Rounder duties

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A TICU rounder is an intern or 2nd year (that is not on call) who is responsible for coming in early, pre-rounding on specific patients, presenting them on rounds, and then enacting and following up on the care plan.

Before rounds. Know your patients.

  • As a rounder you are responsible for knowing your patients inside and out. You will get signout from the overnight call person, and you should talk with the ovenright nurses also.
  • You should know your patients’ entire med list, how many PRNs they required, insulin requirements, etc.
  • If it is a newer patient you should make sure their injury list is updated and complete and that all consults have been placed.
  • You should check for consult progress notes from all active teams daily.
  • Ensure that nutrition notes are checked and the appropriate order is placed.
  • Ensure that electrolyte repletion and follow up BMPs are ordered prior to starting rounds.

During rounds

  • Pay attention and take notes on “to-do’s” on all patients, not just your own. This helps the team run the list after rounds and reduce the chances of something getting missed.
  • When another person is presenting, you should pull up the daily CXR or pertinent imaging studies and have them ready for the team to review.

After rounds

  • First priority is enacting the plans for your patients. Speak with nurses, respiratory therapy, place order, call consults, update families and ensure that everyone knows that plan so it can be done.
  • Place transfer orders, sign out to transfer teams, and complete transfer notes. A transfer note does not count as a daily progress note, and both must be completed. Don’t forget to document the time and date and name of the person you signed out the patient to.
  • Preform any procedures that your patients need.
  • If possible, help other people that are busy complete tasks and procedures.
  • Follow up on results of diuresis, electrolyte management and replete or re-order diureses as indicated and place follow up BMPs.
  • Complete daily progress notes. Everything else prior to this should take priority over completing daily progress notes.

Prior to leaving

  • Ensure that all patient plans are enacted and followed up.
  • Ensure that follow up tests are ordered.
  • Order the appropriate labs for tomorrow and CXR for 0400.
  • Update your patients on the Excel list. Ensure that their injuries, surgeries, medications, vent settings AND signout are all up to date and accurate.
  • Sign out to the call person at an appropriate time for them.