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MICU

Team Structure for MICU B

  • 4 interns and 3 residents.
  • 1 attending.
  • Interns have a 4 day overnight call cycle (long call/post call/pre-call/swing). The long call/post call shift will be 28 hrs long.
  • Day Residents alternate between long and short days
  • Night Residents work 5 nights per week (moonlighters cover 2 nights)

Team Structure for MICU C

  • 4 interns and 3 residents.
  • 1 attending.
  • Interns 1 and 2 alternate between long and short days
  • Interns 3 and 4 each cover 7 nights shifts and 3 short-help shifts over a 2 week block
  • Day Residents alternate between long and short days
  • Night Residents work 5 nights per week (moonlighters cover 2 nights)

Team Members for MICU B

Team Interns

  • Long call/post call:
    • Hours (maximum): 7a (day 1)-11a (day 2)
    • 7 am (day 1): start shift
    • 7 am – end of rounds (day 1): Preround as needed, attend rounds (not responsible for any admissions that come before or during rounds)
    • End of rounds (day 1) – 7 am (day 2): responsible for all new admissions to the unit
    • 7 – 11 am (day 2): Preround, present patients, depart *note: departure by 11 am is required, regardless of the length of rounds. Earlier departure is encouraged if possible.
  • Pre-call/swing:
    • Hours (maximum): 7a-5p
    • 7 am: start shift
    • 7 am – end of rounds: preround, rounds (admissions that come in before rounds or on rounds go preferentially to pre-call intern, though this can be altered depending on team’s preference)
    • End of rounds – departure: Help out with team tasks
    • 2 pm – 5 pm: Sign out to long call intern, depart *note: OK to sign out earlier if workload allows. Latest sign out allowed is 5 pm.

Team Residents

  • Long call:
    • 7a-8:30p
  • Short call:
    • 7a-5p
  • Night:
    • 7p-10a

Team Members for MICU C

Team Interns

  • Long call:
    • 6a-9p (15h)
  • Short call 1:
    • 6a-3p
  • Night call / Post-call (on first day of rotation “post-call” interns should be present as an additional “short” intern if they are not post-nights):
    • 7p-10a. Note: When your shift ends on a vacation day, you should leave at 7am
  • Short call 2:
    • 6a-5p

Team Residents

  • Long call:
    • 7a-8:30p
  • Short call:
    • 7a-5p
  • Night:
    • 7p-10a

Days Off

  • Interns for MICU B:
    • Day off when pre-call falls on a Friday, Saturday, Sunday, or Monday
  • Interns for MICU C:
    • 1 and 2: Day off when Short-call 1 falls on a Sunday or Monday
    • 3: Fridays
    • 4: Sundays
  • MICU B and MICU C Day Residents: Day off when Short call day falls on a Thursday or Friday
  • MICU B and MICU C Night Residents:
    • MICU B – Day off every Friday and Saturday
    • MICU C – Day off every Sunday and Monday

Supervision of Interns

  • Unit residents supervise unit interns during the day.
  • The on-call resident supervises the long call intern after the other residents leave.

Supervision of Interns

  • Day residents supervise unit interns during the day.
  • The Long Resident supervises the Day-Call Intern until 7pm
  • The Night Resident supervises the Day-Call Intern from 7pm to 9pm and the Night-Call Intern from 7pm to 7am

Admitting Structure

  • No admission cap – total census cap defined by number of available beds
  • Daily admitting
  • Sub-Is to have caps as deemed fit by supervising resident. No more than 3 admissions per sub-I per shift.

Rounding

  • Vent Rounds: 7am – 7:30am (not all attendings hold vent rounds)
  • AM Rounds: 8am – 12pm daily with whole team
  • PM Rounds: 7:00pm to 8:00pm daily as passoff between Day Resident/Night Resident in MICU B and Day Resident/Intern and Night Resident/Intern in MICU C.

Night responsibilities

  • Order routine morning CXRs (orders should be in by 11pm) – generally, all intubated or recently instrumented patients should get an AM CXR
  • Document overnight events – briefly summarize events in the handoff
  • Update hospital courses and transfer notes as time permits