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NICU (PEDS 415)

Welcome & Objectives

Welcome to the NCCC. Below you will find general information regarding this rotation. You will receive a complete orientation packet at the beginning of your rotation.

Objectives

  1. Demonstrate an understanding of the physiology of term and premature neonates as it relates to commonly encountered neonatal problems.
  2. Demonstrate an understanding of the pathophysiology of common diseases of the critically ill neonate, such as respiratory distress syndrome, chronic lung disease, persistent pulmonary hypertension, necrotizing enterocolitis, surgical problems, intraventricular hemorrhage, and retinopathy of prematurity.
  3. Demonstrate an understanding of the approach to management of the ill neonate, including the development of differential diagnoses, use of laboratory and imaging studies, and the risks and benefits of therapeutic modalities used in the NICU.
  4. Anticipate the birth of a high-risk neonate based on maternal risk factors, antenatal testing and events during labor and delivery.
  5. Understand the potential morbidities, ethical dilemmas, family stresses and the financial effects of neonatal intensive care.
  6. Demonstrate the ability to communicate effectively with members of the NICU team and families, and maintain the medical record in a clear and concise manner.
  7. Understand the components of discharge planning and community resources for the high-risk neonate.

Please feel free to contact me if you have any questions.

Sincerely,

Sofia Aliaga MD MPH
Assistant Professor of Pediatrics
Division of Neonatal-Perinatal Medicine
The University of North Carolina at Chapel Hill
Email: saliaga@med.unc.edu

Schedule

Daily Schedule (Monday – Friday)

  • 6:15 – 8:00am Pre-round
  • 8:00 – 8:30am NCCC Core Lecture
  • 8:30 – 9:00am Radiology rounds
  • 9:00 – 11:00am Daily work rounds
  • 12:00 – 1pm Pediatric noon conference

Weekly conferences

  • Wednesdays 12:00: Fellow’s Conference (optional)
  • Thursdays 8:00: Pediatric Grand Rounds
  • Mondays 4:00: Center for Maternal and Infant Health Prenatal Care Conference (optional)

Monthly Conferences

  • Simulated Team Training in resuscitation (STTIR) – please ask for details regarding dates
  • Delivery Room Stabilization and Video Recording (DRSAVR) – please ask for details regarding dates

Overnight Call

During your rotation, a minimum of 2 Friday nights of call should be taken. These would be overnight, in addition to the Friday day shift. You will be supervised by the night resident or nurse practitioner. You would NOT stay for rounds that Saturday morning, but would leave after signing out your patients. Identify these Friday call nights at the beginning of your rotation.

Rotation Guidelines

Your Role

You will work the intern shift Monday through Friday. When one AI is scheduled during a block, the AI will be assigned to the “Green Team” (Pods A, B and C) and be supervised by the day resident. When 2 AIs are present, someone will be assigned to the Blue Team (Pods D, E and F) and supervised by a resident and neonatal fellow. Generally the AI follows 2 to 3 patients in the NICU; this number will be individualized.

Your role will be similar to that of the intern. This includes writing admission and daily progress notes. You will assume responsibility for the daily assessment and management plan for your patients, as well as daily communication with families. You will also attend deliveries with supervision by a resident or NNP. Typically you will see your patient along with an intern and/or resident. Discuss all orders with the intern, resident and/or fellow. Write daily progress notes on your patients with signature by your intern or resident. You will be expected to follow patients, present on rounds, sign-out your patients to the on-call resident or NNP prior to leaving for the day. Check-in with your resident or fellow to review plans for your patients before you leave.

Procedures

You should do necessary procedures on your patients under the supervision of an MD or NNP. Given the fragility of NICU patients this will be subject to the judgment of the attending, fellow or resident. Be assertive about asking to do procedures and asking for supervision, but understand that on occasion this will not be possible.

Didactic Presentation

In addition to patient care activities in the NICU, you will prepare a didactic presentation, approximately 30 min in length for presentation to the team. This will generally be scheduled for the last week of your month. You may do a case presentation or choose a topic of interest. Discuss and arrange the time and date with your attending.

Evaluation

Your performance will be observed daily by the NICU attending. A mid-rotation verbal assessment should be given to each student by the attending. A final online evaluation will be completed at the end of your rotation. Please provide us with any feedback you might have about your experience.

References (available in the unit and/or on-line via UNC libraries)

  • Cloherty JP, Eichenwald EC, Stark AR (Eds). Manual of Neonatal Care. 7th Edition. Philadelphia. Lippincott, Williams, and Wilkins. 2011 (most recent edition)
  • MacDonald MG, Mullett MD, Seshia MMK (Eds). Avery’s Neonatology: Pathophysiology and Management of the Newborn. 6th Edition. Philadelphia. Lippincott, Williams, and Wilkins. 2005
  • Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 9th Edition. Philadelphia. Mosby. 2010