NICU Senior Elective:

Rotation Expectations

Welcome to the NICU!

As a resident on the NICU Senior Elective, we know you have a tremendous interest in Neonatology and we would like you to enjoy your time throughout the elective. As a member of our team, we would like you to gain as much experience as possible as a Neonatologist. To help organize your time with us, here are the Rotation Expectations for the NICU Senior Elective:

  • We start our day at 7am in the NICU at our morning Brief. This is where you will hear about the census, number of patients on ventilators, patients leaving the floor for procedures, discharges for the day, critical patients in the unit, scheduled cesarean sections and other potential deliveries for the day.
  • After the Brief, you will review all overnight x-rays with the team at the physician work station in the NICU along with the overnight team.
  • OB huddle will begin at approximately 7:45am. You will attend this with the Green Team Fellow and the Delivery Room Nurse. The huddle will provide the delivery room team with the details pertaining to the potential deliveries of the day.
  • Rounds on the Green Team will begin at approximately 8:30-9am. You will attend rounds with the Green Team Fellow as the morning permits.
  • At 11am, you will attend IHI rounds where you will participate in interdisciplinary rounds on the most critical patients and you will be exposed to quality initiatives including the importance of Alarm Limits and Respiratory Goals/CLABSI Prevention/Nutrition Goals, etc.
  • Throughout the day, you will be with the Green Team Fellow. It will be your responsibility to:
  • Attend all deliveries with the fellow and participate in the initial stabilization of the neonate and resuscitation if needed. (Remember to wear scrubs so you may attend deliveries throughout the day.)
  • Write admission notes and admission orders along with the Green Team Fellow for all NICU admissions.
  • Participate in procedures: endotracheal intubation, umbilical artery/vein catheterization, etc.
  • Inform the respective team of the admission and provide a detailed summary of the prenatal course and delivery room events.
  • During times when there are no deliveries, you and the Green Team Fellow will round with the Green Team along with the attending and NNPs. We would like you to especially participate on rounds with the most critical patients on the team.
  • Attend Prenatal Consults with the Green Team Fellow throughout the day as needed.
  • Conference is held almost daily and you will be given a conference calendar to follow throughout the rotation. During the rotation, you will be assigned to give either a noon

conference on an interesting patient, Neonatal-MFM Conference and/or lead the discussion at Patient of the Week, which is held weekly at 3:30pm on Thursdays.

  • Neonatal-MFM conference is held on the 1st and 3rd Wednesdays of the month at 3pm. This conference is where we review the antepartum course for pregnant mothers with fetuses with potentially significant pathology and/or neonates born with significant pathology. The Green Team Fellow and the MFM Fellow prepare a joint conference related to the patients. As a member of our team, you may be asked to participate in the preparation and presentation of the respective patients to be discussed.
  • During the rotation you will use the Skills Lab to refresh Neonatal Resuscitation Techniques and Procedures. In addition, you will participate in Simulation Sessions with the NICU residents and a Simulation Instructor in the Simulation Lab.
  • Sign-out begins at 4pm with both the Red Team and Green Team attendings/fellows and the On-Call Team. You will attend sign-out rounds and provide any additional information on the admissions you admitted throughout the day to the overnight team.
  • Calls will be scheduled by the chief residents along with the usual elective calls and when possible will be scheduled in the NICU.

Reading Material:

We would like you to become familiar with the Committee on the Fetus and Newborn (COFN) Guidelines for Perinatal care. The following topics are available on the Pediatric Residency Curriculum Site under the Curricular Material in the NICU section of the site:

  • Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate
  • Postnatal Corticosteroids to Prevent or Treat Bronchopulmonary Dysplasia
  • Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis
  • Phototherapy to Prevent Severe Neonatal Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
  • Postnatal Glucose Homeostasis in Late-Preterm and Term Infants
  • Neonatal Drug Withdrawal
  • Antenatal Counseling Regarding Resuscitation at an Extremely Low Gestational Age
  • "Late-Preterm" Infants: A Population at Risk

You can refer to the additional reading material available on the curriculum website including the High Impact Journal Articles located in the Fellow’s Corner. Additional reading material will be made available to you relevant to the clinical cases you will have on the unit during your rotation.

Numbers to Remember:

NICU Office (Corinne DeMeo): 444-7653

NICU: 444-2001

Fellow Office: 8-2196

Remember to have fun on the NICU Senior Elective! We are happy to have you and excited you will be rotating with us. If you have any questions or concerns, please let our team know. We are here to make this a rewarding and worthwhile experience!