Originally Posted by Perrotfish
That's one of the ideas behind new work hour rules: the time to start making independent decisions should not also be the time when you've already been working for 20 hours in a row. Instead, you get to deal with those attending-less nights after a full day of sleep.
The amazing thing is that people seem to think that there is somehow more teaching involved if you are less coherent. We are spending the same number of hours in the hospital as before. The difference is that rather than squandering part of our education on exhausted nightmares of call nights and blurry post-call half days we now are fully conscious for all of the 12 hour shifts (plus sign out and wrap up work) that we participate in.
I could almost buy your argument except for the fact that in my experience you end up MORE TIRED under a night float system than with a handful of 30 hour shifts. The 30 hour shifts are finite. You get a post call day. Sometimes you even get an hour or two in the call room. On night float it's an every night thing for up to 6 nights a week for a month. You get crummy sleep during the day. You are in the hospital literally every day for a month at a time. The day team loads you up with work because you are coming in fresh, not simply staying on. You often don't even get access to a call room because in the program's view it's not a call, it's a shift. So you are more consistently incoherent under this model IMHO. Even if you are a little punchy at the end of a 30 hour shift, it was only twice a week. With night float you go through an entire month in a fog.