Junior Doctor Tips - The Ward Round

Ward rounds are an essential aspect of a Junior Doctor’s responsibilities in the hospital. They provide an opportunity to assess patients, discuss their management plans, and collaborate with the wider MDT. In this blog post, we will explore valuable tips to help you excel during ward rounds, from effective preparation to maintaining professionalism and ensuring clear communication.

Preparation is Key

Try to allocate at 15 minutes of dedicated preparation time before the rounds commence. During this time, ensure you have all the necessary information at hand for each patient. Be prepared to provide the following details:

• Patient ID: Name, age, date of admission, occupation, and presenting complaint.

• Changes in condition and management since the last round, including the dates of any updates.

• Results: Recent investigations, such as blood tests or imaging reports.

• Assessment: Evaluate the patient's physical, social, and psychological well-being.

• Plan for inpatient management: Future investigations, surgical procedures, medication, and specialist team reviews.

• Discharge plan: Considerations for safe and timely discharge

It can be helpful to create a printed list of patients with the abovementioned details to distribute to Consultants and the rest of your colleagues. Double-check with the Ward Clerk, Nurse in Charge, or the hospital's online system to confirm that no patients have been moved overnight.

Interacting with Patients

During the ward round, unless the patient requests otherwise, politely ask any accompanying relatives or visitors to step outside the room while your team examines the patient. Patients often feel more comfortable sharing information in the absence of their loved ones. Consult with your SHO or Registrar to determine which investigations should be readily available if you’re not sure. If your hospital uses an electronic reporting system like sectra-PACS, you may access important scans beforehand to minimise disruptions (alternatively, print out the reports and have them on hand).

Each Consultant may have specific details they prefer to know about each patient. Seek guidance from your predecessor and diligently provide these details during the ward round. It could range from occupation to a specific blood test or travel history to tropical regions (this could really be anything). Always remember to be honest and transparent. Never claim to have done something you haven't, and avoid fabricating results to please anyone. Integrity is vital, and any inaccuracies could jeopardise patient safety. If you realise you have provided incorrect information, admit it promptly.

Maintain professionalism by refraining from arguments or conflicts with colleagues in front of patients. Such behavior is unprofessional and can undermine trust within the team. If you have concerns about any parts of the plan, then bring these up either before seeing the patient or after your team has seen them. Remeber that it’s important to present a united front when seeing patients!

Clear Management Plans and Communication

It is crucial to have a clear understanding of the management plan for each patient. Establish actionable points and, if your Consultant's instructions are unclear (which admittedly isn’t uncommon), seek clarification from your Registrar or SHO. This step is particularly important when making decisions about ceilings of care.

Divide tasks and responsibilities amongst the team so that everyone shares the workload evenly. Arrange a follow-up meeting later on in the day, often called a "Board Round," to review important results, prioritise tasks, and ensure everyone is aware of outstanding responsibilities.

As a Junior Doctor, you are expected to possess comprehensive knowledge about each patient, both medically and socially. Building rapport and maintaining effective communication with other members of the MDT is vital. Collaborate and seek guidance from Nurses, Consultants and other colleagues to ensure holistic patient care.

Conclusion

Ward rounds play a pivotal role in the daily routine of a Doctor. By adopting effective preparation strategies, interacting with patients respectfully, maintaining professionalism, and facilitating clear communication, you can optimise patient care and contribute to a well-functioning healthcare team. Embrace these tips, and you'll be well on your way to mastering ward rounds and enhancing your professional growth in the hospital setting.

by Dr Ahmed Kazie