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PHYSICIAN ASSISTANT POST-GRADUATE RESIDENCY IN NEONATOLOGY
NICU
The PA resident will carry a patient load appropriate to his/her level of training that may vary depending on the number of patients available. The resident will be responsible (with supervision by the attending physician) for the care of all patients assigned to the resident. This includes the management of feedings, fluids and electrolytes, monitoring weight gain, ventilator management, and performance of procedures. PA residents will attend educational sessions provided by the attending physician. The usual census ranges from 30-50 patients. The provider team consists of 4-5 pediatric residents and 1-2 nurse practitioners or physician assistants. A neonatology fellow may or may not be on service. The neonatology attending physicians rotate monthly.
Upon graduation the PA resident will:
- Be able to perform the physical examination on infants of different gestational ages and demonstrate proficiency and safe handling of the neonate during the assessment
- Be able to identify the differences in physical and neurological characteristics of neonates at different gestational ages and variation in normal physical findings
- Be able to identify problems and complications unique to the preterm, term and post-term infant such as transient tachypnea of the newborn, persistent pulmonary hypertension, respiratory distress syndrome and bronchopulmonary dysplasia, neonatal sepsis, hypoglycemia, jaundice, apnea of prematurity, necrotizing enterocolitis and intraventricular hemorrhage, etc
- Be able to discuss and implement treatment strategies for the common problems encountered in the neonatal intensive care unit
- Be proficient at performing common procedures required for neonatal intensive care, including intubation, umbilical line placement, peripheral arterial line placement and lumbar puncture
- Observe how maternal history, pregnancy history, pregnancy complications and labor and delivery events, in addition to physical examination findings, are used in the assessment of newborn problems and in planning management of the patient
NICU Nursing
The PA resident will shadow a nurse in the NICU and observe the nursing care provided to the patient. The PA Resident will learn the language of NICU nursing and some of the basic skills required for the delivery of bedside medical care. The PA may participate in procedures at the discretion of the nurse preceptor.
Upon Graduation the resident will:
- Understand the language of NICU nursing.
- Become proficient at the delivery of bag-valve-mask ventilation.
- Be able provide respiratory suction assistance to a patient either independently or with assistance.
- Be able to appropriately respond to the various alarms encountered during the delivery of bedside neonatal care.
- Be able to recognize cues and characteristics of patients used by nurses to guide the delivery of bedside nursing care.
NICU Graduate Clinic
PA residents will see patients in the NICU Graduate Clinic. The clinic meets once a week and provides follow-up services and developmental testing for high risk graduates of the NICU. This includes VLBW survivors, infants discharged from the NICU on supplemental oxygen, post-iNO and post-ECMO patients, as well as other high risk infants.
Upon Graduation the resident will:
- Be familiar with the post-discharge issues faced by families of NICU graduates
- Be familiar with the long-term management of infants with special needs that result from prematurity and other disorders of the newborn infant
- Be familiar with elements of the normal physical exam of the growing infant
- Be able to identify pathologic findings in growing infants
- Be able to help families access available services for infants with special needs
- Be familiar with common developmental testing tools and be able to discuss the meaning and interpretation of developmental scores
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