Obstetric Wards and Clinics

Description of Obstetrics Rotation
Directions to the OB Clinics
 
Guidelines for Inpatient Obstetric Rounds and Charting (sample progress notes and abbreviations)
Presentation and Progress Note Template  (pdf file)

OB Wards Description and Duties

Students will be assigned to round on either antepartum or postpartum patients.  Multiple complications encountered include: pre-eclampsia, premature rupture of membranes, 4th degree laceration, intrauterine infections, and other chronic medical problems such as diabetes and hypertension. Patients with a fetal demise are on the M.D. service and should be seen by the residents.  Patients who had uncomplicated vaginal delivery are followed by the nurse practitioners.

The L&D/Ward team will participate in rounds with faculty/fellow each weekday morning at 7:30 AM.   During these formal rounds, postpartum patients will be discussed first, followed by the antepartum patients. You will be responsible for follow-up on laboratory, imaging or other diagnostic tests, daily progress notes, discharge prescriptions and forms. See Guidelines for Inpatient Obstetric Rounds and Charting.

Guidelines for Obstetric Wards

  • Students are responsible for completing postpartum (or antepartum) notes on their patients in time for rounds with the residents. Rounds with the attending are Monday through Friday at 7:30 am. The rounding residents will determine daily what time resident rounds will start, depending on the patient volume.

  • Weekend postpartum rounds are the responsibility of the students coming on call; rounds with the residents must be complete by L&D Board Check-out time at 7 AM, so student pre-rounds will need to be completed earlier. Students should check with the rounding residents to determine when notes should be completed. There are no formal rounds with the attending on weekends.

  • During Blocks 1 and 2, students are expected to pre-round and complete a daily progress note on 2 (two) patients prior to rounds with the residents. Students who desire to see additional patients may as long as the guidelines below are followed.  During Blocks 3-6, a maximum of 4 (four) patients may be assigned to each student.

  • Patients should not be awoken for rounds prior to 5 am. If more time is need to prepare for resident rounds, a skeleton note may be written prior to actually seeing the patient at 5 am.  However, this skeleton note should not be written by the night float student who will not be seeing the patient.

  • When possible, students should round on the same patient(s) each day as it will enhance learning and be more efficient. Students should ensure that the types of patients being seen encompass the breadth of the potential post-partum problems.

  • Each day, 1 student should prepare a patient for presentation to the attending. The presentation should be concise, organized, and accurate. Click here for presentation format. Each presentation should be 2-3 minutes in length. Read and be prepared to answer questions about your patient and her medical problems.

  • Students should alternate days of presentations, so that each student has the opportunity to present to the attending 2 or 3 times.

  • Prior to the anticipated day of discharge, discharge prescriptions and forms should be completed  so that only dates and signatures are needed on the day of discharge.

  • Antepartum Student: Prior to attending rounds, the student assigned to Antepartum Rounds is also expected to pre-round and complete progress notes on 2 antepartum patients. After attending rounds, this student will round with the Attending and 3rd year resident on the antepartum patients. This student is also responsible for following-up all pending laboratory results, imaging studies, and other pending information, which can be accomplished following rounds while covering MEU.

Remember to complete “Diagnoses and Procedures” log daily at http://www.e-value.net.

OB Clinics

Students will have the opportunity to rotate through various obstetric clinics, seeing low-risk patients in the UAB Outreach Prenatal Clinics as well as high-risk patients in the OB Complications Clinic (OBCC), and Ultrasound Clinics.

The UAB Outreach prenatal clinics provide good opportunities to become proficient in routine antepartum evaluation and management, measuring fundal height, finding FHTs by doppler, and providing preventive care and patient education. This is done primarily under the supervision of certified nurse midwives and nurse practitioners.

In the OBCC, Genetics, 1st Trimester Ultrasound, and Anomalies clinics, students will learn about the management of high risk obstetric problems, prenatal diagnosis, obstetric complications, and medical complications that co-exist with pregnancy. Remember that these patients and their families are often extremely anxious due to pregnancy complications - therefore, it is best NOT to ask questions directly in front of the patient.  Please be certain to address any unanswered questions with the attending or resident between patients and after clinic.

You must document your attendance at each OB clinic. To do this, please print out the form here and fill in your name, the clinic name, date attended and signature of the preceptor (resident, faculty, nurse practitioner) for each clinic you attend. You must turn the form in to Christy Willis before the end of the clerkship to document participation in clinics.  

 

For questions concerning this web site, contact Christy Willis
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