Bio-Med 450: The Pediatric Clerkship



Normal Newborn Nursery/Neonatology


Goals:
The goal of the week spent with the team in the Newborn Nursery and with the neonatologists in the Neonatal intensive Care Unit (NICU) is to expose the medical student to the physiologic changes and unique attributes of the neonate. An a additional goal is to gain appreciation of how the birth of a child offers a special opportunity for change in a parent and family's life.

Objectives/Competencies:
The following are the objectives to meet these goals. The student will:

  • learn how to gather appropriate history from paretns/guardian
  • perform a complete physical exam on well newborns
  • effectively document the history obtained and physical exam findings
  • be able to describe acceptable variations
  • recognize factors in the maternal and newborn history, which maybe put a neonate at risk for medical problems
  • gain some familiarity with teh workings of a Neonatal Intensive Care Unit
  • become convesant with regard to common problems of the premature and/or sick infant

[Please refer also to the expanded objectives found in the "Issues Unique to the Newborn" which is avaialble from the WebCT site, Marcia VanVleet, M.D., or the clerkship director.]

Location:
The Newborn Nursery at Women and Infant's Hospital is located on three "wards":
- the 6 East and 6 West nurseries on the sixth floor;
and the 5 East nursery on the fifth floor.
The NICU is located on the second floor.

Responsibilities:
The newborn nursery experience occurs from 8:00 a.m. - 12 noon every day except Thursday. Please review the complete objectives prior to the start of your week which begins promptly at 8 a.m. on Monday morning on the 6th floor. (Page the senior resident when you arrive, except for the day of general orientation to the Pediatrics Clerkship after which Helene Felici will direct you to the nursery). Please report in proper attire (white coats, stethoscope, and no sneakers) and be ready to learn! You are an important member of the care team and the more enthusiastically you approach your time here, the more you will learn. You will be responsible for completing the activities described on the Newborn Nursery Checklist. Each activity and competency was chosen to meet specific learning objectives for the nursery experience, for the pediatric clerkship, and for the medical school in general. There is some flexibility in these activities so that you can tailor these to your individual needs, strengths, and interests. If you have any questions about the specific activities please ask Marcia VanVleet, M.D. early in the week.

NEONATOLOGY

Thursdays: will be devoted to Neonatology. Please report to room 6050 for the regular conference at 8:30 a.m. Then at 9-9:30m, you will be brought down to the NICU. Please acquire the required scrubs (described below) prior to conference so that you will be ready to change into them for the start of the NICU session.

Activities in the NICU:
Please introduce yourself to the following key people:
A.) The second year resident: This person will attempt to contact you to accompany him/her to any deliveries. Please give thisperson your beeper number to facilitate contact.
B.) The Neonatologist who will be your mentor for the day. He/she will give you a patient in the NICU to "work up." Introduce yourself to the nurse who is caring for a baby in the NICU. She will advise you when it is appropriate to examine the child and will help you as needed. The x-rays are on the 'PACS' system in the NICU. One of the residents or staff will you how to review them. You should spend the bulk of the morning becoming familiar with this baby and the baby's problems.

When not attending deliveries, you should:

  1. Review the baby's chart.
  2. Talk to the nurse caring for the baby;
  3. Examine the baby;
  4. Talk to the baby's parents if available and nurse and attending deem it appropriate;
  5. Read about the baby's problems in a pediatric or Neonatology textbook.

Be prepared to present your baby to the Neonatology attending when you and your fellow student meet with them between 1:30 and 2:30 that afternoon. The baby you work up in the NICU could be one of your patient presentations for your OSCE.

CONFERENCES (please also refer to the calendar):

  • Tuesday and Thursday: Teaching conferences from 8:30-9:30 a.m. in the 6 East conference room (#6040)
  • Wednesday: Perinatal Management conference at 7:45 a.m. Auditorium C and D (0 level)
  • Thursday: Neonatology teaching for medical students
    11:45 a.m.: Perinatal seminar in the NICU conference room (room 2302/within NICU).
    1-2:30 p.m.: Meet with Neonatologist on service at the NICU conference room. Whatever you do, don't miss this.
  • Friday: 8:30 a.m. Pediatric Grand Rounsd in George Auditorium.
  • Optional Activities: Mon/Wed/Fri: 1:30 p.m. Radiology Rounds in SCN at the board.

 

 

For more information see Issues Unique to the Newborn
in the Clinical Problems Supplement

 

 

Bio-Med 450: The Pediatric Clerkship
Brown University School of Medicine
Providence, Rhode Island
For more information email Randal_Rockney@Brown.edu