Incoming Interns on Night Float?

[vosswater]

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Hi,
I recently found out that Im starting out intern year on the night float...I have read a little/tiny bit about this float system and understand it to be the "put out fires" type of job😱.

My question is then who typically supervises the night float intern? is it a senior resident (no upper levels are assigned to night float per se in my program's schedule) or do I talk directly with the on call attending at night for questions

Any Advice would be appreciated regarding starting on night float.

I guess Im just a bit surprised since I had mentally prepared myself to go in first on a traditional daytime floor routine, find my bearings around the hospital before starting the night floats... 😳

 

[Dr.LeoSpaceman]

Hi,
I recently found out that Im starting out intern year on the night float...I have read a little/tiny bit about this float system and understand it to be the "put out fires" type of job😱.

My question is then who typically supervises the night float intern? is it a senior resident (no upper levels are assigned to night float per se in my program's schedule) or do I talk directly with the on call attending at night for questions

Any Advice would be appreciated regarding starting on night float.

I guess Im just a bit surprised since I had mentally prepared myself to go in first on a traditional daytime floor routine, find my bearings around the hospital before starting the night floats... 😳

It's going to be program-specific. But in general, it is a "put out the fires" job. Do post-op checks, see overnight consults, and handle acute patient care issues (follow up on a late afternoon CT, overnight lab results, low urine output, pain control, hypotension, tachycardia, people who have expired diet orders, etc. etc.).

As for the structure, it can depend. Usually though you will run it by a chief/fellow who is either in-house or at home (with the new ACGME requirements for PGY-1 supervision, though, I suspect you will have a senior resident in house...whether you are actually supposed to contact them is a different story). However, I have had a few months though where you call the attending directly.

 

[Thanatos]

Hi,
I recently found out that Im starting out intern year on the night float...I have read a little/tiny bit about this float system and understand it to be the "put out fires" type of job😱.

My question is then who typically supervises the night float intern? is it a senior resident (no upper levels are assigned to night float per se in my program's schedule) or do I talk directly with the on call attending at night for questions

Any Advice would be appreciated regarding starting on night float.

I guess Im just a bit surprised since I had mentally prepared myself to go in first on a traditional daytime floor routine, find my bearings around the hospital before starting the night floats... 😳

Our night float has a senior resident in house to back you up. You are expected to run any consults past the senior, the senior then calls the attending.

Your senior residents will expect to hear from you a lot in the beginning, you will ask them lots and lots of questions and thats okay. In fact, if they don't hear from you for awhile, they will start to wonder if you're going rogue and maiming people.

Night float isn't a bad place to start. You jump right in with evaluating patients and seeing consults without having to spend all morning writing notes and filling out wound vac insurance forms and other garbage that takes up so much of intern year.

 

[ESU_MD]

Someones gonna be on night float first, why not you??

I kinda liked night float... In retrospect. My advice is to never call an attending without talking to the resident first. The first question from the attending will be " what does the resident think"

 

[VincentAdultman]

Where I did my prelim year there were 3 interns on night float...all services were divided amongst the three, and we didn't handle consults. The night float PGY3 handled that.

When I was a categorical intern (that's right) there were two night float interns. One for the floors and one for vascular/CT/ICU. We were supervised by an inhouse PGY4-5 and we were responsible for the ER/new consults.

Just goes to show how much variance there is.

 

[Jwax]

I start on night float, too, though I'm pretty excited about it (wannabe trauma surgeon here).

We've got a PGY1, 3, and 5 on nights. I think they are setting it up as the intern handles the floor pts, the 3 handles the ICU, and we all rally for the traumas/emergency surgeries.

Should be fun! Sounds like a great way to get to learn my way around the hospital with a bit more relaxed atmosphere.

 

[ZagDoc]

At our institution we were told to page/call the service chief at home for anything except for "patient decompensating." If that's the case, we have a trauma chief and a SICU fellow in-house all night.

If it's something important-that-can-become-unstable, like new onset a-fib with RVR, we were told the chain goes 1. page service chief at home 2. if chief unreachable, page another service chief at home 3. if no chiefs reachable, page attending.

When in doubt, load the boat.

 

[agranulocytosis]

Night float starter here as well. I have no idea what my duties and responsibilities will entail until tomorrow when I get oriented to my service, but I am looking forward to it. I say there's no better way to learn than through trial by fire.


I'm just hoping the cafeteria will be open at night.