mti induction booklet induction booklet

MTI Induction booklet (February 2017)

Firstly welcome to Leeds!! Thank you for choosing to come to Leeds. We appreciate how big a change this is for you and hope you will find us a friendly and welcoming department and that your experience here is worthwhile to your professional development. You will be joining a trainee body of 62 registrars and 7 junior trainees in anaesthesia. We very much view you the same as our own trainees so you will be working alongside them and doing the same training lists and have the same access to local teaching. We also have a lot of local expertise in teaching and examinations which we hope you will prevail upon to help you in your development whilst here at Leeds.

The purpose of this booklet is to outline a rough plan for your induction so as to help you get up and running as soon as possible. There is also a list of all the people you can go to for help and information on how to access further reference material which we send out to all the UK trainees at induction which you should look at as well. Finally there is a tips section compiled from the feedback from previous MTI trainees. We would welcome your feedback to make this a more useful document so any suggestions please forward to me.

Who’s who?

At SJUH the main people involved in your care here are:

Dr Dipesh Odedra - Lead for the MTI schemeDr Sharmeen Lotia - RCoA TutorDr Claie Tordoff - RCoA TutorDr Andy Lumb - Educational SupervisorDr John Jones - Educational Supervisor and Regional Advisor for the RCOADr Indu SIvanadan - Educational SupervisorDr Lorna Eyre - Faculty ICU Tutor

Dr Moira O’Meara - Clinical Director of AnaesthesiaDr Andrew Breen - Clinical Director of ICMDr Komal Ray - Clinical Lead Anaesthesia Dr Lorna Eyre - Clinical Lead ICM

Dr Ashok Elayaperumal - Rota master AnaesthesiaDr Rashmi Seneratne - Rota master [email protected] - trainee rota master for acutes and obstetrics at SJUH_____________________- trainee rota master for ICM at SJUH

Ms Maxine Playford - Administrator in Anaesthetic office

At LGI:

Dr Maralize Van Greunan - RCoA TutorDr Rachel Johnson - RCoA Tutor

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mailto:[email protected]

Jobs to do when you start…

There are a number of jobs you need to do to get up and running. These are: Have a local induction with either myself (Dipesh), Sharmeen or one of the

supervisors Get your Trust ID, access card and IT access (arranged by medical staffing) Set up an appropriate email account (nhs.net preferably) Photo for the department Make sure you have access to eRoster for leave etc Get access to the RCOA ePortfolio ASAP ([email protected], 0207 092 1556) Meet with your designated supervisor to set up a personal development plan for

your time here at Leeds. Consider:o What training blocks you want to doo Exam aspirations

Become familiar with the following:o How to access results, online noteso How to bleep someone (see later)

Get registered with a local GP when you have sorted your accommodation Register with a medical defence union to provide personal liability insurance

o Medical protection Societyo Medical Defence Union

I have written a checklist to assist you keeping track of the above which you will find later in this pack

How to get started…

When you start you will need a period of time to get used to the way we work at Leeds and in the UK. This period is variable and will be very much dependent on your previous experience but typically takes 2-4 weeks. During this period you will be on a basic salary with no out of hours supplement and your hours will be 0800-1600 Monday to Friday. Once you are deemed induced and are happy to go on the on call rota you will have the out of hours supplement added to your pay and will work the normal rota all the trainees work.

It’s really important that both you and your supervisors are happy before going on call so please see this as an opportunity to help you get the most out of your time here with us.

During this period you will do a variable amount of time in theatres before going to your designated area (ICU if doing ICU, obstetrics if doing obs, stay in theatres if on the acutes on call).

The college has also produced some eLearning to help overseas doctors. It may be useful to access this resource details of which are on the RCoA web site at:http://www.rcoa.ac.uk/sites/default/files/e-LFH-International-Induction-Programme.pdf


http://www.rcoa.ac.uk/sites/default/files/e-LFH-International-Induction-Programme.pdf

mailto:[email protected]

Whilst in theatre it is required that you as a minimum complete the RCoA Initial Assessment of Competency:

Demonstrate the following and attain positive assessments for:1. Preassessing a patient (ACEX)2. Managing a spontaneously breathing patient (ACEX)3. Administer anaesthetic for an acute abdominal surgical procedure (ACEX)4. Perform a RSI (ACEX)5. Recover a patient (extubate and ensure stable and appropriate handover to

recovery) (ACEX)6. Demonstrate functions of the anaesthetic machine (DOPS)7. Transfer a patient into the operating table and position them (DOPS)8. Demonstrate CPR (DOPS)9. Demonstrate failed intubation drill (DOPS)10. Demonstrate scrubbing up (DOPS)11. Manages PCA and prescription 0 basic pain management competency (DOPS)12. Discuss how to ensure correct id of patient, operation and side of operation

(CBD)13. Discuss how to minimise PONV (CBD)14. Discuss how airway was assessed and how difficult intubation can be

predicted (CBD)15. Discuss how to choose the right muscle relaxant and induction agents (CBD)16. Discuss post op analgesic options (CBD)17. Discuss post op oxygen therapy (CBD)18. Discuss the issues anaesthetic related to intra-abdominal surgery (CBD)19. Discuss routine for failed intubation (CBD)

Once the above is completed you will then spend time in the area you will be doing your initial on calls in where a further local induction will occur. On ITU the lead for this is Dr Lorna Eyre, on obstetrics it is me (Dipesh). If you are staying in theatre your supervisor will continue to make sure you are happy before going on call.

There is more information available on the virtual learning environment which you access which you should look over for more help and access to unit guidelines for ICU and obstetrics.

PLEASE make sure you look at this resource as there is a lot of useful information related to working practices here at Leeds which is difficult to cover.

http://www.mel-learn.com/login/index.php

select [login as guest], select [specialties] on the right hand sideselect [anaesthesia and critical care]select [anaesthesia and critical care] againinput [gas15] as password

Below are some extra bits of info which will be useful


http://www.mel-learn.com/login/index.php

USING THE BLEEP SYSTEM

Ring 80, followed by the bleep number then the extension of your phone (listen for the instructions). The consultant on call can be contacted via switch.

Bleep Numbers Acute Anaesthetist 5011Senior trainee (SR) 4110Labour Ward Anaesthetist 5012

IMPORTANT PHONE NUMBERS

St James’s 0113 2433144Anaesthetic Department 0113+ 2065580 / 2065789 / 2067076

EXTENSIONS & CODES(all can be rung directly from outside the hospital by 20 plus extension number).Geoffrey Giles Theatres 65534 / 65576 or

6672+ theatre no.Code for Juniors Playroom C135XY

Chancellor Theatres 65783 / 65784 Code for the door of the postroom

C24680

Wards 691+ward number Code for seminar room C1958ZICU 65890/64809/69154 Code for anaesthetic kitchen C2450XLabour Ward Anaesthetic Office

65371 Departmental Toilets (Lincoln wing)

CY0512

Switchboard 0 Code for obstetric office C65371Directory enquiries 65892 Code for doors of GG changing

rooms135 and doors into theatre 2344

Transfusion 65559

I really hope you enjoy your time here at Leeds. Please get in touch if there is anything we can do to help you settle in and please let us know of any difficulties you encounter. I look forward to working with.

Dipesh


ESSENTIAL EQUIPMENT (Sign Off)Welcome to the Leeds Teaching Hospitals Anaesthetic Department. During your time with us you will have the opportunity to gain exposure to, and skill in the use of, a variety of pieces of anaesthetic, intensive care and monitoring equipment. We hope you will have the chance to gain specific competence in the various pieces of kit specific to your area of sub-specialty interest during your training time.

However, there are a number of pieces of kit that you must be familiar with before you start work at LTH because of their essential part in basic anaesthetic practice. A number of these you will already have been exposed to in your previous hospitals, thus you will not have to go through these again and you can self certify. However, if you have not seen them before, or you are not comfortable using them, then you must go through them again now until you are happy to sign yourself off.

It is vital you are aware of your own limitations when using any kit you are not fully familiar with. If you are unhappy using a piece of kit that is not on this list later on in your practice you must bring this up with a supervising colleague and obtain some training before using it.

NAME:(Block Capitals) Anaesthetic Trainee

EQUIPMENT TYPE SIGNATURE DATE

Ventilators and

Anaesthetic Machines

Maquet

Oxylog 3000

Oxylog (other)Datex OhmedaAestiva 5Draeger A500

Pumps

BBraun VolumetricBBraun Syringe Driver PumpsAlaris Carefusion TCI

Epidural Pump

PCA Pump

Defibrillator Zoll

Monitoring

LidCo/LidCo Rapid

Nicom

BISPhillips Intelliview (Setting alarms, Zeroing pressures)

UltrasoundSonosite iLook

S-Nerve


Induction checklist

Completed

Register with GP

Take out medical indemnity cover

Obtained Trust ID

Obtained access card

Obtained IT access

Set up @nhs.net email address and department have it

Know how to access eRoster to book leave etc

Get access to RCoA ePortfolio

Complete Trust mandatory elearning

Know how to access results, PPM

Know how to bleep someone

Know how to use anaesthetic machine

Completed equipment sign off sheet and returned to DO

Completed IAC sign off

For anaesthetic fellows:

Completed theatre induction and ready to go on call

For ICU fellows only:

Completed theatre induction

Completed medical placement

Completed ICU induction and ready to go on call


Anaesthetic Clinical ExercisePlease complete the question using a cross (x). Please use black ink and CAPITAL LETTERSTrainee’s surnameTrainee’s forename(s)GMC number GMC NUMBER MUST BE COMPLETED

Observation

IAC / IAOC Code

Observed by GMC number GMC NUMBER MUST BE COMPLETED

DateSignature of supervising doctor

Clinical Setting:

Theatre ICU ED Delivery Suite Pain Clinic HDU Transfer

Other

What level of supervision does the trainee require for this case?

Supervisor in theatre Supervisor in theatre suite Distant supervision

What went well? *

What could have gone better? *

Plan for learning and development**

Possible areas for feedback:

* Planning, preparation, grasp of theoretical background, understood procedure and alternatives, plans and risks explained to patient, handling of patient, team communication, ability to cope with problems, mindful of cross-infection, ability to evaluate own performance, maintenance of records, post-procedure instructions, professional standards

** e-Learning, simulation, courses, targeted clinical experience, journals


Direct Observation Procedural SkillPlease complete the question using a cross (x). Please use black ink and CAPITAL LETTERSTrainee’s surname Trainee’s forename(s)GMC number GMC NUMBER MUST BE COMPLETED

Observation

IAC/IAOC Code

Observed byGMC number GMC NUMBER MUST BE COMPLETED

DateSignature of supervising doctor

What level of supervision does the trainee require for this procedure?

Supervisor in theatre Supervisor in theatre suite Distant supervision

What went well? *

What could have gone better? *

Plan for learning and development**

Possible areas for feedback:* Planning, preparation, grasp of theoretical background, understood procedure and alternatives, plans and risks explained

to patient, handling of patient, team communication, ability to cope with problems, mindful of cross-infection, ability to evaluate own performance, maintenance of records, post-procedure instructions, professional standards

** e-Learning, simulation, courses, targeted clinical experience, journals


Case Based DiscussionPlease complete the question using a cross (x). Please use black ink and CAPITAL LETTERSTrainee’s surnameTrainee’s forename(s)GMC number GMC NUMBER MUST BE COMPLETED

IAC/IAOC Code

Observation

Observed byGMC number GMC NUMBER MUST BE COMPLETED

Date

Clinical setting:Theatre ICU ED Delivery Suite Pain Clinic HDU Transfer

Other

Special focus of discussion*

What went well? **

What could have gone better? **

Plan for learning and development***

Possible areas for feedback:

* Potential complications, Core Clinical Learning Outcomes** Planning, preparation, grasp of theoretical background, understood procedure and alternatives, plans and risks explained

to patient, handling of patient, team communication, ability to cope with problems, mindful of cross-infection, ability to evaluate own performance, maintenance of records, post-procedure instructions, professional standards

***

e-Learning, simulation, courses, targeted clinical experience, journals


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