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Original papers: Richard Hodgson, A. Jamal, and B. Gayathri A survey of ward round practice Psychiatr Bull 2005; 29: 171-173 [Abstract] [Full text] [PDF]

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Ward rounds-for patients or for CMHTs??!!

Savitha Puttaiah   (27 May 2005)

Our Typical Ward Round

Dr Yasir Abbasi   (27 May 2005)

Ward rounds-for patients or for CMHTs??!! 27 May 2005
Savitha Puttaiah, SHO-General Adult/CBT Send letter to journal: Re: Ward rounds-for patients or for CMHTs??!! saviputtaiah{at}yahoo.co.in Savitha Puttaiah	I am an oversea trainee well absorbed into the system.Although I have enjoyed my training, part of the system I have found hard to come to grips with is the nature of a routine ward round. 'Daunting' is the word that captures what a patient must feel when faced with a bunch of strange faces actually courtmarshalling him in a separate little (or big if you get lucky!) room. It seems rather unfair. Why should we psychiatrists break away from the golden tradition of 'bedside ward rounds'? Isn't it so valuable to see a patient in his own abode...something which could shed loads of insight into one's psyche? What about the following idea which was tried and tested back home- worked wonderfully well.On the morning of the wardround,all the new patients, completely worked up by then, are presented to the gathered team.After the presentation (which goes on for no longer than 6-7 minutes,as in a Part2 Exam),there is a session of brainstorming to arrive at a diagnosis. The SHOs get badgered by all sorts of questions-so, quite important to know your stuff! At the end of it all,the patient is ushered in to clarify points of interest.The rest of the patients are all seen bedside. This way, the SHO has a very good idea of what exactly is going on with every patient and is much more than a mere scribe. It is also a very effective way of learning. More importantly,the patient will not feel so intimidated! .
Our Typical Ward Round 27 May 2005
Dr Yasir Abbasi, SHO in Psychiatry Nottinghamshier Healthcare NHS Trust Send letter to journal: Re: Our Typical Ward Round dryiabbasi{at}gmail.com Dr Yasir Abbasi	“There should be no teaching without the patient for a text and the best teaching is often that taught by the patient” William Osler, 1849- 1919 This was a very interesting article regarding the proceedings and etiquettes of a ward round in an acute inpatient setting. I would like to agree (Foster et all, 1991) that large meetings can be intimidating to patients and addressing their concerns without compromising their care is a delicate balancing act. Our ward round really encompasses a lot of the features mentioned in this article. A patient is always seen in the ward round and if they refuse to come in and request to be seen somewhere else then it might be accommodated at the end as long as the time permits us to do so. The consultant always introduces himself and the team to the patient, if it’s a known inpatient then only the new team members are introduced as he/she would know the regular attendees by then. Before we begin the purpose is explained to the patient and then we commence with the discussion. The number of professionals attending varies and we can end up having a full house at times. Regular participants of the ward round are the Consultant, SpR, SHO, Staff Nurse, CPN and the OT. We often have medical and nursing students with us, permission is always sought from the patient and if in disagreement the students are excused for that period of time. Occasionally we have the Pharmacist coming in while only once in the past three months I have seen the Psychotherapist in the review. Most of the time we also have patient’s relatives wanting to be part of the ward round, they are always encouraged to do so but at times they are seen alone and at others with the patient. Documentation is always done by the SHO, until of course he is on his annual leave. We usually follow the format of having an appointment for every patient at a specific time (we end running late always) and the seating is as a rule pre-arranged, with the patient sitting in the most comfortable chair in the room. As time goes by our caffeine levels starts dropping and typically we take a coffee break midway through the round. While going through the ward round etiquette in this paper it made me feel as they are picturing our typical multidisciplinary team meeting which takes place every Thursday morning