Anyone else favor night float over 24 hour call?

[Bluesaurus]

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24 hour call and post call stuff in them morning makes no sense to me. Why doesn't every residency switch to night float.

 

[ACSurgeon]

24 hour call and post call stuff in them morning makes no sense to me. Why doesn't every residency switch to night float.

To sum it: manpower issues.

 

[Bluesaurus]

I don't see why night float causes less hours.

 

[Rollo]

In surgical services, you would miss out on LOT of interesting cases that attendings will prefer to operate on during day time.

 

[thechad]

Usually teams only admit when they are on call, and night float is there to take care of the pts of teams who are not in the hospital. Night float doesn't admit (at least not at the hospitals I've rotated at), and why should they if the team that is going to be caring for the pt is in house? Also, night float usually only has a couple of residents on for the night, as opposed to half a team (short and long call).

 

[thechad]

Plus it would really suck to come in to like 30 new sign outs in the morning from a, "night-float," team.

 

[Smurfette]

Plus it would really suck to come in to like 30 new sign outs in the morning from a, "night-float," team.

Actually, it depends on how programs work night float as well as what specialty it is.

My program (surgery) had night float take all admissions for all surgical services at night....as chief I often would get a phone call about an hour before signout telling me about the multiple new patients on my service (ave 4-5/night, once got 12 in 12 hours....and that was just for my own service; other services got admits from float as well).

The medicine teams didn't do a night float system, although they were planning to start one soon...their call system was relatively complicated to begin with.

 

[coldweatherblue]

night float varies as to what they actually do..

when i was on medicine at county we had night float, but calls were still ~36 hours long.. night float handled floor issues overnight; our team still had to admit and round post-call.

 

[putyou2sleep]

I don't see why night float causes less hours.

Night float doesn't necessarily cause less hours that each person works, but generally creates the need for more staff in order to have full coverage of the floors. The reason, mainly, is that people don't want to do 10 weeks of night call a year, and with the size of most residencies, this would be required to fully staff nights with a senior and junior resident.

Comes down to the fundamental problem, which is that programs are using residents as a work force rather than a learning force. In the private hospital associated with my medical school, when they had to switch to night-float for interns (implementing now), it wasn't a problem because the residents really aren't *needed* so they just fit a new schedule around the new rules.

 

[USCguy]

One of the explanations I received on the interview trail from a medicine program that doesn't have night float was that night float isn't considered educational (based on NF admitting pts overnight to the team that left at 8 or 9pm) because you admit and work-up a patient but then hand them off in the morning and come back at night and do it again, but never follow a patient through their hospitalization to see how they respond to your treatment or changing your plan as necessary. If you spend 3-4 months over 3 years on NF, then over 10% of your training is "non-educational" and not a good use of your time.

I don't know, this is just what I was told. It did change my perception of NF though.

 

[45408]

24 hour call? try 28-30 hours....

24 hour call would be awesome. It'd be like an entire day off afterwards.