Royal Alexandra Hospital

09:00 - 21:30

Weekdays
Labour Ward, Maternity Triage, Emergency Theatre (and Obstetrics Ward 31 after 5pm)

Weekends
Labour Ward, Maternity Triage, Emergency Theatre and Obstetrics Ward 31

Attend Labour Ward Handover at 9am

• Be on time!
• You need to be in Scrubs and theatre shoes (if you don't have your own find a pair without a name on in the changing rooms)
• Ensure hair is off your shoulders and no lanyards!
• Take the 1st-On page (#56015) from the Night Team
• Grab an Ipad or Laptop and sign into Badger - Save all the patients as 'Favourites' to help the ward round move smoothly
• Join the Ward Round; the majority of jobs generated tend to quick and can be done on the way round
• If you have no urgent jobs and there is no-one waiting to be seen in Triage, feel free to join the Team as they head upstairs to the Obstetric Ward Round. You will always learn something and will be able to see what's happened to patients you admitted or managed the day before!

Duties of the Day

Your time will be split between

• Labour Ward
• Triage
• Emergency Theatre
• Occasionally Early Pregnancy/ Daycare depending on the ebb and flow of activity

Labour Ward

Typical duties include prescriptions, fluids, cannulae, ECGs, patient reviews. *Grey cannulas are required for all women in labour*

• You will also be involved in Emergencies - Post-Partum Haemorrhage, Shoulder Dystocia and Pre-Eclampsia to name a few ...
• If you are called to an emergency, identify yourself and ask the registrar/consultant/Labour Ward Sister what you can do to help. Often this will be IV access, sending bloods, prescribing emergency drugs. It is good to have an understanding of how these Emergencies are managed to appreciate what is happening and how best to contribute

Triage

Essentially A&E in pregnancy

You will likely spend most of your day here and at the weekend when you are being pulled in all directions, triage needs to be prioritised over non-urgent ward jobs.

• If a woman has had an USS showing a viable intrauterine pregnancy (normally a Booking Scan at 10-12 weeks) they will usually attend Maternity Triage as their first port of call for acute complaints relating to their pregnancy

• Women can self-present or be referred by Community Midwives/GPs/A&E/ante-natal clinics. If they are unbooked they will need to be seen by EPAS or Gynae.
• Patients will have a Midwife assessment before you see them, consisting of;
  • Maternal Observations
  • Abdominal Examination
  • Foetal Assessment (CTG if >26 weeks, FHR if <26 weeks)
• We do not expect any of you to be experts in obstetrics and therefore we expect that initially you will need a lot of support and supervision from the registrar/consultant 
• Please do not examine / make a plan if you are not confident with what you are doing – someone will always be there to help
• Please do not discharge any patients without discussing them first with registrar or consultant

Common Presentations in Triage

Women will present with a large range of clinical problems, some warranting admission or delivery (this will not be your call!) and others requiring simple investigations, risk assessment and reassurance +/- plans for follow up.

Below are a few of the most common presentations and important diagnoses to think about;

Headache

• Extremely common in pregnancy due to hormonal change, stress and poor sleep
• Exclude dehydration
•  Severe headaches can be a sign of Pre-Eclampsia so be sure to exclude other symptoms including visual disturbance, epigastric pain, oedema. Always check BP and urine for protein
• Common things are common, but make sure you take a good history and exclude any Red Flag symptoms; first & worst, sudden onset, neurological disturbance, postural link, systemic features of infection/inflammation

Abdominal Pain

Again, very common due to stretching of abdominal wall and displacement of intra-abdominal organs

• Exclude regular uterine activity (contractions) and anything to suggest premature labour (backache, pelvic pressure and vaginal discharge)
• Exclude associated PV Bleeding
• Exclude any abdominal trauma and check Rhesus status
• If epigastric, any other signs of Pre-Eclampsia?
• If suprapubic, any associated urinary symptoms to suggest UTI?

Don't forget appendicitis, gallstones and constipation ... pregnant women can still have these!

Shortness of Breath

Oxygen consumption and tidal volume are increased in pregnancy and it is extremely common for women to feel a subjective shortness of breath, especially in the third trimester where the diaphragm is compressed by the enlarging uterus

• Exclude infectious causes
• Any other suggestive features of Pulmonary Embolus (pleuritic chest pain, calf swelling/oedema, risk factors, tachycardia, low SpO2) - Obstetrics generally has a low threshold for investigating PE's due to their relatively high morbidity/mortality index

Infections

• UTIs - very common. Can stimulate pre-term labour so always treat if you suspect a UTI
• LRTIs - common and can be more serious in pregnant women due to physiological changes and immunosupression
• Sepsis - be on hot alert for Sepsis! If someone meets the criteria, perform the SEPSIS 6 and escalate accordingly

PV Bleeding and Discharge

• Multiple causes for PV bleeding; exclude placenta praevia, placenta abruption, vasa praevia as these are serious and will often need urgent management 
• Rule out associated pain, ensure patient happy that there has been no change in foetal movements
• Has the bleeding been provoked ? Post-intercourse/ ? Abdominal trauma
• Is the discharge 'Show'? Ruptured membranes? Odorous?

Emergency Theatre

Emergency C-Sections

• Category 1 - Immediate threat to the life of mother or baby - Decision-to-Delivery time = 30mins
• Category 2 - Urgent but no immediate threat to the life of mother or baby, often timing is dependant on Labour Ward pressures
  

Your role

• You will be paged from theatre to attend Emergency Caesarean Sections
• At this point the Spinal Anaesthesia is normally in and your presence is required immediately. Drop what you are doing, apologise to whoever you are with and explain you need to attend an emergency
• Head down to Theatre A/B. Normally the registrar/consultant is already there
• Make sure you are in scrubs, theatre shoes and have a theatre hat on before entering Theatre
• Before scrubbing, make sure there is gown and gloves open on the prep-table and you have a mask on (Normally, theatre staff are pretty good at getting this ready but often in an emergency it's up to you!)
• Scrub (presumed you can do this, if you need a refresher ask one of the midwives/theatre staff!)
• Assist in the C-section in the usual way, but be aware of the fact that the focus is on delivering the baby as quickly as possible so stay focused!

If in doubt, ASK!

09:00-17:00 - Obstetric Ward

• Mixed Antenatal and Postnatal ward
• Low and high risk patients 
• Report to the Duty Room in both 31A and B, introduce yourself and make sure you collect the 31 pager which is used 9-5. It is kept on the shelf in 31A duty room.
• Get a Patient List and identify how who's to be seen on the Ward Round and who needs IDLs, VQ Scans or investigations chased and start getting a few jobs done before the ward round
• The Consultant of the Day +/- Registrar will come up after the Labour Ward Round to review patients that need reviewed (this isn't everyone!)
• Try to prepare for this by making sure you are logged into Badger on either an IPad or Laptop and have handheld notes for the women that aren't on Badger
• The Ward Round will generate jobs and midwives may let you know about things needing done for patients that weren't seen
• Please sign off all blood results on Track for all patients and ensure they have been acted on.
• There will always be post-natal IDLs to do ... if you can get these done quickly and early it'll help with patient flow and make everyones lives easier!
• The remainder of the day will be Ward Reviews and Jobs. If you are free, see if help is needed down in Triage!

Jobs 

V/Q Scans

• V/Qs can't be done at the RAH and patients will need to be transferred to the QEUH for their V/Q scan
• There is a protocol for what is required before the V/Q scan can be performed;

1. Trakcare Request - Type 'NM Lung Ventilation and perfusion' into the Item box under the Imaging tab
2. ECG (if between 9am and 5pm on a weekday, an ECG request can be put on Trakcare)
3. CXR - Requires a formal report

IDLs

• Prioritise patients who have long distances to travel

Template for Post-natal IDLsDear Doctor,The above patient attended RAH to deliver her baby. The details are as follows:Date of delivery –Mode of delivery –EBL –Latest haemoglobin –Maternal weight –VTE risk –Allergies –Outstanding results –Follow up: Kind regards, 

Discharge medication:

Meds don't need to go through pharmacy and will be dispensed from the ward.

LMWH (Enoxaparin) 

• Low Risk: No LMWH
• Intermediate Risk: 10 days LMWH 
• High Risk : 6 weeks LMWH

Analgesia

• Paracetamol and NSAID (Diclofenac 50mg or Ibuprofen 400mg for C-Sections)
• Usually SVD/Instrumental Deliveries don't get analgesia for discharge, 3rd/4th degree tears do

Laxatives

• Lactulose and Fybogel for 3rd/4th Degree Tears

Iron

• Post-delivery HB <105 - 6 weeks Iron replacement therapy

Ante-natal IDLs

• Summary of events
• Include any plans for follow up

Bloods

• Midwives will request and chase all routine bloods
• The Maternity Care Assistant will usually do a blood round between 8-9am
• If urgent bloods are required throughout the day, you will need to request these yourself and ask the MCA to take the samples
• These are then your responsibility to chase and sign off on Track.

If in doubt, ASK!

09:00-21:30

Weekdays
Ward 32, A&E/GP referrals, Pre-assessment (Monday - Wednesday) and assist in theatre when required

Weekends
Ward 32, A&E/GP referrals and assist in theatre when required

Attend Labour Ward handover at 9am

• Be on time
• Introduce yourself to the 2nd-on Consultant covering Gynaecology for the day
• Collect Gyn On-Call page #56901 from the Night Team
• Night Team will let you know of any expected referrals/anyone waiting to be seen in A&E
• Head to Ward 32 with the 2nd-on Consultant and go on the Ward Round
• Share the jobs with the Ward 32 FY2/GPST/ST1 on weekdays
• Review GP/A&E referrals
• Pre-assessment nurse will phone the ward or page you when patients are ready to be seen in the clinic area on the ground floor

Referrals

GP referrals

GPs will discuss referrals with:

• 2nd-on Consultant 9am-5pm
• Obstetrics Registrar Weekdays 5pm-9pm/Overnight/Weekends
• They will present to A&E as Gyn expect, where they will have a set of observations and be put in a room. All bloods and investigations need to be done by you.
• If they are clinically stable, you can ask for them to be sent directly to W32 from A&E.

A&E Referrals

• A&E doctors will page you with referrals
• Try to run these patients past the Consultant/Registrar before you go to A&E to guide your assessment/management and give them a heads up
• If patient is clinically stable and clearly needing scan urgently, or admission, you can ask these patients to be sent to W32 and see them directly there. 

Common Presentations

• Heavy Menstrual Bleeding (HMB)
• Dysfunctional Uterine Bleeding (DUB)
• Pelvic pain in non pregnant woman
• Pelvic pain/ abdominal pain in pregnant woman (?ectopic)
• PV bleeding in early pregnancy

Management

Patients will usually go down one of these  management pathways:

1. Discharged with/without treatment and with/without follow-up
2. Admitted for further investigation and/or intervention
3. Require an urgent scan, minor procedure or semi-urgent Consultant review and will go to the Maternity Unit directly for this or return to Rapid Access Gynaecology the following day 

Discharge

If you feel a patient doesn't warrant admission (often this is the case), discuss it with the consultant/registrar before allowing the patient home.

If follow-up is required make sure you have completed the appropriate referral pathway.

• Outpatient Gynae Clinic - Urgent Referral Letter to Gynae Secretaries (specify if the appointment needs to be with a particular Consultant)
• EPAS - Ensure to inform EPAS (in-hours - direct phonecall, out-of-hours - patient sticker in the EPAS referral book in Maternity Triage)
• GP follow up - Discharge Letter to inform GP of admission and what follow up you are requesting

Admission

If you are concerned or the patient is unstable in A&E, do not hesitate to call the Consultant/Registrar to assist you in A&E

• Discuss all other potential admissions with Consultant/Registrar
• Inform Ward 32
• Before transferring the patient make sure you have done these things;
  • Complete the Gynaecology Admission Proforma
  • Cannula (? Ectopic Pregnancy - must have a GREY cannula)
  • Bloods (incl. G&S if bleeding/likely to require theatre)
  • XRays/Imaging done in the main hospital
  • Meds rec including VTE Risk Assessment
  • Kardex with appropriate analgesia prescribed
  • Considered whether they need to fast and if so when from?
  • If fasting, prescribe IV fluids

Scan, minor procedure or semi-urgent Consultant review 

• Maternity Scan department (06748) will often be able to arrange Pelvic/Abdominal Ultrasounds for the same day between 09:00-17:00
• Sometimes the 2nd-On Consultant/Registrar will scan although this is at their discretion depending on skill-set and other clinical pressures and will normally only happen between 9am-5pm
• Organise for the patient to be transferred to Scan Room outside Ward 32

 

• Out-of-hours if the patient is stable they can go home and return for a Rapid Access Gynaecology Appointment
• There are two clinic appointments available each day Monday - Friday and patients will usually be seen after 11am
• Enter patient details into the book in Ward 32

Swabs

• If you take any swabs/samples from patients in A&E, make sure you put a sticker in the Results Book on Ward 32 so these can be chased and acted upon

Ward 32

• Base yourself on Ward 32 and work with the SHO there to complete all the jobs.
• Often your role may be to take on the responsibility of pre-assessment. This is in the Outpatient Clinic area on the ground floor and the Nurses will keep you right!

Emergency Theatre

Occasionally you will be required to assist in Emergency Theatre lists i.e Ectopic Pregnancy

Weekend Shifts

Weekend shifts are similar to weekday shifts with the addition of Social Gynae Admissions. You will be the only SHO on for Gynaecology.

Patients will attend for MTOP in either 1st or 2nd trimester. They should have the majority of their management sorted but will all need bloods (FBC, G&S) and in the case of 2nd trimester – IV access in case of heavy bleeding

• If MTOPs begin to bleed heavily this could be products of conception stuck in the cervical os, preventing the uterus contracting effectively
• They will need a speculum to rule this out. If you are unsure please ask for help - you will not be expected to perform this procedure yourself when you first start the block.
• If bleeding is heavy they may need emergency Surgical Evacuation of Products of Conception. If this is the case, escalate quickly, stabilise the patient and fast for theatre.

If in doubt, ASK!

09:00-17:00 - Gynaecology Ward

• Elective and Emergency Gynaecology
• Gynaecology Pre-Assessment
• Assist in Emergency Theatre when required

Report to Duty Room on Ward 32

• Ward Round - 2nd On Consultant (changes daily) will do a Ward Round of all Emergency Admissions from overnight
• Emergency Admissions will have a Red 'E' Next to their name on the whiteboard - get an idea for why they were admitted and ensure all bloods/investigations are complete and easily available
• Theatre List can be found on the wall under the whiteboard with the cases for the day

Jobs Book

• There is a Jobs Book in the duty room where the Nurses will write any IDLs, Prescription changes and non-urgent jobs
• Get the IDLs done nice and early, this improves patient flow and reduces your workload! (Do not copy and paste operation notes to IDLs but please ensure you record the correct procedure)
• There may seem like there are a lot, try to be concise but provide enough information so that if it's you that next sees the patient at 3am in A&E you have a clear idea of why she presented, what happened and whether there are any plans for follow up .....

Investigations Book

• Chase all the swabs/cultures for that day. If they are positive you will need to call the patient +/- GP to inform them of the results and organise treatment if required
• Use it to keep on track of investigations requested for patients that have gone home from the Ward or direct from A&E (e.g Vaginal Swabs, MSSU, Bloods)
• Always use a patient sticker, specify tests to be chased and provide phone number (it may not be you chasing the result!)
• Generally allow 48-72 hours for samples to come back (longer at weekend/bank holidays)

Bloods

• Weekdays there is a Phlebotomist who will do the bloods you request, although this service has been removed indefinitely following Covid-19.
• Please sign off all blood results on Track.
• Weekends are a bit less predictable
• Make sure you request bloods for the next day for Elective Post-op patients and Emergency cases

Pre-Assessment

• Daily except Thursday
• Morning/Afternoon
• In Maternity Outpatients area

Post-Operative Plans

Most patients have a clear post-operative plan and the anaesthetists have prescribed the required analgesia/fluids/VTE prophylaxis for the following 24-hour period

This is a general guide for follow up plans;

Hysterectomy (Abdominal or Vaginal)/ Pelvic Floor Repair

• Day 1 - FBC, LMWH, TEDS
• Day 2 - Lactulose
• Follow-up - OPD 6 weeks

(If Prolift/Mesh repairs they will have Intra-op Antibiotics followed by a 5 day oral course)

Tension-Free Vaginal Tape

• No post-op Bloods
• TEDS
• Follow-up - OPD 6 weeks

Laparoscopic Surgery

• Day 1 - FBC (+ LMWH, TEDS if complex)
• Follow-up - OPD 6 weeks

Surgery for Malignancy

• Day 1 - FBC, U&E, LMWH, TEDS
• Follow-up - will normally be specific to Consultant/Malignancy - check the plan!

Booking a patient onto the Emergency Theatre List

If you admit a patient who is likely to require emergency theatre you will need to book them onto the list.

• You will need to page the Emergency Theatre Co-ordinator #56275 and the On-call Anaesthetist #56188
• With details of the Name, CHI, Planned Operation and Responsible Surgeon 
• Inform the responsible consultant and nurses on ward 32
• Identify when to fast from; Midnight if on the AM list, 6AM if on the PM list
• Ensure they have up to date bloods, G&S and valid consent 

If in doubt, ASK!

21:00 - 09:30

Obstetrics AND Gynaecology

Weekdays: FY2/GPST/ST1 and Registrar (Consultant on-call from home)

Weekends: FY2/GPST/ST1, Registrar and Resident Consultant

Obstetrics

Similar to day-time:

• Reviews and jobs on Obstetrics Ward
• Triage reviews
• Labour ward jobs
• Assisting in emergency theatre

Gynaecology

• Ward 32
• A&E Referrals - sometimes difficult for Registrar to leave maternity due to labour ward workload!

If in doubt, ASK!

09:00-Lunchtime-ish

• Start in Labour Ward Recovery
• Join the pre-op Consultant Ward Round to introduce yourself to the patients and their partners - if you miss this, please make a point of introducing yourself prior to theatre. 
• Attend the Theatre Brief in Theatre A
• You will need to stay in the hospital until all C-sections for that day are complete
• It is your job to chase the outstanding results in Triage - this requires notifying patients of results +/- prescribing necessary treatment
• Make sure all results are signed off on Track.

What to Expect

• Elective c-sections are usually performed because there is a contraindication to vaginal delivery
• From knife-to-skin to delivery of the baby it will normally take 10-15 minutes, for the whole operation 45 minutes
• As the assistant your role will be keep the surgical field clear for the surgeon, to hold instruments and crucially to apply fundal pressure when delivering the baby

Step-by-step Guide - Some basic principles and tips!

Preparation- Spinal Anaesthesia- Patient lay flat in left-lateral tilt- Catheter inserted- Anaesthetist will check the level of the block

This is your time to Scrub!

It is assumed that you know how to do this! If you aren’t sure speak to the scrub midwife or Consultant and they can guide you through. (There are also instructions above the scrub sinks for further guidance).

Surgical Pause- Essential before any procedure.- Two people (this could be you!) will confirm the patients Name, CHI, Allergy Status, and consent form

Cleaning and Draping

• The Operator will clean the abdomen using chlorhexidine (it looks like Irn Bru, don't worry it isn't!)
• Be helpful by pointing out bits that aren't covered
• A small surgical drape will maintain the patients dignity while this dries
• The surgeon will drape the patient and you will need to pass the top section to the OPD top form a screen. The birthing partner will then come in and sit with the patient behind the screen

Opening the Abdomen- Transverse lower abdominal incision- Swab away blood to keep the field clear, help with cauterising any bleeding vessels- Layers of dissection = Skin – adipose – scarpa’s fascia – rectus sheath- At the rectus sheath you will need to use the Littlewood's to elevate the sheath and allow the surgeon to dissect the sheath off the muscles- If you see the pyramidalis muscle point this out loudly and everyone will think you’re very clever! Mention only 20% of people have them!

Entry into the peritoneum

• Blunt entry to minimise damage to surrounding structures (specifically the bladder, especially in the case of previous LUSCS, there may be adhesions that have formed)
• Once the operator has entry to the peritoneum you will be asked to insert your middle and index fingers of both hands to tear the hole in parietal peritoneum. Stretch upwards to avoid damage to the bladder (this feels brutal but improves healing!)
• You will be given a Doyen's retractor to retract the bladder from the uterus and give a good visual field for the operator
• The visceral peritoneum will be reflected from the uterus and the Doyen's repositioned to capture the visceral peritoneum

Entry into the uterus- Using a clean blade the surgeon will make small, curved incisions into the lower segment of the uterus until the whole muscle layer has been incised. Care will be taken not to rupture the membranes to reduce risk of foetal laceration at this point- Membranes will be broken bluntly, usually with a finger

Delivery of the baby

Why we're all here! And the most important step.

• The uterotomy will be stretched and a hand placed inside the uterus to identify the foetal head/or bum!
• Once the presenting part has been identified you'll be asked to remove the Doyen's
• On command, apply strong, consistent fundal pressure to aid the delivery of the head, shoulders, body and legs (different in Breech deliveries so always follow instructions!)
• After delivery, presuming the baby is in good condition we wait a minute (delayed cord clamping) to allow all the blood in the cord to get to the baby!
• The anaesthetist with give IV Syntocinon at this point to help with delivery of the placenta and involution of the uterus

Delivery of the placenta- Placenta will be delivered by controlled cord traction

Closure of the Uterus

• Normally this is done inside the abdomen but in some cases the uterus will be externalised to allow better visualisation
• Uterine angles are secured with Green Armitage forceps and closed in two layers
• Normally the operator with secure both angles with a stitch and use a small clip to attach to the loose end
• A locking suture will be used for the first layer and you may be asked to maintain the tension by pulling the suture upwards and following the surgeon
• The second layer will be done in the opposite direction (the aim here is to bury the first layer and aid healing)
• The tension will be released and together you check for effective haemostasis. (May require extra stitches/diathermy at this point)
• Use the suction to collect any liquor/blood that has collected in the pouch beside the patient

Closure of the abdomen- Once haemostasis achieved the abdomen is closed in layers, exiting the opposite way you entered- Rectus sheath closure is arguably the most important layer (you do not want this to dehisce and have to bring the patient back the theatre- Once the angles have been identified with Littlewood's forceps, the surgeon will stitch the angle and you will need follow the continuous stitch, maintain tension and elevating the sheath to avoid damage to underlying structures. You can use the handle of the scissors to retract the adipose tissue layer here- Sometimes an adipose tissue stitch is made- Skin will be closed with a continuous stitch to the subcuticular layer (some say this is the most important layer as it's the only part the patient will see!). Normally an assistant isn't needed at this point and if the operator is happy you can take your cue to go and get the kettle on!

This may seem like an awful lot of information but you will get the hang of it!

If in doubt, ASK!

09:00 - 17:00

Inverclyde Royal Hospital

• Report to L Centre (Gynaecology Day Unit) for 9am
• Gynecology Pre-assessment
• Antenatal and Gynaecology Clinics
• Day-case theatre lists
• Antenatal Clinics on F North
• Gynaecology on L South

Gynaecology Clinics

Week 1

	Monday	Tuesday	Wednesday	Thursday
am	Day surgery - McMinn/Blair	1st Part MTOP  Gyn - Dr Bollapragada	Nurse-Led Pessary Clinic  Pre-assessment	2nd Part MTOP Pre-assessment
pm	Gyn -McMinn/Blair Colposcopy - Dr Hafez		Social Gyn - Dr Zwizwai	2nd Part MTOP Pre-assessment  PMB/Colposcopy - Dr Hair/Morgan

 

Week 2 

	Monday	Tuesday	Wednesday	Thursday
am	Day surgery - McMinn/Blair	1st Part MTOP	Nurse-Led Pessary Clinic  Pre-assessment	2nd Part MTOP Pre-assessment
pm	Colposcopy - Dr Hafez		Social Gyn - Dr Zwizwai	2nd Part MTOP Pre-assessment  PMB/Colposcopy - Dr Hair/Morgan

Obstetrics

EPAS

Monday - Friday, mornings only 

Maternity Daycare

All day Monday - Friday 

Antenatal Clinic

Monday - Dr Hafez Scan (Morning)

Tuesday - Dr Hutchison Diabetic ANC (Afternoon)

Wednesday - Dr Hutchison/Hafez Scan (Morning), Dr Hutchison ANC (Afternoon)

Thursday - Dr Murphy ANC (Afternoon)

Friday - Dr Murphy Scan (Morning)

Vale of Leven Hospital

• Report to Pre-assessment Clinic (Main hospital, through the atrium, left towards pre-assessment)

• Gynaecology Pre-assessment
• Antenatal and Gynaecology Clinics
• Day-case theatre lists

	Wednesday	Thursday
am	Gyn - Dr Flanagan	DSU/Gyn - (Alternative wks) Dr Jido Antenatal Clinic - Dr Jadhav
pm	One stop/Colposcopy - Dr Flanagan	Gyn - Dr Jido/Hafez

 

If in doubt, ASK!

09:00 - 17:00

• Additional help and cover unexpected sick leave

If you're allocated float, this is usually a good time to request Annual Leave/ Study Leave to reduce the number of swaps on the rota!

This can also be a good week to attend clinics, theatres and work on Audit/Quality Improvement projects if your colleagues aren't too busy!

From time to time you will be allocated clinic weeks when there is enough cover on the wards.

Introduce yourself to the consultant and registrar. Some consultants will prefer you sit in with them, whilst others will be happy for you to see patients on your own with their support.

Clinic A (to the left of the main entrance)

	Monday	Tuesday	Wednesday	Thursday	Friday
Am	Antenatal Clinic - Dr Thomson	Antenatal clinic - Dr Quinn	Antenatal clinic - Dr Quinn Diabetes ANC - Dr Quinn/Dr Smith	Antenatal Clinic - Dr Jewell	Antenatal Clinic - Dr Bollapragada Gyn - Dr Blair
Pm	Obstetric medicine - Dr Thomson Gyn - Dr Paterson	Gyn - Dr Paterson Gyn - Dr Hair Gyn - Rae Roan	Diabetes ANC (alternate weeks) - Dr Quinn	Gyn - Dr Gupta

 

Clinic B (to the right of the main entrance past EPAU)

Alternative weeks of the following two schedules:

	Monday	Tuesday	Wednesday	Thursday	Friday
Am	Colposcopy - Dr Meti	Colposcopy - Dr Hair	One Stop Gyn - Dr Jido	PMB - Dr Zwizwai PMB - Dr Meti
Pm	One Stop Gyn - Dr Jewell Colposcopy - Dr Flanagan	One Stop Gyn - Dr Hafez/Blair	One Stop Gyn - Dr Morgan	One stop - Dr Tibbo

 

	Monday	Tuesday	Wednesday	Thursday	Friday
Am	One Stop - Dr McMinn	Colposcopy - Dr Hair Colposcopy - Dr Crawford	Menses/One Stop - Dr Jido	PMB - Dr Zwizwai PMB - Dr Meti
Pm	One Stop - Dr McMinn	Menses - Dr Yousef	Menses/One Stop - Dr Morgan

Portfolio

• Educational supervisors will be allocated at the beginning of the block
• Keep ahead with your Portfolio, check what is required and get started early!

Junior Teaching

• Thursday Lunchtime - 1pm
• Supervised by 2nd-On Consultant, taught by YOU!
• Topics allocated at the beginning of the rotation and you will present to the other available SHO and the medical students.
• Aim for a 15-20min long presentation
• Make it good and be original!
• Microsoft Teams available for those not in RAH

Departmental Teaching

• Every Friday -
  • 1230 CTG teaching - Teams
  • 1300 Departmental teaching - Teams
• You can be added to the Teams channel
• Look out for department email for what's on! Usually clinical presentations/audits/M&Ms
• Attendance is encouraged and BE ON TIME!
• Can be a good opportunity for you to present Audit/Projects - please let the consultants know if you wish to present.

A calendar of teaching events is available here