Originally Posted by Thanatos
...around the late morning after rounds my attending tells me to wrap things up and then get home asap so I don't exceed hours. ...With a few sick people on my service, my sign out just might push this guy past the edge.
So instead of going home, I stuck around for a few more hours babysitting my service and putting out a few other random fires, and all was well until I ran into my attending who promptly roasted me for still being in the hospital. ...I'm not about to drop a ton of work on someone who is barely treading water...
...sometimes things have to give a little. And my program can get in trouble for this? The acgme can blow me.
As someone having dealt with the same situation for seven plus years.... I think your perspective is wrong (though it is right-on the way "old school" attendings like it).
You are not the savior, you are a trainee. If there is a "person-power" shortage, it is not your place to solve it, it is the attending's. You were instructed to leave. Go home. If you were aware of an unsafe situation, you should contact the attending/chief resident/etc.... then depart. While some might find it admirable that you CHOSE to stick around and engaged in patient care after one hour of sleep and after being instructed to go home
, it's not. It in itself raises concerns about patient safety. I have seen residents deposed and asked why they were in the hospital when they were not supposed to be.
Bottom line, the ACGME is trying to assure a safe training program with consistency and integrity. Physicians have demonstrated ~forever that they will always find a justification why someone should work more.... because "the patient comes first". Yet, in community practice without residents, seems to work...
Speak with your seniors and/or attendings if you believe the support system is innadequate for safe patient care. You would be angry if your junior residents ignored or decided to countermand your instructions because he/she knew better. As you expect from junior residents, show respect to your attending and leave when he/she instructs you to leave.