Handoff Etiquette

[Beetles]

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I have a question about handoff etiquette.

Let's say you page the intern on-call to sign off. They call back and give you their location. You go right away but when you arrive, they're not there and instead are in a patient room doing an H&P. The patient is stable in the ED. Do you wait until they are done or do you somehow signal them out of the room?

Obviously, this happened to me. Thoughts?

 

[mercaptovizadeh]

I have a question about handoff etiquette.

Let's say you page the intern on-call to sign off. They call back and give you their location. You go right away but when you arrive, they're not there and instead are in a patient room doing an H&P. The patient is stable in the ED. Do you wait until they are done or do you somehow signal them out of the room?

Obviously, this happened to me. Thoughts?

Wait until they come back from the patient (within 30 minutes or so). If they take longer than 30 minutes, page them to let them know you are at the place you said you would handoff.

 

[Law2Doc]

In my experience you kind of just sit tight until they are ready. Unless you are in a field where you are pushing the envelope with duty hours, the issue is going to fall on deaf ears if you complain. But what goes around comes around, and eventually the shoe will be on the other foot, if you are the vengeful sort.

 

[Perrotfish]

I have a question about handoff etiquette.

Let's say you page the intern on-call to sign off. They call back and give you their location. You go right away but when you arrive, they're not there and instead are in a patient room doing an H&P. The patient is stable in the ED. Do you wait until they are done or do you somehow signal them out of the room?

Obviously, this happened to me. Thoughts?

In the short term, if they're in the room with the patient, you may send them one polite text on their cell phone ('ready for you in the call room, just FYI). After that you wait for them. You don't interrupt patient care or make a scene, it doesn't matter how long you've been waiting or how stable the patient is.

Once they leave the patient's room, the question is whether they were right to start on the H&P or whether they should have prioritized your sign out. Its alright to have a polite conversation about this with your Co-Intern. The right answer is program dependent: basically whatever most people are doing is the right answer. As a general rule the closer your program is to work hour limits (or the farther it is above them) the more residents tend to prioritize sign out, but there is no hard and fast rule and some programs prioritize patient care more than others.

 

[AdmiralChz]

Totally agree with the above, remember you are just coming onto your shift so it's on the other intern to sign out so he/she can go home. This happened sometimes to me during internship if you get the dreaded 15-minutes-to-go ED consult. Part of the job.

That being said, if this is an ongoing thing that happens often and in your opinion disrupts patient care, have an honest and open discussion with the intern and see what is going on. There may be other issues at play (lack of organization, slow typing, etc...) that could be helped with some work.

 

[FutureInternist]

We had dedicated time where the seniors handled the pagers while the interns did uninterrupted sign outs

If the intern went into patient room after they responded back then its just poor form, they could at least let you know how long they'll be so you dont have to wait on them