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Obstetrics and Gynaecology Rundown

Rostering

The Medirota app is used for rostering. You will receive a login in your emails. The O&G relief roster covers O&G and NICU.

Sick Calls

Weekdays: call/text Chief resident, call the NRA (ext 29052), and notify your team registrar/SMO. Aim to inform team by 12pm if sick for night shift.

Afterhours: call the CNM/duty manager, leave a message with Arun, and notify the weekend on call registrar/SMO.

Daily duties

There are 5 teams (3 general teams, diabetes team, and maternal foetal medicine team). Each team has an on-call day, and Friday on call rotates between the teams.

Most teams start at 0800hrs in WAU (Women’s assessment unit), some start earlier – check with your reg. Gynae and antenatal patients are seen as a team. As a HO you will see post-natal patients. You will receive a post-natal ward round guide. Always ask for help if you are unsure or overwhelmed.

To request bloods for patients on 96/98/Tamariki ward, tuck the forms in the front of patient file and ask the nurse/midwife looking after them to kindly do them. If you cannot find them, write a message next to the room number on the whiteboard. On Gynae wards there is a phlebotomist round at 0900, leave forms in the cubby on the ward.

Handovers at 0800 and 2200 occur in the Delivery Unit meeting room. Oncoming HOs must print lists for handover.

The team of the day is on call for 24h from 0800 until 0759 the following morning. Any new admissions that arrive during those hours and are not known to another team, are admitted under the team of the day.

Patients for handback to their usual team:

  • Booked with community team (see Healthware frontpage or next to LMC)

  • Seen in team antenatal clinic (note: virtual, PBAC, preterm birth clinics do not count as handbacks)

  • Seen in team gynae clinic (within past year, same problem)

  • Previous admission under team (obs ‐ any admission; gynae ‐ within past year, same problem)

Ensure other team aware and accepting of handback.

Communication

At the start of the run, please set up two separate house officer WhatsApp group chats - one including the Chief Resident, and the other with HOs only.

There is one phone allocated to each team. Staff will use these numbers to contact you during the day shift. There are also two acute phones and pagers for the “Delivery Unit” and “WAU” acute/on-call house officers

Documentation

BadgerNet is used for obstetrics - more detail required

Results

It is important to chase swab results promptly and phone patients/dictate a letter to provide counselling and treatment as appropriate. The NZSHS website has great resources/templates to help with this if needed. Registrar/SMO will deal with smears, histology, imaging results.

Teaching

Thursday lunchtime House Officer teaching in the DU meeting room

0745-0830 CTG meeting in DU room, day varies weekly and should be on medirota

Wednesday 1200 Benign gynaecology MDM via zoom (link will be emailed)

Aspiring to Excellence Grand Round and PROMPT courses – monthly, see posters.

Clinic

Recommend reading NWH guidelines prior to first clinic.

Antenatal clinic:

  • Greenlane Clinical Centre, Level 6.

  • Half day clinic usually 0900-1200 or 1300-1600, usually 15-20 patients.

  • See patients independently and then discuss management with SMO.

  • Document your assessment on BadgerNet.

  • You do not need to routinely dictate letters in antenatal clinic.

  • Don’t forget: check blood pressure, fundal height, auscultate fetal heart.

  • If you think somebody needs a CTG, discuss with the walk-in-centre midwives down the corridor.

Gynaecology clinic:

  • Usually just registrar and SMO, but you will sometimes be rostered and are otherwise welcome to attend if available.

  • Discuss all patients with SMO.

  • Introduce yourself to the nurses when you arrive and discuss with them if you need a chaperone.

  • Dictate a “letter to GP” via Winscribe for each patient. Contact NRA/IT at beginning of run for login details.

  • See Winscribe page on HIPPO for detailed instructions.

  • The letter will appear in your “Unapproved Documents” on RCP in the next few days for you to edit and finalise.

Early Pregnancy Assessment Unit (EPAU):

  • Read the Ectopic, Miscarriage, Molar Pregnancy, TOP guidelines before first EPAU clinic.

  • HO + Nurse-led clinic at Greenlane Clinical Centre, Level 6.

  • Senior Nurse Sara Behrooze knows all and will be your greatest helper - learn as much as you can from her.

  • Occasionally, there is no HO assigned and you may be asked to help out from ANC or GOPC as able.

  • Electronic referrals - send e-Ref on discharge and put through ROERS.

  • See list above the printer in WAU for available EPAU scan slots.

  • If referring to EPAU, ensure discharge summary is complete for EPAU staff to follow up.

  • Any questions/concerns, call the WAU registrar and if unable to get through, walk around the corner to GOPC.

General Information

  • Read the National Women’s guidelines, they are very useful.

  • Other useful guidelines: RCOG, RANZCOG, SOMANZ, NZSHS, FSRH, ASID.

  • Be good to the nurses and midwives and they will make your life much easier!

  • They are a great team of very skilled staff.

  • Be sure to gain consent and offer a chaperone for all intimate examinations.

  • If you are not confident with an exam or procedure, ask a registrar/SMO to support you at first.

  • Do not put the portable speculum lights in your pocket or take them off the ward/WAU without informing the charge midwife/nurse. These disappear too often.

  • Use inclusive and respectful language to make our service safer for everyone, including trans and non-binary people for whom the healthcare system can be hard to navigate. Remember: not all women have a uterus, and not all people with a uterus are women.