Remit

Our department provides emergency and elective plastic and reconstructive surgery to patients from the Lothians, Fife and the Highlands. For some conditions we treat patients from a wider catchment area (for example, sarcoma, ear reconstruction).

We aim to provide the highest possible standard of inpatient and outpatient care and an environment that is conducive to personal learning and teamwork.

Notekeeping

Medical records are not only necessary for good and safe clinical practice, but they are also a medico-legal record. All staff must write decisions in the patients’ medical notes or on TRAK. Junior ward doctors must write daily updates in patient’s notes on the ward round and when any change in their status or management is made. Make sure that all your handwriting is legible, dated and timed, and signed with your name and grade in capitals beneath your signature.

On discharge, please ensure that each patient has an immediate discharge summary completed promptly and accurately with appropriate discharge medications including analgesia and follow-up arrangements. Patients should not be discharged on antibiotics unless absolutely necessary and clearly documented by a plastic surgery trainee or consultant. If in doubt about the discharge plans, consult with the STs or Consultants.

TRAK Handover

We have recently undertaken to use TRAK as a means to document important aspects of patient care throughout their inpatient stay. It is a shared responsibility to keep this record up to date and it is intended that is will eventually replace written notes to avoid duplication of work. The ward junior doctors must ensure that the records are updated daily. The patient list can be printed out and brought on the daily ward round to act as an aide memoir and reduce errors or omissions resulting from poor communication.

Infection control

New hospital guidelines (available on the intranet) require that staff do not wear ties and no clothing beyond the elbow when in clinic areas. Wash your hands or douse with alcohol before and after each patient. Prescribe appropriate antibiotics only when absolutely necessary and for the shortest time possible, following the attached guidelines. If in doubt, discuss with the patient’s consultant, ST and on call microbiologist. There are regular audits for your own safety and that of our patients. You are being watched!

Courtesy

It should go without saying that we expect you to treat all colleagues and patients with the utmost courtesy and respect. We are a friendly department and we wish to keep it that way. Please report concerns to any consultant.

Morbidity and mortality meetings

The department are required to hold and minute regular M&M meetings for learning and clinical governance. In order to identify patients for discussion, Red folders are located in each of our wards and in the plastics dressing clinic. If you see a complication related to surgery or any aspect of care please complete an audit form and return it to the red folder; it only takes a few seconds. These are collated and presented at each audit meeting by the trauma registrars from RHCYP and St. John's. Audit is a core responsibilities as well as an opportunity to learn from our mistakes and improve our service. It is positive thing and we aim for constructive criticism, paying particular attention to cases that could have been managed better.

Hours of work

Lothian Hospitals are committed to insuring that all medical staff work in a manner that is consistent with the European Working Time Directive (EWTD). You will be intermittently sent compliance monitoring forms to complete to insure that this policy objective is being met. It is vital that you complete and return them in a timely manner. You cannot work extra hours for your own benefit. Also, please note that any changes made to your weekly rota must be EWTD compliant at all times. Significant changes must be approved by Mark Hamilton or Mark Butterworth.

Annual leave and study leave

Your discretionary study leave and your annual leave entitlement and the mechanisms for arranging these depend on your grade. The FY1 rota is coordinated centrally at the ERI. The FY2/ST1&2 rota is organised by Mr Mark Hamilton, assistant manager of Head and Neck services. Please do not book any holidays, courses or conferences until leave has been approved. Applications must be submitted at least 6 weeks in advance. Also please ensure that the departmental rota maker knows of your leave in good time to plan the weekly rota. We are always short staffed enough without last minute absentees.

Food at SJH

The staff canteen is on the 2nd floor opposite the entrance to ward 18 & 19. It serves 3 meals a day: breakfast until 10am, lunch until 2pm, and dinner until 8pm. A sandwich bar is situated at the back of the canteen with vending machines for snacks. There is a shop and cash machine near the main entrance.