• The resident will be called for issues with ANY baby in the nursery (private and service) that require orders and/or assessment.
• If the baby requires an actual evaluation, a short note should be written to document the event and either a message left with the PMD's answering service or, if serious enough, direct communication with the PMD/service attending.
• If orders need to be written as per preexisting protocol (CBC, bilirubin, glucose checks) on a service or private baby that is not unstable and does not need evaluation, those orders can be entered by the resident without an assessment or documentation.
• The nurses should not be entering surprise orders for the attendings to discover in the morning; they should be run by the resident first.
• The private attendings are not always able to sign their admission orders in a timely fashion. The current solution (while the attendings are being encouraged to enter and sign their own admission orders) is that the nurses will have verbal admission orders entered when each new private baby is admitted.
• The on-call resident can then "batch" the orders and sign/initiate admission order sets on the new babies, preferably once before midnight and once before leaving in the morning.
• Check the census to see if there are new babies, run the list in the computer to see if their admission orders are signed, and if they are not, then sign them yourselves.
• The NBN resident should not be called for any non-service patient. Please let our chiefs know if this is happening and they will correct it.
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