Interns' Guide to Rotations at VA

VA: Veterans Affairs Rotations

 

Always make sure that your VA login works a few days before you are scheduled to start!

 

Conference Schedule

VA Morning Report: Mon-Tues-Wed-Fri (just like VU except Tuesday also has CXR rounds)

Noon Conference – Mon, Wed & Friday on 7T; 12:00 – 1:00: Lunch with various lectures.

Fox and Hedgehog – Light Hall 208; Tuesdays 12:00 – 1:00; Chief Resident Conference

 

VA General Wards (1A – 6B)

  • Team: 1 Res, 2 Interns with patient cap of 8 each (16 total)
  • Pick up list 6:30 AM; Admit every other day; Can sign-out on non-admit days at 2 PM
  • Rounds alternates at 7 AM on admitting days, 8 AM on non-admitting days, meet at workrooms
    • Workroom: 
      • Teams 1-3 on 2N
      • Team 4 at 2nd floor main elevators
      • Team 5 on 3N 
      • Team 6 2nd floor off ICU hallway
  • Conferences: VA Morning Report; Noon conference, Fox; don’t forget CXR rounds on Tuesdays!
  • Review: Many admissions for falls (review Geriatrics sections), chest pain, ACS/NSTEMI, syncope (review cardiology), COPD exacerbation, Pneumonia (ID), Skin and Soft Tissue Infections (ID), diabetic foot infections.
  • Tips: Admission days can be very busy and anything you can get done on the non-admitting days will make your life easier (especially DIPNs for people leaving the next day); start your own patient list in a word document to use as your pre-rounding sheet as well as sign-out; Roll your pagers via Vanderbilt operator (same as at VU); ensure all orders on patients still in the ED are “Delayed” or they will disappear once on the floor (ask your resident); All consults must be accompanied by page to the covering fellow (see synergy for medicine subspecialties, TVHS website for surgery/other)

 

VA MICU

  • Team: 3 Res, 3 Interns, no specific patient cap (typically 10-12)
  • Day Intern: 7 AM - 9 PM; Night Intern 8 PM - 10 AM; MICU is on 2nd floor between 2N and 2G
    • Night intern presents the old patients on morning rounds
  • Excused from Conferences
  • Review: ARDS, Vent Settings, Modes of Oxygen Delivery, Sepsis, Management of Shock, MICU/CCU Drips, Basics of blood gases (Pulm) Stress Dose Steroids (Endo), Cirrhosis (Hep)
  • Tips: Night intern presents all of the old patients in the morning and signs the notes. The day intern owns the A&P of the notes by keeping them updated. Never hesitate to relay information to your resident overnight if you are concerned

 

VA Nights

  • Team: 1 Res, 2 Interns, total of 10 admissions overnight
  • Start at 7 PM, Admit until 5:30 AM, present new patients to teams at 7 AM, leave by 8 AM
  • Start on Sunday night; Off day is Saturday night for interns
  • Tips: Admissions typically bolus at the start of shift and stop later in the night, so worry about seeing patients, formulating plans with resident and putting in orders as the notes can be finished once it slows downs; the cafeteria at VU closes at 2 AM; communicate everything you do with your resident who is supervising a second intern as well; ensure all orders on patients still in the ED are “Delayed” or they will disappear once on the floor (ask your resident)