YEAR 03 CLERKSHIP - SE CAMPUS
MERITCARE CHILDREN'S HOSPITAL

Your eight week experience in Pediatrics in Fargo should provide you with a broad and exciting introduction to clinical pediatrics. You will be working as a part of a team comprised of community attending pediatricians, pediatric subspecialists, University pediatric faculty, nurses, and paramedical personnel. Your involvement in patient care will be a graduated experience and will be dependent to a great extent on the individual student's attitude, availability, and achievement. The next eight weeks can be a great learning experience for you, varying in scope from pediatric intensive care to ambulatory well child and sick child care to normal and high risk newborn care.

ORIENTATION/PEDIATRIC NURSES:

The pediatric charge nurse or clinical coordinator will conduct an orientation to General and Intensive Care Pediatrics for the students on the first day of the clerkship. Pediatric nurses, by virtue of their specialization in pediatric are, have a great deal of experience and knowledge to offer students and. You will find them willing to help in all aspects of your pediatric clinical experience. Students, likewise, should be available and willing to help when such help is requested from the nursing staff.

WRITING ORDERS:

Students may write orders after consultation with the attending pediatrician. Orders will not be carried out until the attending pediatrician countersigns these orders.

It is very important that students become familiar with and strictly adhere to the policies of Pediatric Infection Control and Isolation Procedures. Nosocomial viral and bacterial diseases are a major Infectious Disease problem on any Pediatric ward, including Rotovirus, RSV, Enterovirus, Varicella, Pertussis and enteric pathogens. Immunosuppressed patients and infants represent those at greatest risk.

INTERACTION OF STUDENTS WITH PARENTS:

The establishment of proper relationships between physician and parents is extremely important in Pediatrics. The student must always identify himself/herself to the parents as a medical student. Student conversations with parents are to be encouraged. In this way the student can begin to understand the impact of pediatric illness on the family unit. Much valuable information about each child is gained by speaking with the parents on a day-to-day basis. ALL information about each patient is confidential and cannot be communicated to anyone who is not involved in the medical care of the patient. Furthermore, medical information given to the family by the students must be restricted to that which is thoroughly discussed with the patient's attending pediatrician. Any violation of confidentiality of patient information constitutes grounds for student dismissal. A brochure, developed by MeritCare Children's Hospital entitled "Physicians Providing Care for Your Child", is given to the family when admitted that clearly explains the role of the medical student in their child's care.

INPATIENT EXPERIENCE:

Each student will spend one month on the Pediatric Unit at Children's Hospital. The student will work as part of a team including community attending pediatricians, pediatric faculty, nurses, and paramedical personnel. The student should work-up and follow 2-3 patients per week. He/she should observe and participate in procedures. E-mail write-ups as a Microsoft Word attachment to Kathy Kraft at kkraft@medicine.nodak.edu and she will forward them to Drs. Tinguely and Blaufuss for their review. Do not use patient names or identifiers as these write-ups are CONFIDENTIAL . Two to three write-ups per week are required. The student should strive towards complete and pertinent but concisely written write-ups. At the end of each write-up a one to two paragraph learning issue or topic discussion regarding the patient's diagnosis and/or management should be attached. Also include your references. Patient write-ups done by the student are not part of the permanent patient record. On the other hand writing daily patient progress notes in the patient chart is encouraged and should be reviewed and counter-signed by the attending or hospitalist. Monday through Friday inpatient care is provided by an assigned "pediatric hospitalist" and these hospitalists rotate weekly. The hospitalist will be the physician responsible for managing the care of most of the patients that you follow at MeritCare Children's Hospital. It is important to identify yourself to the hospitalist as early as possible at the start of each week. The hospitalist will include you in daily patient work rounds and may assign to you patient care and educational responsibilities.

NORMAL NEWBORN:

The student will spend each morning ( 8:00 a.m. - 12:00 N) for one week with the community attending pediatrician in the Normal Newborn Nursery. The student will examine the assigned newborns, discussing normal and abnormal findings with the pediatricians. Along with the attending pediatrician the student will make daily rounds to the mothers' rooms.

INTENSIVE CARE NURSERY ROUNDS:

All pediatric ward students will participate in ICN Rounds Thursdays from 12:00-1:00 p.m.

PEDIATRIC GRAND ROUNDS:

All students on Pediatrics are required to attend Pediatric Grand Rounds at MeritCare Medical Center , each Tuesday, from 12:00 noon to 1:00 p.m. Each student will be required to present a case at an assigned Pediatric Grand Rounds while on their inpatient rotation.

WARD TEACHING ROUNDS:

Separate from daily ward work rounds with the hospitalist, students on the Inpatient Service will participate in ward teaching rounds Mondays at 9:00 a.m. following Endocrinology Rounds, Tuesdays at 1:00 p.m. , Wednesdays at 12:30 p.m. , Thursdays at 8:00 a.m. and Fridays at 7:30 a.m. before Cardiology Rounds and PICU Rounds. It will be the student's responsibility to be prepared to present completely and in detail one or more of their patients for teaching purposes. In addition a variety of patient care topics will be discussed, including genetics, child abuse and pediatric EKG's. Be reminded that patient discussions must not take place in the halls, near patient's rooms or in the cafeteria. Such discussions should be held only in a conference room where complete confidentiality can be maintained.

SEMINARS:

See Seminar Schedule under Schedules section of the Pediatrics website. All students on Pediatrics are required to attend.

ON-CALL EXPERIENCE:

Each student will be on call approximately every third or fourth night while on inpatient service. Students will always be under the supervision of the "on-call" pediatrician. The student will have the opportunity to work-up new admissions, participate in the care of unstable patients and share in the performance of necessary procedures. When assigned weekend call it is extremely valuable to contact the "on-call" pediatrician the day prior to weekend call in order to determine the time and location to meet and commence rounds. The unit clerk will have the pediatrician call schedule, contact phone numbers and pager numbers.

 

OUTPATIENT PEDIATRICS
YEAR 03 CLERKSHIP - SE CAMPUS

Each student will spend three weeks in a private ambulatory pediatric clinic, either at Dakota Clinic-Innovis, Dakota Clinic-West Acres, MeritCare Clinic Southwest or MeritCare Broadway. Students will observe and assist pediatricians, pediatric nurse practitioners and pediatric nurses in the busy office practice of Pediatrics. These patients may include children with acute illnesses, chronic illnesses, behavioral/developmental disorders or children receiving care in subspecialty clinics, as well as infants and children attending well-child care visits.