VA North Texas Health Care System
Surgical/Thoracic Intensive Care
The rotation allows the resident to provide comprehensive clinical services to patients in the Surgican and Thoracic Intensive Care Units under the direction of the Pharm.D. preceptor, resident physician(s), and attending physician on the ICU service. The Thoracic Intensive Care Unit is a “closed” unit, which means the Thoracic Service manages all admissions to the TICU; however the Surgical Intensive Care Unit is an “opened” unit, which means any of the surgical subspecialties, can admit patients to the SICU. The ICU Service is a consult service which consists of an attending physician, 4 anesthesia resident physicians, 1 surgical resident, a medical student, and a clinical pharmacist. It is the responsibility of the ICU service to write all orders while the patient is in the Thoracic and Surgical ICUs.
Residents will conduct daily patient evaluations prior to rounds, participate in team rounds each morning, and attend all educational sessions held by the attending physician. Residents will meet on a daily basis with the Pharm.D. preceptor for “pharmacy rounds” each late morning following rounds (or afternoon if indicated) in either ICU to discuss the resident’s therapeutic plan for each surgical patient. The preceptor will be available to the resident throughout the learning experience for consultation and topic discussions. Residents will also be responsible for reading assignments related to a therapeutic disease state discussion, to be held two to three times weekly. Residents should be prepared enough to competently discuss the pathophysiology and drug therapy for each assigned disease state.
The responsibilities of the resident in the Surgical and Thoracic Intensive Care unit include both patient care and education. The resident will impact patient care through recommendations on the selection, implementation, and modification of drug therapy in this patient population. Residents should be able to define a therapeutic plan and desired pharmacotherapy outcome for each surgical patient. Residents are responsible for medication-related patient education for those patients discharged from their service and for providing education to medical staff, residents, students, and nurses through daily informal educational encounters and participation in structured conferences and in-services. Resident learning is accomplished through the above activities and also acceptance of personal responsibility and dedication to direct patient care and team service. Other rotational activities, such as viewing surgery or procedures, are available upon request.