How does being on call over night at various hospitals work?

[VitaminJack]

Some residency programs have a resident on-call overnight at a hospital you're not at during the day to relieve the current in-house resident who is usually on-call.

How does this work (sign-off at night and such)? Does the on-call resident have to show up at this hospital at 6 -7pm and sleep at the hospital or is there any way for him/her to sleep at home while taking on this over night on-call (which is ever 3rd day or so)? If the resident sleeps at home, how do they get info. on their patients they are unfamiliar with?

Forgive my ignorance. I am a lowly M1. 😳

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[Law2Doc]

Some residency programs have a resident on-call overnight at a hospital you're not at during the day to relieve the current in-house resident who is usually on-call.

How does this work (sign-off at night and such)? Does the on-call resident have to show up at this hospital at 6 -7pm and sleep at the hospital or is there any way for him/her to sleep at home while taking on this over night on-call (which is ever 3rd day or so)? If the resident sleeps at home, how do they get info. on their patients they are unfamiliar with?

Forgive my ignorance. I am a lowly M1. 😳

Being on call rarely involves much sleep. Expect to be at the hospital working most of the time when on call. Sleep is only for the very lucky.

 

[Doctor Bagel]

I might be reading your post wrong but that sounds like a night float situation to me where you start working at night. In that scenario, yeah, you sleep at home during the day, and then whoever was at the hospital during the day checks out their patients to you. You learn about the patients through checkout and through their records, etc..

Traditional call is usually 30 hour call where you show up at the hospital in the morning at your usual time, spend the night working and leave after everything is finished up in the morning (lots of times this means after team rounds).

 

[Winged Scapula]

Some hospitals and/or rotations do not require in house call.

Therefore, in regards to the OP's question: there is really no one way to do it. If you are required to be in house, you will come in shortly before your starting time, go over ("run") the list with the daytime resident and then stay in house covering the service(s).

If you are not required to be in house for call, then usually the day resident will call you with info about patients in-house. Sometimes they do not call and run the list with you.

Get used to covering services and patients for whom you know little about. If you have a large enough service, there is no way you are going to be able to remember or even be told all the little details. In addition, patient status changes frequently. Or you may have just gotten the dreaded, "everything's fine" sign-out.

 

[SoCuteMD]

A few different ways this could work:
1) Night float. You are off during the day, come in at night, 5-6 nights/wk to cover the service and do new admissions. You get signout from the day teams when you come in, sign the patients back out to them when they come back in the morning.

2) Coverage. You are on elective and cover overnight on the floors or in the unit. You usually cover every 4th night or maybe even only on weekends. You will spend the day on your elective and go in to the hospital somewhere between 4 and 7 pm, get signout from the day team. You will admit patients overnight and cover the old patients. You may stay to round with the team in the morning (until noon or so) and obviously have that day off from your day time rotation.

3) Home call. Probably exists somewhere - but nowhere I've ever been.

None of these situations involve much sleep for whoever is involved.

 

[Ashers]

3) Home call. Probably exists somewhere - but nowhere I've ever been.

None of these situations involve much sleep for whoever is involved.

Ortho at my school does home call. When I did my sub-I it sucked because they don't have to provide a bed for people when they're on call. When I did stay overnight helping with the ER stuff, it quieted down about 5AM, and we had to start rounding at 6:30, so the resident and I went to the library and slept on the couches and chairs. When we were in the OR all night, it was all night (and the trauma bay too), and we left the OR at like 9am to go start rounding.

When the residents spent the entire night in the hospital (OR, ER, floor stuff etc), the 30h limit applied to them. However, if they were at home for most of the night, and only their sleep was interrupted, they stayed the next day for the entire day.

 

[Winged Scapula]

Yep, our ENT, Uro, and Plastics residents took home call as did the FM residents. Nearly all fellows took home call. So its not uncommon at all.

The ones in house overnight on call were gen surg, OB, peds/PICU, SICU, Psych, Neurosurg, Anesthesia, IM, Rads and Ortho.

 

[Doctor Bagel]

The psych program at my school has home call for their inpatient months. You stay and admit patients until 9 pm and then get paged overnight as needed. If new patients come in, you call in basic orders, and then they get worked up the next day.

 

[SoCuteMD]

Yep, our ENT, Uro, and Plastics residents took home call as did the FM residents. Nearly all fellows took home call. So its not uncommon at all.

The ones in house overnight on call were gen surg, OB, peds/PICU, SICU, Psych, Neurosurg, Anesthesia, IM, Rads and Ortho.

Now that you mention it, I realize that almost all fellows (except cardiology and critical care) take home call at our hospital. There's always a resident covering plastics (it may not be the "plastics resident" though). Not sure about ENT and Uro, although I do know ophtho takes home call.

 

[Winged Scapula]

Now that you mention it, I realize that almost all fellows (except cardiology and critical care) take home call at our hospital. There's always a resident covering plastics (it may not be the "plastics resident" though). Not sure about ENT and Uro, although I do know ophtho takes home call.

Forgot about Ophtho and Derm...those guys took home call and getting them to come in was a real PITA.

Our Cards fellows were in house as were the CT Surgery; most others were home call as I recall.