maternal lab results may become available 1-2 days after delivery, so please recheck mom's chart if there are any unknowns in the H&P.

  • Communication/signout

    • Communicate directly with your patients and families, private pediatricians, consultants, nurses and ancillary staff.

    • Alert supervising resident and attending to any changes in clinical status of patients.

    • Respond to nurse's questions about non-housestaff babies and discuss with private attending regarding a plan of care.

    • Sign-out all patients thoroughly to night team at 7:00pm.

  • Discharges

    • Discharge Notes should be faxed or electronically routed to the PMD

    • Mommy talks should be done prior to d/c.​

  • Teaching​

    • Closely supervise medical students

    • Provide patient-related teaching frequently.

 

Documentation

​

Housestaff Babies

  • A H&P, progress notes, and discharge summaries are needed for every Housestaff baby

    • Use .nsyhp, .nsypn, or .nsydc​ dot phrases as appropriate

      • Note: a systems-based assessment and plan are not required​

  • Send notes to hospitalist​

  • H&P should be completed on the day of birth

    • If the H&P is completed after the hospitalist has left, assign the note to the next day's hospitalist (amion login: cspeds)

  • Progress notes should be completed daily except for the day of discharge
  • Discharge summaries are required on the day of discharge
  • All notes should be written and signed by the resident or intern who performed the examination and formulated the assessment & plan
    ​

Obs babies

  • Focused progress notes are required daily for Obs babies

    • Send to PMD for co-signature

    • Do not need H&P or d/c summaries (these are the responsibility of the PMD)

  • Dot phrases​

    • Sepsis rule out: .nsyobsrosinitial or .nsyobsrosprog​

    • Hyperbilirubinemia: .nsyobsbili

​

Deliveries

  • Delivery room note for every delivery you attend: Please use "Progress Note" as note type NOT "Delivery Note"

    • .deliveryroomnote as dot phrase​​

    • No cosigner needed if you went alone. Otherwise send to hospitalist or NICU attending

​

NICU

  • All DR/OR to NICU and Nursery to NICU H&Ps and sign-outs are written by the resident

    • Use .nicuhp as dot phrase for H&P

    • Use .nicusignout as dot phrase for sign-out

​

Nursery evaluations

  • An event/progress note is required for any newborn you evaluate in the nursery for any nursing or parent concern. For instance, the team is asked to evaluate all temperature instabilities (with the exception of those that occur immediately after delivery in L&D). For this instance, and any time there is an evaluation, there should be a brief note.

    • Please select "Progress Note"as note type​

    • Can free text note but some custom dot phrases exist

    • If you spoke with PMD, NICU attending, or hospitalist about event, you may route them the event note; otherwise, no co-sign needed

​

NICU Admissions from DR and Nursery to NICU Transfers

 

  • If a patient needs to be admitted to NICU from DR/OR or transferred to NICU from the nursery for escalation of care, the NICU hospitalist/NNP/Neonatologist should be called to triage/evaluate the patient

  • NICU charge nurse should be notified of all NICU admissions and confirm bed placement. A NICU nurse should accompany patient upstairs from newborn nursery if transfer is for respiratory distress.

  • Resident should accompany patient from DR/OR/nursery to NICU

  • Orders should be placed at the bedside WOW after discussion with attending or NP, so that the resident can clarify any orders to the NICU nurse.

    • If nursery orders already exist, please do transfer orders AND discontinue all nursery orders​

    • Use "Neo IP NICU" admission order set, and "Ventilator-Avea" for Vent/CPAP orders

  • If vitamin-K/erythromycin was given in the DR, please do not include these in admission orders

  • If possible, the nursery team should stay in the NICU for 5-10 minutes to follow-up any immediate lab results such as blood gas or glucose (responding to these labs is valuable education), but are not required to stay for imaging studies or other blood work

  • If available, residents can also stay to perform any procedures

  • The nursery residents are responsible for completing the NICU H&P and delivery room note if applicable

  • The nursery can be very busy, so NICU management is not the priority; if the residents need to run to a delivery or triage another patient, they should not feel obligated to stay in the NICU, but should do their best to notify the Neonatologist that they're leaving for something urgent

  • Indications for NICU admission

    • Any symptomatology requiring support (including, but not limited to, respiratory distress)

    • Gestational age <36 weeks; birthweight <2300g

    • If GA is 34w0d to 35w6d OR if BW is 1800-2300g, infant may qualify for “late preterm protocol,” in which case the infant may stay with the mother for up to 2 hours if infant is well-appearing, not requiring any support.

      • Please order POC glucose for DR check and encourage breastfeeding.

      • For admission orders, use "transfer" navigator --> "transfer order rec" tab --> ​use admission order set called "NEO IP 34-35+6/7, 1800-2300 g" if placed prior to actual arrival of patient in NICU

      • Please add "nursery hypoglycemia protocol 24 hours" order set to these orders

​

Nursery -> Ward Admissions (babies are technically not admitted when in mother-baby unit)

 

  • If mother is being discharged and newborn needs non-intensive continuation of care (i.e. phototherapy or IV antibiotics) they should be admitted to the pediatric ward. 

  • If patient is housestaff or on OBS list, the nursery resident is responsible for signout to the ward team, and the ward team is responsible for the admission order (the baby is not technically a patient) and the H & P.

  • If patient is not on the Obs list (private PMD patient), then PMD should notify the ward team that an admission is needed, and provide signout . The nursery team is not responsible for the admission, but should re-direct the PMD to the ward team. The ward team should not expect a transfer note, however, and instead should just write an H&P AND admit orders.

    • The PMD is responsible for placing the transfer orders from NSY to 4NE Ward​

 

Delivery Room

 

  • Level II delivery attendance

    • 8am-4pm: intern, senior, hospitalist, respiratory therapist​

    • 4pm-8am: intern, senior, respiratory therapist

  • Level III delivery attendance​

    • intern, senior, hospitalist, neonatologist, respiratory therapist, NICU nurse​​​

  • "911" = go to ER​

  • ***Note: If multiple deliveries are taking place simultaneously and supervision is needed, call the NSY Hospitalist or NICU first call​. Preferably, for the intern's first 1-2 days on nursery, call for supervision. However, an intern CAN be at a delivery alone as long as RT is also present, and the intern is comfortable being alone.

  • Pages received on the intern nursery pager w/ a number only refers to the L&D room vs. pages w/ preceding zero refer to the L&D operating room (e.g.. "03" refers to OR 3, but "3" refers to delivery room 3).

  • Familiarize yourself with the resuscitation equipment available in the delivery room.  You may have a very limited amount of time to set up the equipment before the baby is delivered!

  • Introduce yourself! The most senior member of the peds team should introduce themselves to the OB and/or the L&D nurse when they attend a delivery. The OBs want to know who is leading the team (resident, hospitalist, neonatologist, etc)

  • The intern is responsible for the airway of the newborn during the resuscitation.  Perform suctioning, intubation, and other procedures as necessary.

  • After the newborn is stabilized, perform a thorough newborn exam.

  • Become familiar with obtaining a delivery history and documenting the pediatric delivery room note.

​

Skin-to-Skin Guidelines

​

  • If the infant is term, vigorous, crying and has good tone, he/she can go to the mother’s chest

  • If the infant continues to transition well, the pediatric assessment can be simple and should be done skin-to-skin: evaluate tone, color, and respirations. Further physical exam is not indicated if infant is transitioning well. The delivery room note should reflect only these elements, and not a complete physical exam.

  • If the infant shows signs of poor transitioning, or signs of distress (poor tone, weak cry, persistent cyanosis), the baby should be evaluated on the warmer. The decision to bring the baby to the warmer is a collaborative decision reached by members of both the L&D team and the pediatric team, or by either team if they feel it is indicated. Good communication between the teams is essential when making this decision.

  • Brief elements of an exam may be performed on the mother's chest, if accessible (such as examining the infant’s head after a vacuum-assisted delivery). If the pediatrician/pediatric resident feels they cannot perform an adequate assessment on the mother’s chest, they may request to bring the baby to the warmer to complete the evaluation.

​

The infant should be evaluated on the warmer if...

​

  • Infant is preterm, <37w0d.

    • The pediatric team will need to evaluate 34w0d to 35w6d infants, or any baby suspected <2300g, at the warmer to determine whether they can bond in L&D for up to 2 hours before NICU admission.

    • For infants with GA 36w0d-36w6d, initial steps of evaluation should be performed on the radiant warmer. If the infant is vigorous and transitioning well, he/she may be returned to the mother for skin to skin to complete transitioning.

  • If there is a prenatal (or postnatal) concern for an anomaly or syndrome that should be formally evaluated (concern for trisomy 21, prenatal diagnosis of congenital heart disease, etc)

  • If there are any signs the infant is not transitioning well.

 

 

Breastfeeding at Cedars Nursery

 

Every mother receives a one-time lactation consultation for free, and has to pay a fee for others.  If you have a mother with questions about breastfeeding you cannot answer, seek the help of the attending or lactation consultant.

 

Feedback

 

Provide verbal feedback on a weekly basis to medical students.  Provide written feedback to medical students, supervisory residents and attendings after each rotation. Provide feedback on your nursery experience to the Chief Resident at the end of the block.

​

Miscellaneous Tips

 

  • Communicate important and STAT orders with the RN via call or text to ensure accuracy. 

  • When informing private attendings of a concern/issue regarding their patient, oftentimes informing them of your plan and asking them to call back with questions is better than contacting them and awaiting their return call to be dictated the plan. 

  • The Neonatologist and/or NICU hospitalist is available 24/7 if you have any concerns regarding a patient, whether housestaff or private attending. 

 

Nursery Nights


Please see CNY Guide for full rotation descriptions as well as expectations, including communication with PMDs at night.

 

Nightly Schedule

 

  1. Arrive at 7pm for sign-out rounds in the resident lounge.  You will be on "first call" pager for all nursery babies.

  2. Get ready for a possibly busy night getting paged to deliveries or to the nursery to assess ill-appearing infants! 

  3. ~2300 Nursery Rounds with the NSY Charge RN

  4. Write H&Ps on all admits to OBS or NICU after co-developing plan with senior resident and NICU attending.  Include growth percentiles in the physical exam.

  5. Write "Progress Notes" for all Deliveries you attend

    • Use .deliveryroomnote as dot phrase​​

    • No cosigner needed if you went alone. Otherwise send to hospitalist or NICU attending

  6. Discuss any newborns requiring intervention with the neonatologist, hospitalist, or private attending.

  7. Morning signout is at 7am to the Nursery Day team.

​

Weekend Schedule

​​

  1. Weekend rounding may be either with the night team or the day team​

  2. Contact the NICU hospitalist (x38371) or Neonatologist (x38369) to determine rounding time

  3. See above in the day schedule for complete suggested workflow

​

 

Last modified: 5/22/2019

 

Days
General Information
The DR
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