Gynaecology department

Ward rounds begin at 08:30 with a handover from the overnight registrar/tier 1 doctor and the charge nurse in the handover room at the end of the ward. The same consultant typically remains on duty for the entire week and also oversees gynaecology triage and PSC.

During the ward round, all patients are reviewed with the consultant, and notes are documented in real time. For FY/GPST/ST1 doctors, the day primarily involves completing ward tasks, conducting patient reviews, and preparing discharge letters. If there are emergency theatre cases, these provide an excellent opportunity to gain additional theater experience.

It is vital that the handover document is completed by the on call team.

The ward tier 1 doctor should hand over to the gynaecology triage tier 1 doctor at 16:30. Similarly, the registrar should hand over to the junior registrar (JR) on the labour ward at 16:30.

The Results Diary on Ward 210 must be reviewed daily. All results should be:

• Actioned promptly

• Signed off

• Documented in TRAK

• Appropriate correspondence sent to the patient and/or GP
  
  

This process is critical to prevent harm from missed or delayed result follow-up.

If you are unsure about the appropriate action, please discuss with the 1625/1616 holder or the Gynaecology Oncology team.

When chasing a result, please:

• Place a sticker with patient name and CHI in the diary

• Clearly mark the result to be chased in 48 hours

Emergency theatre cases are typically carried out in Theatre 17 on the CEPOD list.

The daytime registrar is responsible for determining whether there are any CEPOD cases scheduled for the day and should attend the CEPOD meeting in Theatre 17 at 08:15.

It is not appropriate for the night registrar to attend the CEPOD meeting.

When booking cases contact the theatre 17 phone on 07790826007 or 23241.

It is advisable to check the Theatre 1 and Theatre 12 lists for the day, as there may be opportunities to accommodate an additional case.

Ward 210 does not have dedicated phlebotomists, but some nurses and CSWs are trained in venepuncture. However, if available, the doctor carrying pager 4001 overnight is encouraged to assist with this, usually around 07:00.

Nursing staff often determine which patients require blood tests based on the ward round notes and will print the necessary labels. To facilitate this process, ensure that any required blood tests for the following day are clearly documented in the notes.

Additionally, remember to check and sign off blood results daily on Trak to prevent paper results from being issued.

Ward 210 experiences a high turnover of patients, so planning discharges in advance is especially helpful, particularly for weekends. Trainees on weekend shifts will greatly appreciate any discharges prepared ahead of time.

Be sure to review the operative notes for any specific post-operative instructions.

This is especially crucial for oncology patients, as most will be discharged with prolonged courses of LMWH.

Ward 210 often accommodates boarders from other wards, primarily medical and MOE patients. Ideally, the home team will complete the discharge letter and document a clear plan before the patient is transferred, though this is not always the case.

The junior doctor on the ward is usually responsible for assisting with discharge letters and managing minor tasks for boarders.

However, if a boarder becomes acutely unwell, it is the responsibility of the Ward 210 doctors to assess and manage the patient before coordinating with the home team.

Rooms 14 and 15 on Ward 210 are designated for inpatient terminations and do not appear on TRAK for confidentiality reasons. We are currently transitioning their records from paper-based notes to electronic documentation on TRAK.

Medications and paperwork should already be completed by Chalmers, but you may occasionally need to review or prescribe for these patients.

If unsure about anything, please consult the registrar on pager 1625.

A urinary pregnancy test should be performed for all patients upon admission, with the result clearly documented.

As with any surgical ward, if a patient may require an operation, ensure a group and save is sent, and keep the patient nil by mouth.

All patients should be provided with TEDS.

The majority of patients should be prescribed LMWH—if unsure, consult the registrar or consultant, and check the operative notes for specific instructions.

Patients admitted with pain must have appropriate regular analgesia prescribed. It is not acceptable to prescribe only PRN paracetamol and oramorph. Ensure they receive sufficient regular pain relief, along with additional PRN options as needed.

If in doubt, always check with the on-call registrar or consultant.