Nephrology (Peds 426)
Welcome to the Pediatric Nephrology Rotation!
1. We look forward to helping you both enjoy and maximally benefit from your experiences over the next 2-4 weeks. We hope you will take advantage of your elective time to broaden your exposure to issues related to kidney health and disease in children, and to solidify your knowledge of renal physiology.
2. The attending will change every week on Fridays.. Please check with your attending on call for any changes in the schedule. Page or email the pediatric nephrology attending on call to find out when and where rounds will be or discuss day prior.
3. You will receive impromptu teaching on rounds, relevant chalk-talks throughout the day as time permits, and will have dedicated renal teaching time several times per week (see below).
4. You should expect to give and receive performance feedback from and to your fellow and/or attending on Friday afternoons each week. Please ask for this if attending forgets!
|8:00||Morning Report||Morning Report||Morning Report||Pediatric Grand Rounds||Morning Report|
|8:30/9:00||Peds Neph Clinic – 100 Eastowne Dr||Round on inpatients||Round on inpatients||Round on inpatients||Round on inpatients|
|12:30||Gen Peds Noon Conference||Noon: ped neph clinic conf on zoom||Gen Peds Noon Conference||Gen Peds Noon Conference|
|Afternoon||Peds Neph Clinic||New consults, note writing, teaching||New consults, note writing, teaching||Pathology Conf(3rd fl.Women’s Hospital)|
*Nephrology Offices & Conferences are located on 7th floor Burnett Womack
Attendings: Keisha Gibson, Dorey Glenn, Keia Sanderson, Katie Westreich, Jess Stahl, Liz Kotzen
Fellows: Duy Vu, Anisha Gerber, Ashley Carver
Staff: Lynn McCoy, RN
- Be kind, respectful, and reliable
- General hours are 8:30 am – 5 pm M-F (morning report attendance is up to you or per residency guidelines)
- Let us know ahead of time if you’ll be absent for interviews, doctor’s appts, or other responsibilities
Expectations: Outpatient clinic
- Outpatient clinic is every Monday from 8:30 am – 5 pm on the 3rd floor of the Eastowne Building at 100 Eastowne Drive, Chapel Hill. Please park on the 4th floor or higher, then proceed to 3rd floor and ask the front desk for directions to the Pediatric Nephrology workspace (pod F) on Monday morning.
- Participation in clinic visits will depend on clinic schedule and available preceptors. Speak with preceptors in the morning about how they would like to run clinic. Start visit with the patient, get history, perform pertinent exam (all in about 15 min). Present the patient to your attending, as well as your ideas about differential diagnosis, work up, and plan (keeping in mind we understand you are working on the fly and haven’t h ad time to read or sit and think). Write note for the patient. Please finish your notes by the end of the day, so we can sign them that night.
- Outpatient notes from a consult service have a special purpose that is quite different from that of a patient’s primary care provider. The goals of a consult note are two-fold: gather and organize the relevant history, explain the differential diagnosis, find a diagnosis (if possible), explain that diagnosis to the referring physician, recommend or start a treatment and explain that treatment to the referring physician. Additionally, there should be anticipatory guidance for the referring physician (side effects or prescribed therapies to watch for, reasons to refer back to us sooner than scheduled follow up). One common pitfall to avoid: teach, but don’t condescend to your referring physician! You will receive feedback on your progress writing consult notes throughout the rotations.
Expectations: Inpatient service
- Rounds are typically at 8:30 or 9. Discuss time and location with your fellow or attending the day before, or page them after morning report. Pre-rounding is not expected but I’ll be honest – it’s both impressive AND helpful.
- You will be given the opportunity to see new consults and follow existing consults, following a total of 2-5 patients depending on your level of training and number of patients.
- For new consults: discuss first with fellow/attending on call, then go see patient, gather history and physical, come up with differential diagnosis, assessment, and recommendations. Present to attending/fellow. Read relevant medical literature about your patient’s condition, work up and treatment before presenting your plan (as time allows).
- For existing consults: discuss with fellow/attending whether a note is needed that day. Discuss nephrology’s recommendations and plan with the primary team. Serve as primary point of contact for your patients and the primary team, and a conduit for communication in both directions.
- Inpatient consult notes: should include what to do, but also your rationale. Your thought process on the patient should be transparent. Include a detailed explanation of the differential diagnosis and your thoughts about what is going on for the patient, as well as recommended work up and management, with clear anticipatory guidance for what to do overnight or if things change (ie sodium goes up too fast, SBP exceeds 150, etc.)
- On the last week of your rotation at the Wednesday noon conference or Friday inpatient review, we would like you to present a 5-minute talk on your chosen renal topic. Powerpoints not necessary, chalk talks or a one page handout are great.