POSITION DESCRIPTION/RUN DESCRIPTION POSITION TITLE: FIRST YEAR HOUSE OFFICER DEPARTMENT/SERVICE: WHANGANUI HOSPITAL REPORTS TO: HEAD OF DEPARTMENT RESIDENT MEDICAL OFFICERS SPECIALIST CONSULTANT OF ASSIGNED AREA APPROVED: Manager Date ACCEPTED: Employee Date ROLE SUMMARY This position works principally within the department or service specified above, however all employees at Whanganui District Health Board may be required to undertake duties in other areas of the organisation which promote the efficient and effective operation of Whanganui District Health Board which reasonably fall within the general parameters of this position PURPOSE OF THE Each run is of three months duration at Whanganui Hospital POSITION rotating through: Medical Services Surgical & Orthopaedic Services Paediatric Services / Obstetrics & Gynaecology Services Emergency Department DIRECT REPORTS Nil DELEGATED AUTHORITIES Financial Nil Staff Nil 1
FUNCTIONAL RELATIONSHIPS Key Contacts (internal): Nature or purpose of contact: Clinical Director/Head Professional Responsibility / Accountability of Department Delivery of strategy and advice on clinical related issues Other doctors within Facilitation of Patient Care the Hospital The multi disciplinary Referral to Specialist care health care team Clinical advice Support Services Facilitation of Patient Care Key Contacts (external): Nature or purpose of contact: Patients/clients and families/whanau To develop effective relationships in providing management of patient care External agencies Referral of patients to other health service providers REGISTRATION/SCOPE OF PRACTICE You must be able to demonstrate that you are registered with the Medical Council of New Zealand and that your scope of practice enables you to undertake the duties of this position RECOGNITION BY ROYAL COLLEGES Whanganui Hospital is recognised by: The Royal Australasian College of Surgeons for the purposes of surgical training in General Surgery (Part I); and in advanced trainee Orthopaedic Surgery The Royal Australasian College of Physicians for basic training It is also recognised in Paediatrics for the Diploma in Child Health (Otago) and the Diploma of Obstetrics & Gynecology (Otago)
Key Accountabilities (Key areas of focus) Emergency Department Ward duties KEY PERFORMANCE INDICATORS Tasks (How it is achieved) All House Officers when rostered on duty shall attend the Emergency Department at 8am to receive handover from the night House Officers and attend a supervised Emergency Department handover session, if they were on evening duty the previous day (4pm-10pm). The House Officer shall attend all ward rounds conducted by the consultant(s) in rostered hours, unless there is a medical emergency. Each patient is to be seen and examined at least on a daily basis on week days, and as clinically indicated outside of working hours / weekends. Instruction from consultants re-investigations/ treatments are to be carried out as soon as is practicable. Consultants or Registrars, where applicable, shall be notified of admissions, significant changes in patients' condition and deaths as soon as practicable. Review and action investigation results as appropriate. Key Performance Indicators (How it will be measured) 3
Acute admissions Responsible for assessment and management of general practitioner and emergency admissions, and for clerking patients of the appropriate consultant. Consultants or Registrars, where applicable, must be informed of all acute admissions to the ward and emergency monitoring unit as soon as practicable. Outpatient clinic Attendance at these clinics is recommended (if Pre-admission clinics (Surgical / Orthopaedics / O&G runs) Theatre (Surgical / Orthopaedic / O&G runs) Minor operations (Surgical / Orthopaedic runs) possible). Attendance at pre-admission clinic of assigned consultant, assessing and clerking pre-operative patients. House Officers have the responsibility for organising appropriate investigations and liaising with anaesthetic staff. Assisting in Theatre as requested by Consultant. Encouraged to attend Theatre when ward duties permit. General Surgical House Officers may assist Registrar with day case list once a week. Where minor operations are performed by the House Officer the House Officer is responsible for organising follow-up including GP letter. Documentation Clinical records must be updated as often as indicated by the patient s condition; the minimum requirement is daily during week days. Investigations, changes of treatment, including prescriptions and procedures, are to be documented in the clinical records. Discharge summaries must be completed prior to discharge. Written referrals are to contain adequate clinical information, degree of urgency and a legible signature. Specialist referrals must be discussed with the consultant or the appropriate Registrar first. 4
All documentation must be dated, with time of entry recorded, and signed by the House Officer making the entry. Medical practice Must be conducted in accordance with legislative requirements and normal professional standards. Speciality cover On rostered evenings and weekends, House Officers cover the specialty area where rostered for both admissions and inpatients. House Officers rostered on night duty will be expected to cover both the wards and the Emergency Department alternatively with the other House Officer on duty. Out of regular hours, (ie 4:00 pm to 10:00 pm, 9.30 pm to 8.30 am and weekend and statutory holidays) House Officers are expected to assist with the caseload in the Emergency Department as ward workload allows. House Officers may be expected to cover departments to which they are not attached at that point in their current run. This should be the exception rather than Health and Safety in Employment the rule. Comply with all safe work procedures, policies and instructions. Report all incidents hazards and injuries to supervisors in a timely manner. Actively participate in the ongoing development of safe workplace practices in Whanganui District Health Board. Completed the WDHB Health and Safety Orientation Course and updates Attendance at workplace safety meetings (indicated by minutes) Demonstrated by signed training records Active Involvement in, and completion of, rehabilitation programmes as required Timely, full and accurate completion of accident and hazard forms if and when required. 5
TRAINING AND DEVELOPMENT Professional development of a House Officer's skills and knowledge should occur during the run Whanganui Hospital provides the following tutorials and all House Officers must attend their departmental meetings. The other training and development sessions are available for attendance if their clinical commitments allow Monday 0800 to 0900 hours Emergency Dept / O&G RMO X-ray meeting Tuesday 0800 hours Surgical X-ray tutorial 130 hours Post graduate lecture topics published in advance Wednesday 0800 hours Orthopaedic meeting 130 hours Multidisciplinary lecture Thursday 130 hours House Officer tutorial Friday 0830 to 0930 hours Medical X-ray meeting 1130 hours Paediatric tutorial 130 hours Medical meeting alternate weeks 6
IDEAL PERSON PROFILE QUALIFICATIONS, SKILLS AND EXPERIENCE Essential Registered with the Medical Council of New Zealand Hold a current Annual Practising Certificate Have a medical indemnity insurance (which complies with New Zealand requirements) Desirable Ability to communicate fluently in English, both verbally and in writing Ability to work effectively as part of a multi-disciplinary team Sensitivity to the needs of other cultures High professional standards Commitment to professional development Reliability and flexibility PHYSICAL ATTRIBUTES Under the Human Rights Act 1993 discrimination based on disability is unlawful. Whanganui District Health Board will make all reasonable efforts to provide a safe and healthy work place for all, including persons with disability. Every effort has been made to outline requirements clearly. If a potential applicant has uncertainties about their ability to fulfill these physical requirements, enquiry should be made whether it would be possible to accommodate a particular issue by obtaining advice from Occupational Health Unit/Infection control team. Must be able to function in rapidly changing and demanding conditions when required Hearing and speech sufficient to communicate clearly with patients and co-workers, monitor patient status and equipment, recognise impending emergencies relating to patients and equipment and hear emergency alarm Ability to wear face masks and rubber gloves for protection against infectious disease. Absence of a health condition which could increase appointee's susceptibility if exposed to infections more frequently than usual Skin condition should allow frequent contact with water, soap/disinfectant soap, chemicals and latex rubber Skin should not be fissured, scaly, cracked on hands, forearms, face or neck The appointee must not have infection or colonisation with MRSA The appointee must not have a health condition that will put others at risk Manual dexterity sufficient to operate a variety of specialised equipment used within wards/departments at Whanganui Hospital as required, including syringes and intravenous pumps together with safe administration of drugs and use of clerical items including personal computers A high degree of physical capacity is required as the work is physically demanding, involving standing, walking, sitting, stretching, twisting bending and lifting/moving weights up to and above 15 kilogram s frequently. (Stature extremes may increase hazard of shared activities). A high degree of mental concentration is required 7
BEHAVIOURAL COMPETENCIES Whanganui District Health Board has a Competency Framework that describes the behavioural competency levels required for each role within the organisation. One = high level of competency required to perform this role five = low level of competency required. Level Competency Description Required Communication Time Management Responsibility/ Accountability Teamwork and Cooperation Problem Solving Customer Responsiveness Leadership Cultural Awareness All communication has a clear purpose, is well structured, uses appropriate language and grammar and conveys the information in a clear and concise manner. Asks questions and summarises key points to ensure understanding Is able to set goals and realistic timeframes to meet those goals. Understands the significance of their time management skills from an organisational perspective. Accepts responsibility for implementation and completion of a task/action. Learns from mistakes to ensure improvement in future performance. Accepts accountability for outcomes and seeks to improve future performance. Invites all members of a group to contribute to a process. Understanding and appreciative of different and opposing perspectives on an issue. Actively promotes a friendly climate, good morale and co-operation within the team. Accepts responsibility for the effectiveness of the team. Takes a logical approach to problem solving by eliminating irrelevant information and analysing relevant information to reach a workable and appropriate solution. Suggests alternative approaches based on consideration of the issues involved, in a consistently positive and constructive way. Anticipates current and future customer needs by seeking information about the underlying needs of the client, beyond those initially expressed. Regularly introduces work practices designed to improve service quality Sets a good example by providing a clear sense of purpose. Actively seeks to improve others skills and talents through coaching, training opportunities and feedback. Uses strategies to promote team morale, quality service etc, e.g., team projects, multi-skilling. Has an understanding of the Articles and Principles of Te Tiriti O Waitangi / the Treaty of Waitangi. Is aware of the Maori Model of Health Te Whare Tapa Wha. Attempts to pronounce Maori words correctly. Is aware of Kaupapa/Tikanga Maori. Demonstrates some understanding of health gains. 3 8
HOURS OF WORK All House Officers will be rostered four "Night / Weekend" duties per quarter; no more than two of these will be night duties. However, in order to fill the roster requirements, every House Officer will be required to work an extra weekend, but this will usually happen only once in any 1 months. These duties will not exceed Category C hours. Rostered basic 40 hours 0800 to 1600 hours Monday to Friday Rostered weekday evening duty 1600 to 30 hours long day Rostered weekend duty 0800 to 00 hours long day Rostered night duty 7 nights 130 to 0830 hours Unrostered hours hours per week On call requirement Approximately 1 in 7 RUN DESCRIPTION During the first two months the First Year House Officer will have no Emergency Department duties, but is encouraged to work in the Emergency Department under supervision. For the remaining four months the First Year House Officer will be rostered on these duties under the supervision of senior staff members, having fulfilled the Medical Council criteria for practise in their first six months of registration. Thereafter they will participate on the regular RMO roster having completed an orientation programme and fulfilled the Medical Council criteria as described by them for provincial / peripheral centres. 9
MEDICAL/GERIATRIC RUN DESCRIPTION The run is categorised A for the purposes of registration with the New Zealand Medical Council. PAEDIATRIC / OBSTETRICS & GYNAECOLOGY RUN DESCRIPTION Medical Staff Numbers 5 Consultant Physicians 5 House Officers 1 Geriatrician 1 Geriatric House Officer The run is recognised for the Diploma of Paediatrics and recognised for the Diploma of O&G. Paediatrics, Category A / Obstetrics & Gynaecology Category C runs for the purposes of registration with the New Zealand Medical Council. The House Officer covers both Paediatrics and Obstetrics & Gynaecology after hours, ie, evening and weekend duties. Medical Staff Numbers 4 Consultant Paediatricians Paediatric House Officers Obstetrician & Gynaecologists 1 Registrar O&G House Officers GENERAL SURGERY / ORTHOPAEDIC RUN DESCRIPTION Both Surgery and Orthopaedics are Category A runs for the purposes of registration with the New Zealand Medical Council. House Officer covers both general surgery and orthopaedics after hours, ie, evening and weekend duties. Medical Staff Numbers 4 Consultant General Surgeons General Surgical Registrars 3 General Surgical House Officers 4 Consultant Orthopaedic Surgeons 3 Orthopaedic Registrars Orthopaedic House Officers 10
EMERGENCY DEPARTMENT Emergency Department run is a Category B run for the purposes of registration with the New Zealand Medical Council. Medical Staff Numbers 1 Director Emergency Department 3 Medical Officers on Special Scale 6 House Officer to cover 7am 1pm on a rotating 6 week roster. RELIEF RUN DESCRIPTION Clinical Responsibilities The Emergency Department House Officers are rostered for duties between 0700 and 400 hours with a 30-minute lunch break to be arranged with the Head of Department or senior doctor on duty, while gathering emergency medicine experience. At a point mutually agreed by the Emergency Department Director and doctor, a component of shift work may be required. This position involves working in a variety of specialities covering Emergency Department after hours Monday to Friday, Annual Leave / Night Duty / Sick Leave, etc, to meet the needs of the hospital. The House Officer is responsible to the Consultant for whom he/she will be working for clinical practice. 11