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Coliseum Medical Centers Patient Relations Internship Guidebook
Coliseum Medical Centers Patient Relations Internship Guidebook
Orientation Guide:
Arrive 15 minutes early
Located in the classroom on bottom floor (Walk through main lobby, turn right, classroom is on
your left)
Dress warm and in layers (room was freezing and you are in there all day!)
Breakfast, snacks, lunch, and beverages (coffee, water) are provided
Talk to the main instructor about when to leave as an unpaid intern before they start that
morning, we stayed longer than needed because they did not announce we could leave
You do not have to report to your supervisor after orientation
Dress Code:
Business Casual
Comfortable shoes is the most important thing! You are standing and walking all day.
Mainly wore dress pants and tops
Some days can be colder on the floor so it may be helpful to keep a sweater in the office or your
purse just in case
Make sure to wear name tag everyday where it can clearly be seen
We both carried Large totes as our purses and brought our computers and planners in them every
day as well (vending machine on our floor takes debit cards so we got snacks from there
sometimes when we had busy mornings)
Internship Guide:
Grand Rounds:
Each morning you will begin your day doing grand rounds at 9:00am. This is when the care team
comes together including: doctor, nurse, respiratory therapy, pharmacist, case manager, chaplain,
social worker, therapist, patient relation coordinator, patient relation interns, etc. The case
manager will print an extra chart in order for you to fill in important information on each patient.
The doctor will discuss the patient's history, the reasoning behind why the patient is in the unit,
give an update and discuss their plan of action for the next couple days. It is important to note if
the family is present so you can make it a priority to check on those members after rounds and
make sure they do not need anything. Also note medical history that stands out to you and the
main drugs the patient is currently on.
All information discussed is confidential always, keep a blank piece of paper on your clipboard
to cover the top of the chart
s
t
:
physician
24/7 in the unit; ICU criteria focus; has a knowledge of all parts of the organ system
Hospitalist: a dedicated in-patient physician who works exclusively in a hospital; idea of most
organ systems but usually come from a main focus
Intubate: insertion of a breathing tube through the trachea for ventilation if patient has
compromised breathing.
Extubate: Removal of intubated tubes
Fentanyl: pain medicine (not sedative) that is 100x more powerful than morphine
Propofol: sedative; milk of amnesia
Dopamine: It works by improving the pumping strength of the heart and improves blood flow to
the kidneys.
Levophed: a peripheral vasoconstrictor and an inotropic stimulator. It works by making the blood
vessels narrower, which increases blood pressure.
Pressors: is any substance that elevates arterial blood pressure
Terminal wean: wean from care of support for the patient to undergo a natural death
RASS: level of sedation score from chart insert chart
Stages of disculptis: level of ulcer formed in a patient
Purpose of Dialysis: protect or take place of kidneys (removes poison from blood)
CRRT: slow, low volume dialysis
Sepsis: infection fighting decreases, immune system in distress
children and elderly most at risk
Aspirate: A condition in which food, liquids, saliva, or vomit is breathed into the airways.
Sinus Rhythm: is any cardiac rhythm where depolarisation of the cardiac muscle begins at the
sinus node
Sinus Tachycardia:(also colloquially known as sinus tach or sinus tachy) is a sinus rhythm with
an elevated rate of impulses, defined as a rate greater than 100 beats/min (bpm) in an average
adult. The normal resting heart rate in the average adult ranges from 60100 beats/min.
Sinus Arrhythmia: The normal increase in heart rate that occurs during inspiration
Code Sepsis: is called when a patient exhibits signs of infection along with at least one sign of
sepsis (low blood pressure, high serum lactate or evidence of organ dysfunction.)
TEE: is a test that produces pictures of your heart. TEE uses high-frequency sound waves
(ultrasound) to make detailed pictures of your heart and the arteries that lead to and from it.
COPD: a chronic inflammatory lung disease that causes obstructed airflow from the lungs
CPAP: a common treatment for obstructive sleep apnea. It includes a small machine that supplies
a constant and steady air pressure, a hose, and a mask or nose piece.
DNR/No Code: Do Not Resuscitate order applies to situations where your child has a
respiratory arrest (stops breathing) or a cardiac arrest (heart stops beating). DNR means that no
CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed.
DNI: Do Not Intubate order means that chest compressions and cardiac drugs may be used, but
no breathing tube will be placed.
Full code: means to intercede if a patient's heart stops beating or if the patient stops breathing. It
is the opposite of DNR/DNI.
Midline: the median line or median plane of the body or some part of the body.
PICC: a thin, soft, long catheter (tube) that is inserted into a vein in the arm, leg or neck. It is
used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws.
NG tube: a narrow bore tube passed into the stomach via the nose. It is used for short- or
medium-term nutritional support, and also for aspiration of stomach contents.
OG tube:Orogastric (OG) tube insertion involves the placement of a dual lumen. tube into the
stomach via the oropharynx to facilitate gastric suctioning and/or decompression
CTA: a type of medical exam that combines a CT scan with an injection of a contrast media to
produce pictures of blood vessels and tissues in a part of your body.
Finishing HD:
AMA: Against Medical Advice
Foley: a catheter that is a flexible tube that is passed through the urethra and into the bladder to
drain urine
Apnea: temporary cessation of breathing, especially during sleep.
DKA (Diabetic ketoacidosis): is a life-threatening condition that develops when cells in the body
are unable to get the sugar (glucose) they need for energy because there is not enough insulin.
When the sugar cannot get into the cells, it stays in the blood.
CHS (Chediak-Higashi syndrome): is an extremely rare form of partial albinism that's
accompanied by problems with the immune and nervous systems
Integrated Comprehensive Care (ICC): means the patient isnt being handed off from one part of
the system to the other; the patient moves to a different environment, their home, but the team
remains the same. The Integrated Care Coordinator is a key person in this model of care; they
help the patient navigate through every step of their journey, in the hospital and the community.
Planning for home care after discharge from hospital starts before the patient arrives for their
surgery.
DC: abbreviation for diphenylcyanoarsine; which means to discharge or discontinue
Doctors:
You will notice that each day you do grand rounds, there will normally be a different ICU doctor.
There are three different doctors that rotate in the unit: Dr. Wright, Dr. Farman, and Dr. Kadiyala
Doctors can change daily depending on their schedules.
You will get to know the doctors different personalities and how they like to do things so make
sure to keep that in mind each day depending of the doctor
Take note of the doctor in the unit each day at the top of your chart
Each patient can also have a personal doctor, specialist or surgeon who is not in the unit but
comes by when needed or to check on them every once in a while. This you can make note of on
the patient chart as well when doing rounds if their name is mentioned
Pastoral Services:
Pastor Sandra Pastor Keith Pastor Cynthian
The
Pastors will hold a Devotion around noon on specific days in the Chapel on the first floor. This
will be announced on the speaker throughout the hospital.
The pastoral service is very well organized and utilized here in the unit and rest of the Hospital
Most everyday there is a Chaplin here during rounds, they too take notes on the charts and help
talk to families of patients in the units
Notebooks for Community Initiatives:
We usually create two notebooks for the community initiative project, one for Franchetta and one
for Dr. Funke.
Notebooks include clear protective sheets with all the papers, flyers, and brochures created
throughout the project.
We took several pictures the day of the event and made them into a PowerPoint to also print and
include in the notebook.