LBJ Physician Assistant and Nurse Practitioner Emergency Medicine Rotation

Welcome to your Emergency Medicine Rotation at Lyndon Baines Johnson Hospital. We’re looking forward to working with you and want you to have a great experience here. Below you will find some general information concerning your rotation as well as how scheduling works.

Where is LBJ?

LBJ Hospital is located at 5656 Kelley St, Houston, TX 77026. You can park at entrance 6 on Kelley St, just before you reach the hospital on your right. Please do not park in the Employee Lot F as parking is limited for full-time staff. The Emergency Department is at the East end of the hospital facing Kelley Street.

When you enter the Emergency Department, ask to be directed to the appropriate “Pod” where you will meet your preceptor. There is a physician work area in each Pod where the providers congregate. On your first shift you may want to arrive a few minutes early to orient yourself to the hospital. You can access the hospital website directly for more detailed information regarding the facility.

How will my schedule look?

Your schedule at LBJ will somewhat mimic that of a practicing APP in a busy community ED. Expect to work hard and have long shifts. Your shifts in the Emergency Department will be comprised of days, nights and weekends. Most shifts are 12 hours and start at 6:00 (a.m. or p.m.). If a “D” or “N” follows your shift, it denotes “Day” or “Night.” There are some “mid-shifts” and sometimes an eight-hour shift as well. Those will be specifically labeled on your schedule. The name of your preceptor will follow the shift. You will be working with a few different preceptors during your stay but usually with the same one per shift. You may have shifts where you work with two different preceptors if the shifts overlap. You will receive your schedule at least a week before your start date with any last-minute updated information regarding the rotation.

Regarding your schedule, sometimes things change (preceptors change shifts, you/they may become ill) and you may be asked to switch some days around to give you the best experience. We will work together to make up shifts for a smooth rotation. The emergency department (ED) is a fluid environment, and we’re all required to be flexible.

In some circumstances the schedule can be manipulated in the event you have predetermined obligations during your rotation (i.e., professional conferences, presentations or program-granted time away); however, we need to know about these in advance to adjust your schedule accordingly. Please contact me directly or have your Clinical Coordinator inform me in advance if there may be a scheduling conflict. Once your schedule is complete, it becomes difficult to change it due to the high volume of rotating students and limited preceptor availability.

How do I get my badge and parking access?

During your first shift you will receive your badge and parking permit ($10). In order to expedite your registration, badge and parking, please fill out all the documents required by Medical Staff Services and email it back to them at least one week prior to your rotation start date. You can email the documents (Harris Health Trainees Registration Packet June 2017 and Request for Medical Exemption For Influenza Vaccination to Medical Staff Services. Harris Health requires that you provide proof of your influenza vaccination at the start of your rotation or the hospital will not allow you to begin until you have received.

How do I get Epic access?

Once you have your badge and ID information, you can call the IT Helpdesk at 713-566-4357 to obtain network access for the EPIC system. You can also call the testing center that first day to schedule your exam time. You can access the attached documents which outline the steps for EPIC training for both PA and NP students. Testing is on Thursdays, and I have worked the testing into your schedule for that week (for PA students). It is very important that you test that first week to have access during your rotation.

Students are required to complete the following course curriculum for Physician Assistant:

  • Epic 2014 Ambulatory Provider Training (All Provider Roles).
  • Epic 2014 Inpatient Provider Training (Students).
  • Epic 2014 Emergency Center Provider Training (Students).

Students are required to complete the following course curriculum for Nurse Practitioner:

  • Epic 2014 Emergency Center Provider Training (Students)

Reference Guide for course

Testing

  • Once you’ve completed the required training based on your role and service area(s), you will need to test at the Epic Training Center at 9250 Kirby.
  • Provider Competency Exams are typically offered on a walk-in basis Mondays from 8:00 a.m. through 3:30 p.m. and Thursdays from 8:00 a.m. through 1:00 p.m. Appointments are not necessary* but if you know when you will be coming in, kindly respond in email your the date and time.
    *Please schedule a testing day and time with IT-Education during the month of June due to Baylor and UT House staff Influx.
  • PA Students will be tested on the Ambulatory, Inpatient and EC environments in Epic. Please allot 60 minutes for each exam (3 hour total testing time).
  • EC NP Students will be tested on the EC environment in Epic. Please allot 60 minutes for the exam (1 hour total testing time).
  • Please plan accordingly. If you do not complete the required training modules prior to arriving for your exam, you will be asked to return at a later date.
  • After successful completion of your test, the test proctor will grant your access before you leave the testing room.
  • Questions regarding related topics may be directed to IT Education Operations at extension 713-634-1590 between 7:00 a.m. and 5:00 p.m. Monday through Friday.
  • Please be sure to bring your Harris Health badge.

Why do I need Epic access?

Having access to Epic allows you to gather information on your patients including past clinic or ED visits, imaging, labs and procedures. You can also see their current vital signs, lab and imaging results as well as medications. You will not be charting electronically on the patients, but Epic is a window into their care otherwise not attainable to you. Being able to review their chart allows you to have a better understanding of individual patient care. The training is intended to give you access to this information however you will learn the nuts and bolts of how to navigate Epic when on rotation. Your preceptor will be able to assist you in familiarizing yourself with what you need to know on Epic.

What do I need to do to prepare before or during my rotation?

There is no specific preparation for this rotation. You can throw a dart at any organ system or disease process and likely run into them on a daily basis during rotation. Any reading you do will benefit you. Big subjects are abdominal pain, chest pain, electrolyte imbalances and neurologic emergencies just to name a few.

During downtime there are resources to read about active cases, discuss topics with your preceptor and to hone procedural and exam skills. I encourage reading about cases you see and discussing treatment plans with your preceptor to better identify and treat similarly presenting patients in the future. We want you to learn and have a hands-on experience to make you a better clinician. I also encourage you to contact students that have completed this rotation as they may give pointers on resources they found useful or other pearls to help strengthen your time here.

I’ve provided an LBJ Emergency Medicine Procedure Log Sheet which can be printed and used to keep track of what you’ve done and what you need a chance to perform. These procedure logs are for you to keep for future reference. If you have another way of tracking your procedures, please do so; these are solely for your benefit if you need them.

Who fills out my evaluations?

For your evaluations, I suggest you choose the preceptor(s) you have worked with the most. It is always wise to ask them early in the rotation if they are willing to fill out your evaluation and do not wait until your last shift to have this done. We cannot be responsible for scrambling to fill out an evaluation that was due yesterday.

Do I have to fill out an evaluation for LBJ?

I have created LBJ-Emergency-Medicine-Rotation-Evaluation for you to fill out to tell us how we’re doing. These are not mandatory but give you a candid platform to tell us what you enjoyed or didn’t enjoy about the rotation. These are important for us to ensure you and future students are having a good experience here. Please turn them in at the end of the rotation. You can fill them out for specific preceptors and/or the rotation in general. We are always striving to make this a better rotation site and evaluations are a great way to do so. You can always contact me to discuss things that are working or not working. I’m happy to hear from you and work with you to improve your experience here.

Who do I get in touch with if I have an unexpected emergency?

Below are some contact numbers for the ED in the event you need to contact someone regarding a delay in arrival, emergency absence or other concern:

Blue Pod: 713-566-5635
Gold Pod: 713-566-9468
Orange Pod: 713-566-5899

If you have any questions, feel free to contact me at the information below. In my absence, you can email Anne Ervine or Liz Curtis for any questions regarding your rotation.

This emergency department is a busy and educational environment, and we want you to enjoy your rotation here. It is our goal for you to have a safe and memorable experience and anticipate that you can identify and treat common emergent medical conditions when you begin your career as a PA/NP! We look forward to working with you!

Janice Lee, ENP
Assistant Director of Advanced Practice Providers
LBJ Hospital Emergency Department
McGovern Medical School
Part of UTHealth | The University of Texas Health Science Center at Houston
Department of Emergency Medicine
6431 Fannin Street, 2nd Floor JJL
Houston, Texas 77030