New doctors (and an explaination of British medical hierachy!)

[wensday, MSN, RN, APN, NP]

It's the most frustrating thing ever. Our SpRs have just changed 2 weeks after the SHOs changed. (Specialist Peadiatric Registrars are between Senoir House Officers {we don't have House Officers in NICU} and consultants- SHOs are junior docs that make life hard for us, consultants live in offices and come round once a day to make decisions and are available if things go VERY badly, and registrars are your shop-floor decision makers and teachers to the SHOs)

So the SHOs are just finding their feet and can't do anything useful yet because they have to ask the SpR everything first. The SpR's don't trust any of us and haven't been beaten into submission as yet. By the end of the 6months the SHOs will be useful and the SpRs will jump when we ask...but then they rotate again and it all starts again with the consultant being called in from home at 3am because the baby is deteriorating in front of our eyes and the SpRs haven't noticed despite us waving the monitors and test results at them. Luckily this particular consultant is more clinical and can do femoral lines and ECHOs etc, others are professors and very clever but not clinical in any way anymore so if that's your on-call, your baby is screwed.

[ayla2004, ASN, RN]

I'm just getting used to the new titles foundation year and and Specialist Training which once i it was explained i callsed h.o/s.h.o

so its a bad time to be a patient in your unit

[SteveNNP, MSN, NP]

I guess your consultants are like our attendings, your officers are fellows, and your registrars are like residents. Sounds like they need to spread out the changeover a little. Our residents and fellows learn real quick here to listen to the nurses. The attendings make sure of that.

[ayla2004, ASN, RN]

intern = h.o 1st year docs(do medicine, surgery and emergency care rotations.

resident = s.h.o 2nd- to 4th depending on intended speciality (rotational posts)

fellow= registar supervises s.h.o specialized in on area

attending= consultant the big boss

[preemieRNkate, RN]

That's why July is a bad time to be a patient in a teaching hospital here in the states, all the new interns start!

We're going to be going through alot of changes soon. 4 out of our 6 fellows will be finishing this summer, and 2 of our attendings are leaving (one is the director of neonatalogy!). We weren't particularly fond of the director, but it's scarier to think of who they may replace her with.