NCH ENDORSEMENTS  Tuesday
o Neuro Dev Clinic – 9AM, Annex
*** 3 days before start of rotation, text Dr.
Grospe-Holgado (0916-629-0686) and when,
where and what time is your courtesy call with
her
Schedule:
 Monday-Friday:
o Pre: 7:00 AM – 5:00 PM
o Duty: 7:00 AM – 8:00 AM (next
morning)
o From: 7:00 AM – 8:00 AM
EXCEPT if there are scheduled
lectures, conferences, OPD etc.
(see activities part)
 Weekends:
o Pre: 8:00 AM – 10:00 AM
o Duty: 8:00 AM – 8:00 AM (next
morning)
o From: 7:00 AM – 8:00 AM
***YES, pati Sunday may pasok ang
PRE na 8-10 AM
***Skeletal duty: ONLY if may
government announcement na
suspended OFFICE WORK, pag
SCHOOLS lang hindi pa but you can
ask Dr. Grospe to confirm
Attendance:
 BUNDY CLOCK and LOG BOOK (go
earlier than 7AM sa first day kasi
magsulat pa ng info sa time card, just
ask the front desk pag pasok sa
entrance across Jollibee)
 7:01-7:14  Minor late (3 minor lates =
4 hours make-up)
 7:15 onwards  Major late (1 major late
= 8 hours make-up)
 You cannot make-up during NCH
rotation so be on time
Activities:
 Monday
o ADCON – 8:00 AM, Annex 6th
Floor conference room
o 2D ECHO session – 7-9 AM,
Radiology department, 1st floor
(2 per session so pagusapan
niyo na lang)
5th Floor (study autism spectrum
disorder, ADHD, red flags on
development, DSM V criteria)
o Derma OPD – 1PM, 4th floor
 Wednesday and Saturday
o Hema Procedures – 9AM, Annex
4th floor room 402 (pero pwede
umakyat yung M3 ward intern to
ask if may procedures ba and
what time), read on bone marrow
aspirations, intrathecal
methotrexate, lumbar tap, layers
na dadaanan ng needle sa back
(let’s go anes)
 Thursday
o Nephro OPD with Dr. Grospe – 1
PM, Annex 4th Floor
 Read on hematuria and
proteinuria (si doc
Grospe nagturo sa atin
so aralin yung transes,
side effects of long term
Corticosteroid
(prednisone) use
 Common cases:
Nephrotic syndrome,
Nephritic syndrome, RTA,
PSGN, RPGN, CKD,
Leptospirosis
 Friday
o ADCON – 8:00 AM, Annex 6th
Floor conference room
Requirements:
 1 Clinical Tool 3 + Professionalism: 1
resident per rotation (ER, ICU, M3
wards)
 1 Clinical Tool 3 + Professionalism: Dr.
Grospe
 Put all grading sheets and time cards in
a brown envelope and submit to Dr.
Grospe WITHIN 5 DAYS after end of
rotation
Rotations: ICU, M3 wards and ER
 M3 WARD ENDORSEMENTS
Things to bring:
 Tourniquet (handy and kasi wala talaga
sila)
 Stethoscope (preferably both adult and
pedia)
 Pen light (for make-shift vein viewer)
 A BIG JUG or BOTTLES of water!
(PRAMIS!, JINIT JACKSON ditooooo)
 Food (pantawid gutom pero note walang
ref doon)
 Optional: BP app, O2 sat (clerkies
nagdadala) masks, sterile gloves,
leukoplast, micropore (kasi meron
naman sila nyan)
Location:
 Annex 3rd floor
 Divided (informally) into four rooms:
o INFECTIOUS (pink room near
the respi unit)
o NON-INFECTIOUS (green room
across cardio-nephro room)
o DENGUE (jam-packed pink room
na may nakalagay na Pulmo
CCU label haha)
o RECOVERY / STEP DOWN
(less jam-packed green room)
Other locations:
 Respi unit - the unit you'll pass by before
M3 ward (if you’re coming from the
elevator sa Annex bldg.)
 M3 Nurse station
o Treatment room: where you'll
bring the patient if you'll insert an
IV line
o Supplies section:
 where you'll get syringes,
cotton balls, gloves,
alcohol, betadine and
other hospital stuff which
are labeled accordingly
 where you could throw
used needles, syringes,
cannulas etc (labeled
accordingly naman)
 where you could get your
IV CANNULAS! Just ask
the nurse if they IV
cannula and they'll show
you the drawer where
they keep it. (My favorite
is yellow kasi that's the
smallest gauge pero
madaling maubos *sad*)
o Comfort room
 used by residents,
interns, clerks and nurses
 relatively clean
 no tissue paper
 working flushing
mechanism but no bidet
 working faucet with liquid
soap
 mirror attached at the
door
 Nephro/Cardio ward
o contains patients admitted under
nephro and cardio ward! Haha
o across the non-infectious room
o has separate residents and
clerks assigned to this ward
 Residents table
o two tables along the hallway: one
for M3 residents and one for
Nephro/Cardio residents
o where residents put their stuff,
write in their charts, sits down,
eats, etc.
o where I put my bag :) (usually
under the table with their bags)
o where I slept na nakaupo on my
last duty :(
o has two electric fans na
nakatutok sa table ng M3
residents. You cannot turn them
off haha.
o has nearby outlet naman where
you can charge your phone.
o you can also sit there naman
with residents. Ayaw nila na
nakatayo ka sa gilid haha.
Pinapaupo nila ako.
 Clerkies table
o situated at the far end of the
room near the stairs
o contains their monitoring sheets,
databases etc.
 o they have a list of the current
patients for VS monitoring
o where clerkies spend their time
pag tapos na mag-VS
o you could hang-out here and
meet some new peeps.
Cases:
 INFECTIOUS: most cases are abscess,
cellulitis and hospital acquired infection
 NON-INFECTIOUS: weird cases like
SLE, JIA, Ichthyosis vulgaris, leukemia,
food intolerance, UTI; most are only
admitted for further work-up and
evaluation
c. DENGUE: patients with Dengue who are on
Febrile and Critical phase are admitted here;
some patients here are from ICU (what they call
ICU FLOATERS aka SQUAT “SQUATTER” for
short daw sabi ni junnel haha di ko alam kung
legit haha) here kasi overflow and no space na
doon. So sometimes there are cases of Shock
due to Dengue severe
d. RECOVERY: patients with Dengue who are
on Recovery phase are transferred here; some
patients tranferred here are not cases of
Dengue but completing their antibiotics lang
and would be discharged eventually.
Tasks:
 Most of the time, pwedeng
nakatayo/nakaupo ka lang talaga
(walang magagalit naman) pero:
 You can read the charts of the patients!
 You can volunteer for procedures like
inserting IV lines, extraction of blood
etc.!
 You can respond to codes!
 You can help the clerkies in taking VS
(but not your main duty to ah); take
referrals from them, teach them about
the case of a patient; guide them on
their journey; provide life lessons haha
 You can visit/interview/examine patients
without the residents guidance! (akalain
mo)
 You can ask/consult/discuss the
diagnosis/management of a patient with
a resident!
 You may be asked by residents or
nurses to do a certain errand like
complete a datasheet, monitor a
particular patient, do a procedure like
putting an ECG lead, etc.
Residents:
 have patients that they are "in-charge"
just like in St. Luke's.
 most of them doesn't fully know other
patients that they are not "in-charge" of
so be wary when you are referring a
patient to a random pedia resident. They
would ask you things.
 do their own rounds and write on their
patient charts starting 7AM and finishes
by 8AMish in the morning in preparation
with rounds with a consultant.
 are divided by the color they wear. Red
is third year(?), blue is second year(?)
and yellow is first year(?).
 may ask you to certain procedures
 nawawala/umaalis sila for an hour or
more. Sometimes, nag-iiwan sila ng
number sayo para if something
happens, you could call them.
Nurses:
 stationed at the nurse station (duh haha)
 most of the charts are with them.
 Mabait sila so far walang nagsungit sa
akin.
 Always calls me and the clerkies, DOC
:)
 Can be referred if the patient has fever,
if may line na yung patient etc.
 Looks for the chart if you ask them
where is the chart of a specific patient
(because usually, nasa sa kanila ang
chart)
 Duties - alam ko marami haha pero
most of the time, they write on the
nurses progress notes. Parang yun yung
pinakanatatagalan sila. They're still
willing naman to lend you the chart,
basta balik mo lang.

Clerkies
 hails from FEU-NRMF, OLFU, Manila
theological college of sciences
 Duties: vital signs q2, q1 or q30
 In duty: usually one clerk is assigned to
nephro/cardio ward and two clerks are
assigned to the rest of M3 ward.
 Refers to residents (or to you if they
trust you hihi) if something's amiss with
the patient (i.e, fever, hypotensive,
tachypneic, abdominal pain, no urine
output >6 hours, etc.)
Other friends:
a. MGA LAMOK (good thing nakatutok electric
fan sayo)
b. MGA PUSA (watch out, nangunguha ng
food)
c. MGA BANGAW (mostly yung mga pasyente
dinadapuan)
What to expect during mornings:
 magulo lang sa umaga due to rounds ng
residents
 always nice to introduce yourself to the
M3 residents doon.
 one resident told me to get breakfast
muna since matagal pa bago mag-
rounds talaga
 when the consultant arrives, start na ng
rounds. Buong bayan kasama sa rounds
including you and clerkies.
 Rounds usually start at Non-infectious,
then Dengue, then Infectious, then lastly
Recovery.
 after rounds, bahala ka na haha.
Usually, I read charts na at this time eh.
Pag may admission, I go with the clerks
during interview.
What to expect at evenings
 kasama mo is 1-2 duty residents and 1-
2 duty clerkies sa M3.
 there's also 1 duty resident and 1 duty
clerk sa cardio/nephro
 MOST OF THE TIME: nawawala yung
M3 resident kaya it would be helpful if
you get their number para kung may
mangyari, ma-message/call mo sila
agad. Lalo na pag-madaling araw.
 Pwede ka naman matulog pero doon
lang sa table haha
WHAT TO STUDY:
1. DENGUE: READ READ READ WHO
guidelines for Dengue. Naka-post na rin sa wall
yung updates regarding management sa
Dengue
2. Interesting cases sa non-infectious room.
MY EXPERIENCE:
- very life changing (char haha).
- No one would say what you should do. Mag-
kusa ka lang talaga.
- Mainit and malagkit. Di naman ganun kabaho
compared sa other wards.
- Maraming patients maraming tanong. Dito ako
nag-enjoy :)
- Maraming patients mahirap kausap. Dito ako
badtrip.
- Pa-grade ka two days before mag-rotate since
maraming resident ang nakakalimot magbalik
ng eval sheet.
- Nagtuturo ang residents so don't hesitate to
ask!
- ENJOY LANG! :)
ER ENDORSEMENTS
 7-8 AM: usually may audit. Uupo lang
kayo dun at makikinig about the
rundown of patients during the previous
tour of duty. After nun yung mini lecture
(usually residents but one of us (paul
lang haha) pinag lecture din
 After mini lecture, do ER stuff
 Paalam kayo pag maglulunch or dinner
or pag may mga ganap tayo. Di naman
sila nanonoxic
Tasks:
 Patients are divided into AMBULATORY
(green), URGENT (yellow) and
EMERGENT (blue)
 If you saw na may EMERGENT patient
 call the resident right away (but
 usually the triage nurse/resident
ipapasok na agad yan sa loob)
 Yung mga emergent diretso sila sa
residents usually so green at yellow lang
problema natin. Pero pag toxic....
hehehe impt unahin sila
 Nilalagay yung papers ng patient sa
basket labelled urgent. Unahin lahat ng
yellow bago magstart sa green. Lalo na
sa hapon yung mga green galing opd na
hindi umabot yun, so tatawagin lang sila
after 5pm. UNAHIN LAHAT NG
YELLOW BAGO GREEN (walang 1st
come 1st serve)
 Kukunin yung paper tapos tatawagin sa
labas yung patient. Interview ng Hx and
PE, fill up yung ER consultation form at
growth chart.
 Extra stuff: pag may trauma, DOI TOI
POI MOI. Pag burns, may burn sheet sa
cabinet sa likod ng pinto. Pag newborn,
kailangan ng ballards sheet. Sa big
cabinet sa may ng entrance ng ER
makikita lahat ng forms
 Bago mqg interview, height and weight
at vitals ka muna. Tapos call mo if
kailangan makita agad
resident/consultant, like pag toxic or
something, refer mo agad
 If febrile, impt pa rin last paracetamol
intake, so if due na, bigay ka na meron
naman sa ER, compute compute ng
mkd
 if DOB, tachypnic, wheezing, usually
nagpapaneb sila doc. Tayo rin
nagbibigay nun. Nasa malapit sa CR
mga nebulizers
 after interview and fill up, staple lahat ng
papers tapos ipila sa small PINK basket
ACCORDING TO NUMBER sa upper
right corner
 You can ask for procedures such as
insertions, OGT, NGT, IFC, extractions,
IV line insertions etc. pero usually may
nurses naman to do them
Must haves:
 Pulse ox
 Tape measure
 Stethoscope
Others:
May 2 CRs sa loob one for employee use only
and one for patient’s use
May locker area kung saan tayo pwede mag
iwan ng gamit
Yung isol area, katabi ng room ng lockers. wear
ppe if kailangan niyo mag interview ng px dun
WALANG SIGNAL NG WIFI AND TEXT!!!!!
HUHU (so pag may ganap daanan niyo na lang
yung nasa ER lalo kung biglaan lang like
lectures or reporting ng clerkies kasi di talaga
nakaka-receive ng text sa loob ng ER!)
ICU ENDORSEMENTS
Location: 3rd floor New building
1. You can put your belongings sa Doctors
Lounge. From the elevator turn RIGHT then
may label naman yung room
2. Then go to changing room: PERO NO
NEED TO CHANGE! Magpapatong lang kayo
ng white linen, then wear head cap + face mask
+ slippers. So saan nakukuha:
ng -White linen: pag wala nakasabit sa changing
room, labas ka muna saglit sa door across saan
ka pumasok (isa lng naman Yun! Haha) then
turn left, punta ka linen room, it’s on the table
(WHITE linen data, quasi lung GREEN is for
nurses)
-Slippers: usually meron sa changing room pero
pag wala labas ka lang ulit then look at your
right may slippers rack dun (you can bring your
own slippers NA MALINIS AH if you don’t want
to borrow)
-Face mask and Headcap: labas ka na ng
changing room then go to your LEFT then pag
lagpas ka na sa pabilog na nurses station turn
RIGHT makikita mo yung stock room sa loob
may face mask and cap
***Sa stock room rin kumukuha ng supplies for
extraction, ABG, IFC et.c
3. Kung maaga kayo pumasok tapos di pa
tapos magrounds and magsulat sa PICU unit
record yung outgoing duty resident, ask na lang
kung and pewee niyo matulong.
-PICU unit record: every morning nagsusulat -MAKE DATABASE (it’s in a labeled folder
residents dito. FRICHMOND format. Nakaipit sa inside a box on the table for the resident; BY
malaking cardboard (BLUE if PICU then PINK if AGE pa rin parang sa SLMC)
NICU); it is SEPARATE from the Steel charts -Pag kasama parent try to interview for the
-DOCTORS ORDER Sheet: usually nakaipit additional parts for the database
along with the PICU unit record; here you can -TIP: wag umalis ng 4PM Dahil visiting hours
see the updates and orders of the doctors starts at 4PM so dadating mga parents so this
(BALE PARANG PINK SHEET NATIN SA is your chance to interview the parent to
SLMC) complete the database
11. Pag may for TRANS-OUT: help the
4. Ask if may extractions ba sa umaga then resident with the DISCHARGE SUMMARY
ask if you can do it to help the resident 12. It’s better if you make your own census
5. Ask if may prescriptions pa na kailangan or notes of the important things so you’re ready
isulat whenever a consultant comes in for rounds
-1 copy unless specified by nurse 13. Bring study materials because YES
-Antibiotic: 1 drug per sheet there will be downtime and you can study
-Rest: up to 3 drugs per sheet during those times
-Even for IVF, dilutions we make Rx 14. May water dispenser sa Doctor Lounge
so you can just bring a water bottle or tumbler
6. Then mag endorsements na outgoing 15. Restroom: there are 2 restrooms inside
duty with incoming resident so sama ka and the ICU, 1 in the Doctors lounge and 1 in the
LISTEN 3rd floor
7. After, medyo downtime so ang
ginagawa ko binabasa ko and tintype ko yung
updates sa umaga from the PICU record (so ENJOY ICU!!!! :)
that I have my own notes) in preparation for the
next happening which is…
8. ROUNDS WITH CONSULTANT haha.
Usually meron sa morning then meron sa
afternoon. So accompany the resident and
consultant sa rounds. BE READY TO
ENDORSE (bring your CHEAT NOTES from
NUMBER 7 haha. ALSO BE READY TO BE
ASKED about theoreticalsssss (especially if si
Dr. CASAS siya pinakamatanong)
9. Then abang abang na lang sa muna Prepared by: August 1-15, 2019 Interns (John
labs, procedures etc. Lloyd ng Cavite, Daughter of Danny Capistrano,
10. Then monitor the patient na lang. Di Francis M and James Reid)
naman kailangan Q1 basta tingnan tingnan niyo
lang yung vitals from time to time and making
sa mga chika ng nurses kasi usually sinisigaw
nila mga abnormal things (NAKO MAY
LAGNAT PA RIN!, NAKO NAGSUKA SA
GANITO, NAKO DI PA RIN UMIIHI SI ANO,
NAKO NAGDEDESAT SI GANYAN HAHA
basta I-close niyo lang nurses tapos sabihin
niyo endorse sa inyo kung may mga stuff ba na
kailangan I-address haha)
11. Pag may ADMISSION:
-LISTEN to the endorsement
APPENDIX