The Post-Take
As an FY1, you may be rostered to cover the "post-take". For those of you new to internal medicine, this may seem a little confusing, but this is essentially the ward round of patients admitted overnight who happen to still be in the Emergency Department. The number of patients seen on this round varies depending on how busy the hospital is.
Don't worry too much about the logistics of this shift as you will be accompanied throughout by an experienced consultant, who will make it clear who they need to see.
A Day on the Post Take
08:00
Morning Handover
Weekday morning takes place at 08:00 in Medical SDEC. The post-take FY1s will then follow the post-take consultants to the Emergency Department to review patients admitted overnight who have not yet seen a consultant.
12:00
End of Ward Round
Most days, you should be able to finish the post-take round of night patients in the Emergency Department by noon. If any of your patients are moved to AMU or a downstream ward, you should hand over any outstanding jobs to the team taking them over.
13:00
Afternoon Touch Point
The Acute Medicineand General Medicine consultants will meet with the medical registrars in ED to assess the state of the take. If you've finished the jobs for the post-take, you may be asked to start clerking patients from the day take.
17:00
End of Shift for Post-Take
You should have wrapped up any and all urgent jobs from the night take by the end of your shift, but any unwell or potentially dischargeable patients should be handed over to the evening ward cover team.
Role of the Post-Take FY1
The evening consultant on-call finishes at 20:30. As a result, patients admitted between 20:00 and 08:00 are not seen by a consultant overnight. All of these patients need consultant reviews in the morning.
Ideally, all of these patients would leave the Emergency Department for either AMU or Medical SDEC, but with the volumes seen, this isn't possible for every patient. On average, at least 20 remain in the Emergency Department at 08:00.
At least two consultants are assigned to see these patients on the "post-take ward round". As the FY1 on post-take, you are expected to accompany one of the consultants for the round and then complete any jobs that arise. Your priority must be patients who are unstable and those who might be able to go home.
Often, some of your patients will move to AMU as the day goes on. You should hand these patients over to one of the AMU doctors to ensure urgent jobs are completed.
If you have questions about these patients after the round has finished, you should be able to contact the consultant either by EPIC message or by telephone. If they are unavailable, you should discuss the patients with the medical registrar based in ED.
Role of the Day 2 SHO
You will review patients who are on Day 2 of their admission, but still in ED.
You should attend Morning Handover at 08:00 in SDEC to report in.
In Winter, the Day 2 list can be long. You should prioritise patients who are unstable or potentially for discharge.
Later in the morning, one of the consultants will catch up with you to discuss these patients. If you are worried, you can find one of the post-take consultants in ED for a more urgent discussion.