RxPG - the perfect Rx for medical Post Graduate entrance blues!
Mobile Edition | Help/Newbie? | 24/7 Support
HOT | PrePG | MCQ | DNB | Careers | Books | Colleges | Dental | DocIndia | PLAB |  USMLE  | Australia | Canada | GLOBAL | OffBeat!
Articles | Forums | MCQ Crammer | Downloads | Mnemonics | Revision Tools | Recent Shouts | All Features


What you need to know about Ward Rounds for you F1/PRHO Interview

Author: tezb, Posted on Monday, July 10 @ 17:50:03 IST by RxPG  

 FRIEND Add to My Pages   PRINTER Printer Friendly   FRIEND Email Story  FRIEND Download Story  PLAB Jobs alerts 

PLAB Jobs

This article aims to cover the salient points about ward rounds that you will need to know for F1/PRHO interviews in the UK.

I have been asked prepared this for those of you who have concerns about demonstration of ward round skills during your interview for PRHO/Foundation Posts.


I have prepared this for those of you who have concerns about demonstration of ward round skills during your interview for PRHO/Foundation Posts.

In the UK there are different types of round. After a patient is admitted to hospital, they are usually clerked in by a junior doctor on the ward (or admissions unit). Within 24 hours, they will be seen by a consultant on a ward round - known as a Post-Take Ward Round.

On the wards, patients are usually seen on a round every day by junior doctors (ie PRHO/SHO/Reg). These rounds usually monitor management and progress of the patients condition. Most consultants have a Consultant Ward Round twice per week where all the important decisions regarding management are made.

So.... We know about ward rounds, but who does what?

A Ward Round usually will consist of a consultant and his team (Medical Students, PRHO, SHO, Registrar) & nurses (ward sister, plus the nurse looking after the patient). In some hospitals, other members of the multidisciplinary team are also in attendance (specialist nurses, physiotherapists, social care). Take note of everything everyone says. A multidisciplinary approach is important and the nursing and allied staff will have valuable input into the patients care.


The Paper Work

This bit is important!!! It is a legal requirement that during an inpatient stay, a doctor makes an entry into the patients notes at least every 3 days!! It is good practice, however, to write something every day!

Junior Doctor Rounds

These usually monitor progress of the patient. When writing in the notes, consider the following points
1) Do the notes give enough information that another person could treat the patient if you were not there?
2) Will the notes be legally covered if they were ever taken to court?

There is a useful acronym for daily notes (junior rounds) - C.R.A.P
This stands for:
Change in condition - ie how is the patient doing
Results - blood results, radiology etc
Asessment - of the physical and psychological state of the patient (ie - your examination)
Plan - what the plan is for the next few days.

Consultant Ward Rounds

Slightly different - more information is exchanged here, but essentially the paper work is the same.

The consultant will see each patient in turn and report his/her findings as he/she goes along. It is the job of the junior medical staff to document what they say and do.

A useful way of doing this is to use the S.O.A.P acronym.

This stands for:
Subjective - what the patient says (ie brief history and progress notes)
Objective - what you find out from the patient (ie the examination findings and results of any investigations
Assessment - the diagnosis and how things are progressing
Plan - future managment, investigations to be ordered, referrals, plans for discharge.

You will also have a seperate book (or sheet of paper) with a list of all your patients on it. If anything needs doing (ie: blood forms, changes in Rx, referral, discharge letters etc), then you write it on this list in addition to the notes, so you know what jobs need doing later on. I have given two examples of what to write in the notes below.

Important General Points for Notes
- Always write the date and time of your notes!
- Consider writing the location (ie A&E, Admissions Unit)
- Write the name of the most senior doctor leading the round
- Write your notes clearly and legibly
- Sign your entry
- Print your name
- Print your designation
- Write your bleep number
- Each page should have the patients name, date of birth and hospital number at the top!!


Example 1

CRAP notes:
3 day post operative patient - appendicectomy.

07/07/06 - 10:00
SHO Ward Round - Dr Smith

Patient is in good spirits today. Not experiencing much pain and now only using paracetamol. Wound site healing well. No signs of infection. Eating and drinking without any problems. Passing urine. Passing faeces.

Wound swab cultures negative.

On examination, chest clear, heart sounds normal, abdomen soft and not tender.

Plan - Continue management. Consultant to review tomorrow. Home monday.

HUDSEN - PRHO
Bleep 1234


Example 2
SOAP Notes.

Here is an example of a medical patient seen on the consultant post take round with plueritic chest pain.

07/07/06 - 13:00

PTWR - Dr Packard. Admissions Unit.

S -
Left sided pleuritic chest pain for 2 weeks with associated cough. No sputum. Long term smoker. No previous history of chest problems.

O -
Temp 38.1C Sats 100% on oxygen. BP 130/80, pulse 84 reg. Chest - crepitations on the left lung base. CXR - Consolidation at the left base. No pneumothorax present. Raised WCC. ECG normal. Cardiac enzymes normal

A -
Impression - L basal pnuemonia

P -
Continue oxygen and monitor sats. Culture blood and sputum today. Amoxicillin 500mg TDS orally. Not for V/Q - unlikely to be PE. Speak to physio - re: chest percussion to remove sputum.

HUDSEN
PRHO to Dr Packard
Bleep 1234


For the interview you will either
- be invited to attend a mock round and make notes
- watch a video and make the notes

Good luck!



4 (Excellent) 3(Good) 2(Good) 1(Bad)   


Recommended Books for PLAB Jobs
 Books to read for PLAB Jobs by RxPG

Related PLAB Jobs articles
 Applying for 2007 MMC Jobs in UK: Timeline, Tips and Guidance
 What you need to know about Ward Rounds for you F1/PRHO Interview
 Blah Blah on the present situation for overseas doctors in UK
 HOW TO GET AN ATTACHMENT IN UK!!!!
 Realistic chance of training for an overseas MBBS graduate in the UK
 The 10 DO'S And DONT'S For Clinical Attachment in UK
 SHO Job Crisis in UK - Advice to juniors looking for SHO posts
 Psychiatry Interview Questions and Experience
 Where Does a Post Plabber Stand?
 Buying a Laptop in UK - Some Research
 Realistic Career Path In The UK
 Useful First Contact Points for Clinical Attachments
 The Postgraduate Medical Education and Training Board (PMETB), UK
 After the Foundation Programme
 Foundation Year 2 (F2) - Essential Information
 Foundation Year 1 (F1) - Essential Information
 Applying to the Foundation Programme
 Applying to the Foundation Programme
 What is the Foundation Programme?
 Some Tips for Post Plabbers

Related PLAB Jobs Discussions

Other articles by tezb
 UK Mental Health Act - What You Should Know for Your OSCE
 What you need to know about Ward Rounds for you F1/PRHO Interview

 PLAB Jobs FAQ
  Browse all FAQs


Write an Article on PLAB Jobs
You can share your exam experiences, preparation strategies, books you have read or just any information about PLAB Jobs on RxPG website and we will publish it under your name.

Article Rating
Average Score: 4.85
Votes: 21




Most Read Article
Middle Grade Hospital Jobs in UK

Related Links
· BMJ Careers
· Specialist Info
· PLAB Books at Amazon.com
· RxPG First Aid for PLAB I
· Work Permits UK
· DOH UK Manual
· GMC UK
· NHS Careers






ARTICLE TOOLS

· PLAB Jobs section
· Articles by tezb
· Add to my pages
· Printer friendly version
· PDF version
· Email article
· Feedback on this article
· Medical tutorials
· Related forum posts
· Related articles
· Related downloads
· Submit article
· PLAB Jobs alerts
· PLAB Jobs books
· PLAB Jobs past papers


Most read story about PLAB Jobs:
Middle Grade Hospital Jobs in UK



Server Status: 151 pages served in last minute. Page generation time: 0.040 seconds

Site Maps: [Books] [News] [Forums] [Reviews] [Mnemonics]

sitemap - top30 - centuries - testimonials


About Us :: Disclaimer :: Contact Us :: Reporting abuse :: Terms of Services :: Privacy Policy

Advertise with RxPG!
Made in India by RxPG Medical Solutions Private Limited

"RxPG" is a Registered Trademark

Chrome Web Store YouTube Twitter LinkedIn Wikipedia Facebook