Wards

Welcome to your Wards rotation at the DC VA Medical Center!

 

There are 6 day ward teams and a night float team that our wards residents rotate through. Each team consists of one resident (either PGY-2 or 3) and two interns. You will work with residents and interns from Howard University, George Washington University, Walter Reed Military Medical Center, and Georgetown University. 

 

Each team will also have between one and four students (MS3/MS4/PA/Podiatry) from George Washington or the Uniformed Services University. 

 

One team will have an additional resident as the “Teaching Resident” or TR, who will be a PGY3 selected for additional teaching responsibilities.

Call 

Every team admits patients each day, including weekends, from 7am-3pm. Two teams are on late call each day, which means they continue to receive admissions past 3pm until 6pm. This rotates amongst all 6 wards teams every 3 days. 

Med Consult Coverage:

During the week, one call team will hold the med consult pager when the med consult resident is done for the day (~4pm-6pm) and throughout the day on the weekend. Reference the weekend email to see which team holds the med consult pager. The med consult pager will then be passed to a night team resident at signout. 

 

The call team resident will return the page, assess the patient, write a h/p using the Med Progress note template and present the patient to the Med Consult attending. (Due to CPRS constraints, you cannot use the Med Consult note template). OF NOTE: it is important to assess for stability of the patient when returning the page as a rapid response may be more appropriate first with a med consult to follow (if necessary). 

Weekends

Weekends are gray here at the VA, meaning you will work one day and have the other off. Interns will work together, and residents will be on their own. If your team was on call Friday, interns will be on the Saturday post-call. 

Each team has a sister team, i.e. Teams 1 & 2, Teams 3 & 4, and Teams 5 & 6. On the weekend the two sister teams become one Super Team. They round together and complete admissions together. The call schedule still stands on the weekend, so two teams will admit until 6pm. The sister team should stay to help with admissions through call.

Teams who are not on call may sign out at 3pm to the call teams if and only if all work is done. Refer to the night float email you receive the Thursday/Friday before the weekend with the call schedule to see if you are able to sign out early and whom to sign out early to. 

caps

Each medicine team caps at 20 patients total per GME guidelines. When the total medicine census is less than 84, the team cap will drop to 18. 

Interns can receive a maximum of 7 new patients on any given day (5 admissions + 2 transfers) and can carry no more than 10 patients.

Residents can supervise a maximum of 14 new patients on any given day (10 admissions + 4 transfers) and can carry no more than 20 patients at a time.

duty hours

Please let the chiefs know if you are approaching duty hour limits. You cannot work over 80 hours per week averaged over the month and we will work with you to make sure that is not the case. 

Refer to the buttons below for more information on how to do admissions, best practices with discharges, more information on the night float rotation, etc.