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RMO International Clinical Handbook Revised 24 03 2014 Inc PDF Extras

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   1  RMO CLINICAL HANDBOOK   2  Dear Doctor 24th March 2014 Welcome to the team of doctors at RMO International! (And to those of you reading this during the interview process I hope the above will apply to you soon.) This is the written induction material for RMOIH RMOs. We ask that even those of you who are experienced RMOs to read the information in this Handbook carefully, because it is updated regularly.  Appendix 1 of this Handbook contains examples of some relevant Hospital Policies, which may or may not be in use at the time you arrive at work and are used here as examples only. The best way to get the most up-to-date policies on escalation or clinical issues like blood transfusion or major haemrorrhage is to speak to the clinical lead at your hospital, and we ask you to do this when you arrive at work. Please read the Handbook carefully and follow the video links. You will need sound on your computer to watch these videos. The Handbook is drawn from our experience of the learning needs of previous RMOs and is designed to reduce your stress! If the information in this Handbook is at a level that is too low for you, then I apologise, but please read it carefully anyway. What I have written here is in plain English and is similar to what I would tell a doctor sitting face-to-face. Please contact me, or clinical manager Petio Anguelov, with any queries about the information in this Manual. Finally I must emphasise that while every effort has been made to make the information in this Handbook both accurate and up-to-date; the advice, and descriptions of medications and procedures in this Handbook are by no means exhaustive or even complete, and are not intended as a substitute for experience, or as a textbook. You must use your own professional judgment on all information in this Handbook. Warm regards Dr Danny Barker Managing Partner   3  CONTENTS OF THE RMO CLINICAL HANDBOOK 1. The 12 Golden Rules for RMOs- please read carefully (p4-8) 2. The generic Job Description of an RMO (p9-11) 3. Further explanation of your duties in the ward and descriptions of common RMO procedures (like intravenous cannulation and IO access) (p12-26) 4. Advice on prescribing and list of common ward medications prescribed by RMOs, and TTOs (p26-33) 5. List of common English medical abbreviations (p33-34) 6. Format when making medical notes and reporting to consultants (p35-37) 7. Filling in death certificates; DNAR orders and cremation forms (p37-38) 8. Policies and procedures (p39-45) 9. Hospital dress codes (what to wear) (p45-47) 10. British manners and medical culture; discrimination (p47-49) 11. Boundaries and relationships with patients and some advice on communicating with patients and their relatives as an RMO (p49-51) 12. Revalidation of all UK doctors (p51-52) 13. Handover routine and hospital induction (p52) 14. Safety at work (p53-54) 15. Elderly patients, falls (p54) 16. Blood transfusion safety- check the patient’s identity (p54-55) 17. Wound care and a word on unusual post-operative complications (p55-56) 18. How to lead the resuscitation team (p57-58) 19. Safeguarding of Children and young persons and Safeguarding of Vulnerable  Adults (SOVA) awareness (p58-67)  Appendix 1: Examples of Hospital Policies, EWS Charts, ANTT diagrams (all external policies are used only as examples and with permission of the publishers) and RMO International Sexual Misconduct Policy (p68 onward)   4  THE 11 GOLDEN RULES FOR RMO INTERNATIONAL RMOs 1. Firstly please note that there must be an RMO (by law) on the premises of the hospital 24/7. Please under no circumstances leave the premises until you have physically handed the bleep and keys to your replacement. 2. Every doctor is expected to behave and practice medicine according to the GMC’s Guidance- basically a set of descriptions of what a doctor has to do at work and also what we are not allowed to do. To perform your contract with RMO International to work as a doctor, you will have to comply with the GMC’s Good Medical Practice. Please see: http://www.gmc-uk.org/guidance/index.asp or and then click on the links “Good Medical Practice” and then “begin reading.” We need you to read through this Guidance very carefully. If the link above does not work then please Google “GMC Good Medical Practice” and read it carefully. A guide for patients to tell patients what they should be expecting from you as the ward doctor is available at http://www.gmc-uk.org/guidance/patients.asp so again please Google “GMC guide for patients” and read this please. 3. If there is any deterioration in a patient’s condition, or if any new treatment of management is needed, always call the patient’s consultant   If in doubt, check with the nursing staff, pharmacist or consultant. The consultant takes responsibility for all decisions about a patient’s care while the patient is in the hospital, so keep him/her informed at any time of the day or night- all consultants are on 24 hour call for their patients.   Sometimes a surgeon is not 100% familiar with how to approach a medical problem raised by an RMO. Surgeons are surgeons. Consider calling the on-call anaesthetist first, or the anaesthetist who anaesthetised the patient concerned. The anaesthetist, or a physician, may have a better idea of how to deal with medical complications than the surgeon. That said, also make a quick phonecall and let the surgeon know if you think the patient needs to be referred, and call to update them.   Please speak to the director or nursing or the nurse in charge on the ward immediately if a consultant is not contactable or not responding to your attempts to get care for the patient. Follow up and persist until you and/or the nurses have arranged consultant review of the patient or received what you agree are appropriate instructions or advice from a consultant. Some hospitals’ escalation policies (for example the BMI escalation policy in  Appendix 1 of this manual) allow the DoN or Nurse in Charge working with you to call and arrange a second opinion or action from another consultant. Make use of the on call manager roster if there is one, in emergencies.

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