Coliseum Medical Centers

Patient Relations Internship

Guidebook
 Table of Contents
1. After Interview Checklist
2. Orientation Guide
3. Dress Code
4. All About Lunch
5. Internship Guide
a. Grand Rounds
b. ICU vs CVICU
c. DeBriefing
d. Medical Terminology
e. Heart Patient Relations
f. Doctors
g. End of Day Tasks
h. Rounds Throughout the Day
i. Critical Care Meetings
j. Journals/Discussion Posts
k. How to Read Boards/Charts
l. Pastoral Services
m. Notebooks for Community Initiatives
n. Duties of a Patient Relations Coordinator
o. Code Blue Description and Duties

After Interview Checklist:

Background check
Go online to www.precheck.com Complete background check for students.
 Upon clearance of background check send Franchetta an email with information stating
clearance was made
Picture for Badge (after Background check cleared)
We went to the bobcat office and asked for them to take a picture for us and put it on a jump
drive! Then we emailed it to Franchetta and she will use it to get your badge made to save a trip
to Macon.
Macon Occupational Medicine Health Exam
Call Linda Morgan (478-751-2907) and make an appointment (say employee health exam for
Coliseum)
What you need to bring:
Drivers License
Social Security Card
Shot/Immunization record from local health department, previous employer or physician
Copy of your most recent TB skin test; if not older than 12 months (got mine at Wellness Center
for free and they sent the results for me to the Occupational Health Place)
You also need to have a flu shot within the year
Buy Insurance (38.00)
See Syllabus for instructions, this is required by Dr. Funke for every intern
Choose Orientation Date
First day of Internship or you can do it beforehand, the day counts towards hours and is usually
on a Monday.
I would email Franchetta and ask her for some of the days it's offered and pick one so she can
make sure you are signed up for it ahead of time.
Pick up Badge from Franchetta before Orientation (or ask her to have it at orientation for you if
you can't come before)

Orientation Guide:
Arrive 15 minutes early
Located in the classroom on bottom floor (Walk through main lobby, turn right, classroom is on
your left)
Dress warm and in layers (room was freezing and you are in there all day!)
Breakfast, snacks, lunch, and beverages (coffee, water) are provided
Talk to the main instructor about when to leave as an unpaid intern before they start that
morning, we stayed longer than needed because they did not announce we could leave
You do not have to report to your supervisor after orientation

Dress Code:
Business Casual
Comfortable shoes is the most important thing! You are standing and walking all day.
Mainly wore dress pants and tops
Some days can be colder on the floor so it may be helpful to keep a sweater in the office or your
purse just in case
Make sure to wear name tag everyday where it can clearly be seen
 We both carried Large totes as our purses and brought our computers and planners in them every
day as well (vending machine on our floor takes debit cards so we got snacks from there
sometimes when we had busy mornings)

All About Lunch:

Lunch is FREE every day. Franchetta will give you meal swipes (piece of paper) and you have
unlimited. You can also take advantage of this opportunity for breakfast if you choose to arrive
early.
Variety from Sodexo
Salad bar
Sandwiches and wraps prepared
Grill: Burger, chicken fingers, fries, mozzarella sticks, etc.
Home Cooked: usually a protein, vegetable and other side choice
Chips, candy, cookies
Bottled drinks and fountain drinks

Internship Guide:
Grand Rounds:
Each morning you will begin your day doing grand rounds at 9:00am. This is when the care team
comes together including: doctor, nurse, respiratory therapy, pharmacist, case manager, chaplain,
social worker, therapist, patient relation coordinator, patient relation interns, etc. The case
manager will print an extra chart in order for you to fill in important information on each patient.
The doctor will discuss the patient's history, the reasoning behind why the patient is in the unit,
give an update and discuss their plan of action for the next couple days. It is important to note if
the family is present so you can make it a priority to check on those members after rounds and
make sure they do not need anything. Also note medical history that stands out to you and the
main drugs the patient is currently on.
All information discussed is confidential always, keep a blank piece of paper on your clipboard
to cover the top of the chart

ICU vs. CVICU:

ICU (Intensive Care Unit) : patients in
critical care
CVICU (Cardiovascular Intensive Care Unity):
mostly patients recovering from
different heart surgeries and conditions
specifically. In some cases, available rooms
are used for overflow patients from ICU or
dialysis.
 Debriefing:
After grand rounds we go into the physical consult room located in the CVICU in order to go
over our notes and compare in order to plan the rest of the day.
This is where we meet and can discuss behind the scene matter in private and communicate our
thoughts on what happened during rounds and what needs to be changed.
This is more of an advocate perspective rather than clinical
Present is usually us with Franchetta, Chaplin and Dee (social worker)
 Medical Terminology:
Clinical coordinator: manager of the floor. In charge of ordering supplies,
scheduling, respond to codes, take patients,
give medications or anything else needed
for things to run
smoothly.
Intensi
vi

s
t
:

physician

24/7 in the unit; ICU criteria focus; has a knowledge of all parts of the organ system
Hospitalist: a dedicated in-patient physician who works exclusively in a hospital; idea of most
organ systems but usually come from a main focus
Intubate: insertion of a breathing tube through the trachea for ventilation if patient has
compromised breathing.
Extubate: Removal of intubated tubes
Fentanyl: pain medicine (not sedative) that is 100x more powerful than morphine
Propofol: sedative; milk of amnesia
Dopamine: It works by improving the pumping strength of the heart and improves blood flow to
the kidneys.
Levophed: a peripheral vasoconstrictor and an inotropic stimulator. It works by making the blood
vessels narrower, which increases blood pressure.
Pressors: is any substance that elevates arterial blood pressure
Terminal wean: wean from care of support for the patient to undergo a natural death
RASS: level of sedation score from chart insert chart
Stages of disculptis: level of ulcer formed in a patient
Purpose of Dialysis: protect or take place of kidneys (removes poison from blood)
CRRT: slow, low volume dialysis
Sepsis: infection fighting decreases, immune system in distress
children and elderly most at risk
Aspirate: A condition in which food, liquids, saliva, or vomit is breathed into the airways.
Sinus Rhythm: is any cardiac rhythm where depolarisation of the cardiac muscle begins at the
sinus node
Sinus Tachycardia:(also colloquially known as sinus tach or sinus tachy) is a sinus rhythm with
an elevated rate of impulses, defined as a rate greater than 100 beats/min (bpm) in an average
adult. The normal resting heart rate in the average adult ranges from 60100 beats/min.
 Sinus Arrhythmia: The normal increase in heart rate that occurs during inspiration
Code Sepsis: is called when a patient exhibits signs of infection along with at least one sign of
sepsis (low blood pressure, high serum lactate or evidence of organ dysfunction.)
TEE: is a test that produces pictures of your heart. TEE uses high-frequency sound waves
(ultrasound) to make detailed pictures of your heart and the arteries that lead to and from it.
COPD: a chronic inflammatory lung disease that causes obstructed airflow from the lungs
CPAP: a common treatment for obstructive sleep apnea. It includes a small machine that supplies
a constant and steady air pressure, a hose, and a mask or nose piece.
DNR/No Code: Do Not Resuscitate order applies to situations where your child has a
respiratory arrest (stops breathing) or a cardiac arrest (heart stops beating). DNR means that no
CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed.
DNI: Do Not Intubate order means that chest compressions and cardiac drugs may be used, but
no breathing tube will be placed.
Full code: means to intercede if a patient's heart stops beating or if the patient stops breathing. It
is the opposite of DNR/DNI.
Midline: the median line or median plane of the body or some part of the body.
PICC: a thin, soft, long catheter (tube) that is inserted into a vein in the arm, leg or neck. It is
used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws.
NG tube: a narrow bore tube passed into the stomach via the nose. It is used for short- or
medium-term nutritional support, and also for aspiration of stomach contents.
OG tube:Orogastric (OG) tube insertion involves the placement of a dual lumen. tube into the
stomach via the oropharynx to facilitate gastric suctioning and/or decompression
CTA: a type of medical exam that combines a CT scan with an injection of a contrast media to
produce pictures of blood vessels and tissues in a part of your body.
Finishing HD:
AMA: Against Medical Advice
Foley: a catheter that is a flexible tube that is passed through the urethra and into the bladder to
drain urine
Apnea: temporary cessation of breathing, especially during sleep.
DKA (Diabetic ketoacidosis): is a life-threatening condition that develops when cells in the body
are unable to get the sugar (glucose) they need for energy because there is not enough insulin.
When the sugar cannot get into the cells, it stays in the blood.
CHS (Chediak-Higashi syndrome): is an extremely rare form of partial albinism that's
accompanied by problems with the immune and nervous systems
Integrated Comprehensive Care (ICC): means the patient isnt being handed off from one part of
the system to the other; the patient moves to a different environment, their home, but the team
remains the same. The Integrated Care Coordinator is a key person in this model of care; they
help the patient navigate through every step of their journey, in the hospital and the community.
Planning for home care after discharge from hospital starts before the patient arrives for their
surgery.
DC: abbreviation for diphenylcyanoarsine; which means to discharge or discontinue

Heart Patient Relations:

 The cardiologists who perform the heart surgeries are Dr. Wanna and Dr. Hetzler.
After debriefing check the boards in CVICU to see if there are any heart surgeries that day. The
board will tell you what type of surgery the patient is receiving, the hour they are in surgery, the
room they will be transferred to, and the nurse that is in charge of them.
If so take note to perform needed tasks.
Tasks:
Franchetta will print off the heart surgery patients top sheet. This is a document with all the
patients information. Use this to fill our our patient tracking sheets and visiting hours sheet (for
family) given by Franchetta.
Communicate with the nurse and ask when the patient's family will be able to come back to the
unit. This is usually an hour after they have transferred he/she to the unit, allowing plenty of time
to get the patient stable. Add 15 minutes to the time the nurse has given you! We do not want to
get the families hopes up and then let them down, would rather be earlier than later.
After you have a specific time, go to the waiting room and ask for the heart patient's family.
Communicate the expected time of visit and then you will need to complete the Coliseum
Regional Cardiac Center Patient Tracking Sheet. This is where you fill in the patient's history on
his surgery (date, time, physician), the patients information (name, address, number), and their
top two family contact numbers.
A copy of the Coliseum Medical Center Family Centered Care need to be given to the family
member. This sheet tells them the patient's name and their ID number in case they want to call
and check on their family member. The ID number is the last 4 digits located on the top sheet.
This is the only way a nurse will disclose personal information about a patient so they must have
it.
After you have received all contact information, transfer the numbers to a notecard and tape it to
the nurses chart (inside front cover).
You will need to place a patient sticker, which can be located in the chart, on both the Coliseum
Regional Cardiac Center Patient Tracking Sheet and the notecard.

Doctors:
You will notice that each day you do grand rounds, there will normally be a different ICU doctor.
There are three different doctors that rotate in the unit: Dr. Wright, Dr. Farman, and Dr. Kadiyala
Doctors can change daily depending on their schedules.
You will get to know the doctors different personalities and how they like to do things so make
sure to keep that in mind each day depending of the doctor
Take note of the doctor in the unit each day at the top of your chart
Each patient can also have a personal doctor, specialist or surgeon who is not in the unit but
comes by when needed or to check on them every once in a while. This you can make note of on
the patient chart as well when doing rounds if their name is mentioned

End of Day Tasks:

File Coliseum Regional Cardiac Center Patient Tracking Sheet in the filing cabinet located in
Franchettas office. This is alphabetically organized.
 Return key to filing cabinet located in the CVICU on your way out.
Place charts from rounds in the secure shredding bins located in the ICU or CVICU. This patient
information is confidential. You can NOT take this paperwork home with you.

Rounds Throughout the Day:

During rounds each morning make sure to note the rooms with family present
After debriefing and throughout the day walk round the unit and visit the rooms with family to
see if they need anything
Make sure to introduce yourself by giving your name and title (patient relations), ask if there is
anything you can do for them or if they need anything such as a drink
If they say yes: find their nurse if it is something clinical they need, go to the room where drinks
and snacks are located if they want that, or listen if they just need someone to talk to.
Also mention our pastoral services if they need and make sure to let them know
Take note the time on your chart or sheet of paper every time you visit a family or make rounds,
it helps keep track of how often the families are taken checked on

Critical Care Meetings:

Held on the last Thursday of every month with most of the administrative team members
throughout the hospital.
There will be a handout with summaries of statistics for the past month in the hospital.
The director of the meeting will pull up a website that shows all the percentages in different areas
and discuss what is being done well and what needs to be improved.
They usually don't last too long and are productive for planning and discussing new plans and
changed that need to be made.

Journal and Discussion Posts:

Dr. Funke will have a journal post that will be scheduled for submission every Monday by noon.
There will also be a discussion post due on Monday at noon majority of the time.
When completing this you can do this one of two ways. You can write about what each day
consisted of our you can wait till the end of the week and write a summary of the whole week.
She requires the journals to be at least one page long every week.
Points will be deducted if these assignments are turned in past noon.

How to Read the Boards and Charts:

ICU Board: This board is located on the wall in the middle of the desks, directly across ICU Bed
4. This is a white board and it contains information on who the intensivist is for that specific day
and which rooms each nurse is in charge of. If the number has a circle around it, that signals that
the patient is going to the floor. For the patients that have orders to the floor, they will be skipped
during rounds and will not be reported on.
CVICU Board: This chart is located on the back wall across from bed 5. This chart contains
information such as the bed number, patient's name, the procedure they had, and the doctor. In
the bottom right hand corner the heart surgery patients that are scheduled for that day will be
 listed. It will tell you the initials of the patient, which doctor is doing what procedure, and the
time that the surgery is taking place.

Pastoral Services:
Pastor Sandra Pastor Keith Pastor Cynthian

The

Pastors will hold a Devotion around noon on specific days in the Chapel on the first floor. This
will be announced on the speaker throughout the hospital.
The pastoral service is very well organized and utilized here in the unit and rest of the Hospital
Most everyday there is a Chaplin here during rounds, they too take notes on the charts and help
talk to families of patients in the units
 Notebooks for Community Initiatives:
We usually create two notebooks for the community initiative project, one for Franchetta and one
for Dr. Funke.
Notebooks include clear protective sheets with all the papers, flyers, and brochures created
throughout the project.
We took several pictures the day of the event and made them into a PowerPoint to also print and
include in the notebook.

Duties of a patient relations coordinator:

1. Orient family members to the intensive care unit:
a. Give family members visitation sheet explaining intensive care unit guidelines.
b. Obtain contact phone numbers of patients family and place on the chart.
c. Familiarize families with the intensive care unit and the intensive care waiting area.
2. Update family members in both the intensive care unit waiting room and the Cath lab waiting
area, of patients condition.
3. Answer phone calls within and outside the hospital concerning intensive care unit patients.
4. Remove visitors from patients rooms during critical emergencies.
5. Notify family members when patient codes. (see attachment)
6. Contact family members, i.e. codes, deaths, upon physicians and nurses request. Utilizing
appropriate crisis intervention/ bereavement facilitation skills.
7. When necessary explain and initiate no visitor policy.
8. Make necessary phone calls for patients/families.
9. When deemed necessary assist with visitor control in the intensive care area.
10. Escort/direct family members to floors, intensive care unit, intensive care unit waiting area,
Admitting office, Cath lab waiting area, and Emergency Room.
 11. Respond to patient/family concerns. Document, and follow up with the patient and family.
Make appropriate referral if needed, i.e. Quality Resource Management, Business Office,
Security.
12. Responsible for preoperative teaching of cardiovascular patients and their families during
preoperative orientation.
13. Communicate patients condition to family i.e., vital signs, patient stability, level of
consciousness and/or orientation, to family members.
14. Escort family members of surgery patients to the intensive care unit for the initial visit.
15. Initiate and receive calls from operating room, recovery room, and Cath lab, in order to
communicate necessary patient information to family members.
16. Responsible for in-depth orientation of cardiovascular surgery families. Orientation of the
family includes:
a. Informing the family about the phone calls they will receive from surgery.
b. Give family an estimate time frame when the physician will be able to talk with the family
after surgery.
c. Explanation of patients general appearance after surgery.
d. Review, orientation checklist, visitation guidelines and other unit rules and policies.
e. Obtain phone numbers on each immediate family member to place on patients chart.
f. Receive and initiate information on patients status during surgery from circulating nurse or
physician to relay to family.
g. After surgery place family in a consultation area for the physician.
h. Remain with the family during postoperative consult with the physician
i. After the arrival of the patient to the unit, check with the patients primary nurse for an
estimated visiting time.
j. When the nurse is ready for the family to visit, escort the family back to the unit. Remain with
the family while the nurse gives an overview of the patients status.
k. After the family visits the patient, review the Coliseum Cardiac Centers Patient Advocacy
Program, assist with making long distance phone calls, and also with lodging accommodations if
necessary.
l. Give family members instructions on how to contact the Patient Relations Coordinator.
17. Maintains documentation of all contact and activities during the work shift.
18. Serves as a liaison for families dealing with dysfunctional/conflictual issues that concern the
patient in the unit. Report these problematic issues to the appropriate manager of department.
19. Responsible for postop visits and phone calls for cardiovascular surgery patients.
20. Assists medical personnel with non-medical tasks and activities needed to provide
appropriate patient care.
21. Responsible for assisting healthcare customers with questions, directions, and locating other
medical staff.
22. Performs other job-related duties as assigned by the department manager. Responsible for
establishing patient representation standards house-wide.
23. Primary areas of responsibility:
a. Cardiovascular intensive care unit
b. Intensive care unit
c. 5 East
 d. Cath lab
e. Cardiovascular surgery waiting area
f. Intensive care waiting area
g. Cath lab waiting area

CODE BLUE Duties:

When a code blue is called, be prepared to go to the room they announce
Look to see if a family member is around and escort them out of the way for the care team to be
able to do their job
If you don't see a family member try and ask someone who was already in the department if they
know if family members are in the hospital and where they would be
Also find the chart of the patient and call any contact numbers listed to call the family to let them
know of the situation as best as possible
Let them know you can meet them downstairs if they are coming to the hospital or if they are
already in the hospital you go to them.
If you can get a nurse that was involved or knew what was going on it's nice to bring them along
to answer any medical questions they might have
If the patient is going to ICU bring them visiting hours sheet with the patient ID already and you
can show them the waiting room for them to wait in until they can go see their loved one
Make sure once the patient is in the unit to let the nurse taking care of them knows the family is
waiting for an update in the waiting room