Does everyone hate overnight call as much as I do?

[ReadyFreddy]

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...just wondering. The overnights themselves aren't so bad. It's the 30+ hours awake and working that leave me on edge. I about can't stand it. Help. I need some commiseration.

This isn't sane, right?

🙁

 

[Dawn1980]

Yeah, the 30+ hours awake really sucks.

Not that I would know anymore since I went into Path.

 

[CityDweller]

i assure you, you are not alone. Call f-ing sucks.

 

[microscp2]

i assure you, you are not alone. Call f-ing sucks.

woo hoooo in January I am no longer having those, since my program will convert to the new regulation hours , to have it in place before july

 

[Jeff Smoker]

Remember this...steel forged in the flames of hell can cut through anything.

 

[Dr.LeoSpaceman]

I actually like call. Well, not for the call itself, but for the post-call day. Being awake 30 hours is less tan optimal, but it's usually only the last 3-4 where I'm really struggling. If I can sneak in an hour or two of sleep, even that is generally not an issue. I find that time flies by faster than it otherwise should.

Now in the days of "no post call", I don't doubt it would have been exponentially more terrible.

 

[Ronin2258]

I actually like call. Well, not for the call itself, but for the post-call day. Being awake 30 hours is less tan optimal, but it's usually only the last 3-4 where I'm really struggling. If I can sneak in an hour or two of sleep, even that is generally not an issue. I find that time flies by faster than it otherwise should.

Now in the days of "no post call", I don't doubt it would have been exponentially more terrible.

Glad I am not the only one who liked call.

But trust me, the "no post-call day off" (got to put that last bit in. There was post-call, but that usually means being in the OR until 6pm,) was quite the suckage.

 

[Long Dong]

Yeap hate call, the only time I'll be up 30+ hours is in Las Vegas partying it up or at the Miami Winter Music Conference.

 

[Boba Q Fett]

Nothing makes you feel more alive than admitting 15 patients and handing them off alive.

 

[Doctor Bagel]

Hate it. I'm on a call free month, and it's so weird to be able to sleep normal hours every night like regular people do. We had a sleep expert meet with us at orientation, and he told us that on average it takes 2 nights of regular sleep to make up for call. So with my Q5 call schedule, there's the call night, two nights making up for that night (leaving me tired the next day), and then 2 nights where I get maybe adequate rest. With a q3 schedule, you'd never get caught up.

Also, I'm not a fan of the 24 hour part, but I can deal with that. It's the post-call rounding/finishing up stuff for those extra 6 hours that kills me. Nothing like writing notes and presenting when you're having trouble putting together a coherent sentence.

 

[peppy]

Also, I'm not a fan of the 24 hour part, but I can deal with that. It's the post-call rounding/finishing up stuff for those extra 6 hours that kills me. Nothing like writing notes and presenting when you're having trouble putting together a coherent sentence.

I definitely agree. I have been on rotations where we did 24 hours straight then left after signout. It was not that bad. But those last six hours, the patients just blend together and I've long stopped caring.
(Why, yes, I am presently post-call, and I have to write a bunch of notes!)

 

[Long Dong]

Nothing makes you feel more alive than admitting 15 patients and handing them off alive.

Nothing made me feel more alive then the other weekend when I was in vegas and took this lesbian couple back to my room for them to make a mansandwich out of me. Different strokes for different folks.

 

[JelloBrain]

I love being on call and love night shifts too. Though I am currently in a non-clinical research environment, I was (still am) one of the weird night owls.

As part of my surgical training in the UK, where we had to do 6 months of ER, and I chose to do a whole month of nights (quit ER and moved to Urology after 3 months). My longest continuous on call periods have been 57 hours in the UK and 12 days before that in India.

The way I see it is we as doctors are one of the few professions in the world that has a job important enough that we have to do it all times of the day or night. Maybe if you see it that way, you will start liking calls better.

My body doesn't seem to care about circadian rhythms, 🙂. Just writing this makes me miss call, guess I'll just work all night tonight.

 

[Ronin2258]

I love being on call and love night shifts too. Though I am currently in a non-clinical research environment, I was (still am) one of the weird night owls.

As part of my surgical training in the UK, where we had to do 6 months of ER, and I chose to do a whole month of nights (quit ER and moved to Urology after 3 months). My longest continuous on call periods have been 57 hours in the UK and 12 days before that in India.

The way I see it is we as doctors are one of the few professions in the world that has a job important enough that we have to do it all times of the day or night. Maybe if you see it that way, you will start liking calls better.

My body doesn't seem to care about circadian rhythms, 🙂. Just writing this makes me miss call, guess I'll just work all night tonight.

Good gods. I thought I was coming off as hardcore.

I know what you mean about missing call. *sigh* Soon, I hope.

 

[SouthernSurgeon]

I don't like call, but I like it a lot more than night float...

 

[Dejavu]

Not to take your thread in a different direction, (I apologize if I do) but I was 38yo when I started Med school (I was a nurse and CRNA first) and when I took residency call I was 42-46yo.

Do any of you have a personal opinion about the relative hardness of a 20yo and a 40yo surviving the rigors of call. Does it matter how old you are, with the extremes probably being obvious. I had a fellow student who was 56 when she started Med school. I don't know how she did it in residency. Lucky, as an attending, our department dictates that no one over 55 can, or has to, take overnight call. So I am off the hook now.

 

[Ronin2258]

Not to take your thread in a different direction, (I apologize if I do) but I was 38yo when I started Med school (I was a nurse and CRNA first) and when I took residency call I was 42-46yo.

Do any of you have a personal opinion about the relative hardness of a 20yo and a 40yo surviving the rigors of call. Does it matter how old you are, with the extremes probably being obvious. I had a fellow student who was 56 when she started Med school. I don't know how she did it in residency. Lucky, as an attending, our department dictates that no one over 55 can, or has to, take overnight call. So I am off the hook now.

Oh, that is some good fortune then. Probably got a lot of the younger folk green with envy

I was in my mid/upper 30s during my first residency, second oldest in the program at the time. I actually found it a bit easier on call. Doused the embers before they became fires during the night, talk to floor staff in a more...well, diplomatic fashion than some of the younger people.

 

[SoCuteMD]

I hate call. Hate. With a passion. I don't mind "easy" calls quite so much - the ones where you get to lay down for a few hours and your pager doesn't go off so much (peds). MICU call with cross-coverage or even floor call where you end up cross-covering 50+ patients = MISERABLE. The pager never stops. And after the first 24 hours, no one seems to grasp the concept that you aren't the "go to" person for all those cross-coverage patients any more. And goodness knows that whatever you do on cross-coverage will be exactly the WRONG thing - no matter how many times you pass it up the chain of command.

I will take the last call of my life some time during my next year of residency and that day can NOT come soon enough.

 

[maceo]

Now in the days of "no post call", I don't doubt it would have been exponentially more terrible.

I spent one year as an intern on call q3 with no post call day off. I loved being on call on friday or saturday. can yo ubelieve that? because I had post call days off. thats 110 overnight calls with no post call days off except for my calls on the weekend. true story.. ****ing brutal. .

 

[ReadyFreddy]

I know a lot of you had or have it worse than I do. You're right. It is brutal. It's inhumane. I hate it hate it hate it - I turn into a different person without sleep, exercise, or a social life. I can't imagine what I'd do with >100 overnights. Cry, I suppose. And a lot more of it, at least.

It does help hearing that other people struggle and suffer through the overnights or the next mornings. Thanks for helping me realize I'm sane to feel tired.

As for those people that like call: good for you. I'm glad it works for some people; it just doesn't work for me. I slept 18 hours straight after my last call, and I was still exhausted and dragging the next day. Some people recover, some people fake it, some people can tolerate caffeine more than others. I still maintain that I don't do well with sleep deprivation, and that I never will.

With all the discussion that occurs on these forums, it seems that there's often a divide between surgical vs medical call, duties and training. I can imagine that long hours on surgical call would be necessary. For my position in intern year of medicine, though, I know that my long calls don't teach me anything. I feel I am learning drastically less than I could if I were well rested. I am so disenchanted and overworked that the last thing I want to do when I get home is read about my patients. So, I go to work, do the job, and then come home and try to forget about it. (Until I sleep, that is. Then I return to the hospital in my dreams. Sigh.) Surgery needs experience in procedures. Thankfully, medicine doesn't rely on practice with procedures as much and therefore, (hopefully,) will be adequately served by shorter shifts. More rested residents make for better learning all around, I would argue. At least that's how it would work for me.

I hate being bitter, spiteful, hateful and apathetic. But that's what I become after 2 months of wards. And like I said, my call schedule isn't as bad as some, I know. I don't know how all of you go through it, but I hope if most of us make it, I can too.

Thanks.

 

[Resuscitator]

Hi, your program is violating the ACGME 2010 standards, call them immediatly:

Maximum Duty Period Length
VI.G.4.a) Duty periods of PGY-1 residents must not exceed 16 hours in
duration.
VI.G.4.b) Duty periods of PGY-2 residents and above may be scheduled to
a maximum of 24 hours of continuous duty in the hospital.
Programs must encourage residents to use alertness
management strategies in the context of patient care
responsibilities. Strategic napping, especially after 16 hours of
continuous duty and between the hours of 10:00 p.m. and 8:00
a.m., is strongly suggested.
VI.G.4.b).(1) It is essential for patient safety and resident education that
effective transitions in care occur. Residents may be
allowed to remain on-site in order to accomplish these
tasks; however, this period of time must be no longer than
an additional four hours.
VI.G.4.b).(2) Residents must not be assigned additional clinical
responsibilities after 24 hours of continuous in-house duty.
VI.G.4.b).(3) In unusual circumstances, residents, on their own initiative,
may remain beyond their scheduled period of duty to
continue to provide care to a single patient. Justifications
for such extensions of duty are limited to reasons of
required continuity for a severely ill or unstable patient,
academic importance of the events transpiring, or
humanistic attention to the needs of a patient or family.
VI.G.4.b).(3).(a) Under those circumstances, the resident must:
VI.G.4.b).(3).(a).(i) appropriately hand over the care of all other
patients to the team responsible for their
continuing care; and,
VI.G.4.b).(3).(a).(ii) document the reasons for remaining to care
for the patient in question and submit that
documentation in every circumstance to the
program director.
VI.G.4.b).(3).(b) The program director must review each submission
of additional service, and track both individual
resident and program-wide episodes of additional
duty.
VI.G.5. Minimum Time Off between Scheduled Duty Periods
VI.G.5.a) PGY-1 residents should have 10 hours, and must have eight
hours, free of duty between scheduled duty periods.​

VI.G.5.b) Intermediate-level residents [as defined by the Review Committee]
should have 10 hours free of duty, and must have eight hours
between scheduled duty periods. They must have at least 14​

hours free of duty after 24 hours of in-house duty.

 

[Samoa]

My toughest hours were 3-5am. After that, I'd usually get a second wind and feel like I could go another full day. It was weird, because I felt more alert when I was pre-rounding on a post-call morning than I did the previous morning after a full night's sleep.

I don't feel tired post call until I lie down to go to sleep, and I've never even come close to falling asleep on the way home.

 

[yohimbine1]

...just wondering. The overnights themselves aren't so bad. It's the 30+ hours awake and working that leave me on edge. I about can't stand it. Help. I need some commiseration.

This isn't sane, right?

🙁

call sucks man, everyone hates it

you shouldnt be on for over 30 hours

 

[Neuronix]

Hi, your program is violating the ACGME 2010 standards, call them immediatly

The 16/24 hour shift rules, with the rest of the updated rules, go into effect July, 2011.

 

[ReadyFreddy]

I'm awake 30+ hours, working for at least 29.75 of them. 🙁
On elective now, life is much better for the time being. 🙂
6 months down, 6 months to go. :|

 

[medicinesux]

My toughest hours were 3-5am. After that, I'd usually get a second wind and feel like I could go another full day. It was weird, because I felt more alert when I was pre-rounding on a post-call morning than I did the previous morning after a full night's sleep.

I don't feel tired post call until I lie down to go to sleep, and I've never even come close to falling asleep on the way home.

I was the same way. I believe it was the euphoria knowing your eternal shift was coming to an end.

 

[coldweatherblue]

I'm just a med student whose done inpt medicine and surg call so I know i haven't experienced it nearly as much as most.. but really for me, I'd much rather be on call than rounding. the best days on med and surg for me were taking consults in the ER. love the hospital at night, anything can happen, it's much less constricted and for students we can actually help out and LEARN (which is what we pay for)

what absolutely kills call for me and makes me feel like i'm dead inside post-call is having to round and do floor work post-call. the first 24 hours are fine, i can be chipper and coherent and deal with the craziness, but after a really busy 24 hours were you don't really sleep or eat or sit down much, having to work hard for 10 more hours just kills the call experience imo. it really is basically inhumane and to be honest my critical thinking abilities after 30+ hours are basically knee-jerk reactions based on experience and nothing more, which isn't best for patients.

 

[CardiacIntensivist]

I loved all the calls I took as a clerk. There is something about the hospital at night that is quite peaceful (until the **** hits the fan). I do wish I'd have time to shower. After a 30 hour shift, no one really wants to stand near you on the train ride home....

 

[bigDinLV]

Call isn't bad.. Pager from home, might have to go in and throw in an epidural, sometimes I might be up for a few hours for something like an ex lap, then post call days off...

Anesthesia is good!!

 

[chocomorsel]

Not to take your thread in a different direction, (I apologize if I do) but I was 38yo when I started Med school (I was a nurse and CRNA first) and when I took residency call I was 42-46yo.

Do any of you have a personal opinion about the relative hardness of a 20yo and a 40yo surviving the rigors of call. Does it matter how old you are, with the extremes probably being obvious. I had a fellow student who was 56 when she started Med school. I don't know how she did it in residency. Lucky, as an attending, our department dictates that no one over 55 can, or has to, take overnight call. So I am off the hook now.

It's not how old you are, but how much energy you have. How you feel is really what's important. We have a 49 year old man at our program and he does just fine. One of our interns is at least 40. If you can hang, then you can hang, no matter what age. There are some truly weak, lazy 20 year olds and some seriously fit and energetic 50 year olds.

 

[45408]

Most of the time I'm on call, I get at least some sleep between 2-5am (I start pre-rounding at 5 or so, and if I get calls about piddly stuff after 1-2am, I just tell them I'll deal with it in the morning). There's some stuff that I like about being on call - I get to see and do a lot more than during my usual day, and I'm not as beholden to someone above me. The free(er) reign is nice.

 

[deleted126335]

Call only gets harder as you get older. I am pushing 20 years out of residency. Didn't mind it at all in my 20s, found it annoying in my 30s, starting hating in in my 40s. Dread the thought of doing it north of late 50s.

 

[alittlestory]

how about "teaching" after night-call? during my intern year, after rounding for example- I had to sit through a horrendous lecture on respiratory phys & vent settings after being on call in the MICU-

please note- we had to sit thru this lecture knowing we still had to put our notes in!

i hate(d) call. i hate(d) my hospital.

 

[Winged Scapula]

how about "teaching" after night-call? during my intern year, after rounding for example- I had to sit through a horrendous lecture on respiratory phys & vent settings after being on call in the MICU-

please note- we had to sit thru this lecture knowing we still had to put our notes in!

i hate(d) call. i hate(d) my hospital.

Yep this was common...mandatory lectures late in the afternoon that you'd have to attend post-call. 😴

 

[Ronin2258]

how about "teaching" after night-call? during my intern year, after rounding for example- I had to sit through a horrendous lecture on respiratory phys & vent settings after being on call in the MICU-

please note- we had to sit thru this lecture knowing we still had to put our notes in!

i hate(d) call. i hate(d) my hospital.

Try lectures at 2am done by the senior on call with you when you could have an opportunity to sleep.

Yeah, the surgery program I did as a student prior to the 2003 rules was that sadistic.

I refuse to beat students that badly.

 

[45408]

Try lectures at 2am done by the senior on call with you when you could have an opportunity to sleep.

Yeah, the surgery program I did as a student prior to the 2003 rules was that sadistic.

I refuse to beat students that badly.

I had a surgery prelim July intern (failed to match into ortho) do that to me as a surgery sub-I. I wanted to slap him silly.

 

[Ronin2258]

I had a surgery prelim July intern (failed to match into ortho) do that to me as a surgery sub-I. I wanted to slap him silly.

A JULY intern pulling off that crap?!

Had it been an intern when I was a resident, I would have given him a severe dressing down, telling him to get over himself and the self-pity and not shove the anger onto sub-I/students. Call it me having issues against abusing students, but things like that trip my triggers hard. 😡

Tell me a true happy ending, and he got called out on it?

 

[45408]

No, no one called him out on it. We were on different services, and my chief was a non-confrontational type anyways. I didn't bring it up to anyone. I got sleep later that night, no worries 😉

 

[Biscuit799]

Try lectures at 2am done by the senior on call with you when you could have an opportunity to sleep.

Yeah, the surgery program I did as a student prior to the 2003 rules was that sadistic.

I refuse to beat students that badly.

We have a couple residents who do this to interns and medical students pretty regularly... I don't want them to die, I just want them not... to... live... anymore...

 

[nlax30]

As a student, thankfully I was never "abused" on call and definitely appreciated being sent to get rest if nothing was going on.

The only thing I did enjoy was that the hospital was usually a little quieter at night and I did get some procedures in without having half a dozen interns/residents in line before me.