The working week

Information for trainees rotating to my service:-

The working week

1. Trauma week

Our trauma week is 1 in 10.  I will have been on call the weekend before, but the registrar is often different, unless you chose to swap.  All the patients admitted during that week will be under our care, and I rely on you to steer the juniors to make sure the post op patients are well, and the relevant x-rays etc have been carried out.

I do a ward round following the trauma meeting every day.  On that ward round I usually want to see every patient in the hospital referred to us, even if they’re under a different parent speciality.  This is to offer a consultant led service to our colleagues in other specialties, but also to try and prevent serial referrals from struggling teams who don’t know who the point of contact is.

Generally we try to arrange the lists so that there is a golden first patient, so that I can break the back of the ward round.

2. Elective clinics

These start at 08:30 and 13:30, but it takes a 20mins for the computer to load.  So we should arrive by 08:15 or 13: 15.  We try to mix the templates for new and follow ups.  I need to meet every patient who is new to the elective clinic, so I ask that you come and join me while I finish my last consultation, and then we go together to say a quick hello to your new patient.

Rheumatology often email referrals to me, and I try to see their patients as urgently as possible as they have often been stuck in the system for ages, and we sometimes need to offer urgent synovectomy.

3. Fracture clinics

I usually ask that you screen the fracture clinics and request the necessary x-rays and ‘cast off’ forms for the fracture clinic. 

4. Operating lists

At our start of placement meeting I should have an understanding of how much operating you've done and what you're comfortable with.  It’s very variable whether we have an SHO allocated to us or not.

I ask that you make sure the discharge summaries are done after every case.  On the orthopaedic shared drive there is a ‘wharton’ folder.  One of the subfolders marked ‘SOPs’ has discharge summary information for our common operations, including what the patients need to look out for, and the phone number if there are any issues.

The operating notes for common procedures are in a similar folder on the shared drive.

5. Academic writing

Within the six months I am keen that you try to produce and submit one manuscript, be it a case to write up, or something more complex hand related.

6. PROMs

At the moment I am uploading all my elective patients to the Amplitude registry which the BSSH has funded for us.  They are send a PEM score intermittently.  We will need to email Sharon Ross at BSSH to request access for you.  

I would like to work on collecting PEM routinely, and DASH and PRWE for wrist patients.

7. Concentric

Concentric is the system the Trust uses for electronic consent.  We send them to the patient from clinic.  You need a log in, which is often your main or email log in, and if that doesn’t work then R.S. can set one up for you – search on email.

8. Secretaries

The PPCs' offices are above the Consultant office, and you should try to say hi in the first week.