Rush Emergency Department Orientation Letter

Dear Resident Physician,

I would like to take this opportunity to welcome you to the Rush Emergency Department.  We look forward to working with you this month and hope to make this an enjoyable and educational rotation for you.

As a part of your introduction to our department there are several important topics to discuss:

Orientation

Your orientation to the emergency department can be completed by reviewing to 'orientation' tab found at rushemergency.blogspot.com.  If you have further questions or concerns regarding orientation beyond this please feel free to contact me at Paul_Casey@rush.edu

Schedule

Your number of shifts in the department will depend on the length of your rotation in the emergency department.  Most residents will have 2 week rotations during which they will complete 10 shifts.  All shifts are 8 hours in length and will be 7am - 3pm, 3pm - 11pm or 11pm - 7am.  

Your shifts in the department will be determined by block scheduling.  Prior to rotation you will be emailed the available schedules and submit your blocks preference (this is further detailed at rushemergency.blogspot.com).  I will try to accommodate your preferences as possible but if multiple residents request the same block seniority and timeliness of your schedule request will determine resident block assignment.  After receiving you schedule if you need to switch a shift you will have to arrange for the switch with your fellow residents.  

If you need to miss a shift, please speak with your chief to arrange coverage for your absence. You will be required to make up this shift later in the schedule or in the next block. Unexcused missed shifts will not be tolerated and will penalized with a requirement of 2 shifts for everyone one missed. This will also be noted on your final evaluation as unprofessional behavior.  Similarly, if you are late more than 20 minutes you will be sent home and scheduled to make up the shift at a later date. 

Lectures

Every 2nd Wednesday of the rotation we will have lecture from 8am-11am in the Emergency Department Conference Room West.   Every fourth Wednesday of the rotation, we will attend the Stroger Emergency Medicine lectures.  You can view the lecture schedule at the lecture link from rushemergency.blogspot.com.  Attendance at both are mandatory and there will be a required sign-in. 

Evaluation

Your evaluation comes from end-of-shift evaluations which you will have completed at the end of each shift. This also serves as your proof of completing that shift. An example is included with this letter. By giving this to you ahead of time, we intend to give you the opportunity to meet and exceed our expectations. 

During the shift, put the sticker of each patient you see on the back of the card and write their diagnoses beside it. At the end of each shift, have the attending with whom you worked complete and sign the front of the card.  Below are resident expectations:

• Residents are expected to be present on time for their scheduled shifts to take over care of those patients whose work-up and management is in progress; as well as start the evaluation and treatment of new individuals who present to the department during their shifts.
• Residents are expected to write-up complete and accurate history & physical exams, review old patient records when available, to confirm medication profiles with patients and families, and to assist primary care providers in the care of their patients.
• Residents are expected to share the burden of patient load in a fair manner with their cohorts and inform the attending physician on duty of any difficulties that might be arising.
• Residents are expected to interact with physicians of different services in a collegial manner and make them selves available to assist in providing the best care for patients and their families.

• Residents will be expected to develop more detailed differential diagnoses and streamlined work-up and treatment plans as they advance from PGY1 to PGY3 in their respective residency programs.
• Residents will be responsible for calling for consults, giving report and (if necessary) contacting primary care physicians of the patients they are caring for in the department.

Objectives

In turn, our responsibility to you is to provide you with an education regarding Emergency Medicine. It is our goal that by the end of the rotation, you should be able to:

• Develop improved and focused clinical evaluations, differential diagnoses and diagnostic plans.
• Demonstrate basic proficiency in procedural skills such as wound care, suturing, and splinting and resuscitations.
• Demonstrate respectful and compassionate use of medical skills for all individuals.
• Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, sexual orientation, and/or disabilities.
• Communicate clearly and respectfully with patients and their families.
• Create a positive relationship with the patient and family to assure optimal medical care, assuring the emotional and cultural needs and expectations of all patients.
• Work effectively and professionally  with others within the department (nursing and ancillary staff) and those on other services to promote optimal patient care.
• Communicate effectively with primary care providers concerning their patients’ clinical presentations, assessments, conditions, and disposition planning.

Again we look forward to working with you and hope your rotation in the department is a valuable educational experience.  Please feel free to contact me with any questions or concerns that arise during the course of your rotation with us.

Respectfully,

Paul Casey, MD

Department of Emergency Medicine

Rush University Medical Center

1653 W. Congress Parkway

Chicago, IL 60612

Email: Paul_Casey@rush.edu