The Patient Comes First

Senior Resident Responsibilities
Inpatient Teaching Service
(including float)
 

1. Senior Resident (SR) will see all patients in the ER in supervision of the Junior Resident (JR). 

2. Patients transferred to the ER are the responsibility of the ER physician. 

3. The SR, after usual working hours (the Chief Resident <CR> during usual hours), may accept hospital inpatient to hospital inpatient transfers.  

NOTE: Have a low threshold for involving your attending.  Do not accept direct admissions from an outside ED; these must go ED to ED.

1.  The SR will write an admission note on all patients. 

2.  The SR is responsible for the supervision of the JR and the care of the patient; senior resident must see all patients daily and document involvement.

Unstable, special care unit, angry patients, patients likely to expire in hospital should be seen by the SR frequently during the day and night.

The SR should see unstable and/or ICU patients before 8:00 a.m. conference. 

3.  The SR must keep the attending informed of important problems and situations (angry patients, deaths, angry families, unexpected worsening of patient status, untoward events, adverse reactions, angry consultants, unresponsive consultants).  The attending should be notified the same day of “bounce back” admissions. 

The attendings hate surprises that are negative – keep the attending informed. 

4.  The SR will care for the patients on an as needed basis not when the “shift” is over.  The SR, whether it is medical service or as float, must be involved. 

5.  The SR will attend arrest codes and emergencies of many descriptions when in possession of the code pager.

6.  The SR will supervise the JR in the performance of procedures for which the SR is competent.  The SR will record all procedures performed and turn into the department. 

7.   The SR will attend morning teaching report at all times (expect residents clinic) and present cases when the JR cannot be present. 

8.   The SR will ensure timely DC summaries; off service notes, death notifications, etc. 

9.   The SR will handle consultations that are limited without involvement of the JR. 

10. The JR will write all orders when on duty (8:00 a.m. to 5:00 p.m., on call, etc.); the SR may write necessary orders when the JR is not on duty or in continuity clinic. 

11. You must go weekly to medical records to complete your charts when on an inpatient service and thereafter until all records are complete. 

12. The library in the WVU building is available to you on a 24 hour basis.  Call the CR or me if you get any grief from security. 

13. Part of your duties are to support and aid the JR.  You must assure that there is high quality, safe care.  No part of patient care is the sole duty of the JR and beneath the SR. 

14. You must take time out of the hospital when on in hospital call services.  A call schedule and out of hospital schedule will be provided. 

15. Return all evaluations within 5 days of the end of service. 

16. Take responsibility (with the attending) for organization of teaching efforts. 

17. The SR should call the community physician who will see the patient after DC at the time the patient is discharged.