Is it allowed by ACGME regulations to call residents during their time off?

[alternatego]

For example, what does ACGME says about IM residents/interns getting phone calls during the evening/night time from other residents about patients they take care of during the day?

I am just about to transition to PGY2 and would like to avoid screwing up by calling someone if its not allowed.

Thanks for your replies.

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[Raryn]

For example, what does ACGME says about IM residents/interns getting phone calls during the evening/night time from other residents about patients they take care of during the day?

I am just about to transition to PGY2 and would like to avoid screwing up by calling someone if its not allowed.

Thanks for your replies.

If you're formally on "home call", only the time actively working (i.e. on the phone) counts towards duty hours.

If it's an informal thing and you're just asking your colleague for some insight on one of their patients... the ACGME and program administration have better things to do than to harass you about doing whats necessary for patient care.

 

[Dog_luver]

For example, what does ACGME says about IM residents/interns getting phone calls during the evening/night time from other residents about patients they take care of during the day?

I am just about to transition to PGY2 and would like to avoid screwing up by calling someone if its not allowed.

Thanks for your replies.

Depends what you mean. If your senior is on call sure give them a call. If it's some random resident depends - I have occasionally been called by colleagues for complicated patients when not on call and since I was more familiar w the patient I have given suggestions and guidance. So if that's what you are asking I guess it depends how nice or amenable your fellow residents are to helping you out during their off time. I think it's fine to be helpful even if you are off if it does not terribly trouble someone. I don't think there is any ACGME info on this. However I would not make a habit of calling colleagues who are off, generally call those on call. When I'm officially on vacation I don't answer any hospital related question nor do I return texts, pages or emails.

 

[rokshana]

Depends what you mean. If your senior is on call sure give them a call. If it's some random resident depends - I have occasionally been called by colleagues for complicated patients when not on call and since I was more familiar w the patient I have given suggestions and guidance. So if that's what you are asking I guess it depends how nice or amenable your fellow residents are to helping you out during their off time. I think it's fine to be helpful even if you are off if it does not terribly trouble someone. I don't think there is any ACGME info on this. However I would not make a habit of calling colleagues who are off, generally call those on call. When I'm officially on vacation I don't answer any hospital related question nor do I return texts, pages or emails.

that email thing could get you in trouble...we were told to check our email at least once a day...there can be non patient related but program related issues that may need to be addressed.

 

[Dog_luver]

that email thing could get you in trouble...we were told to check our email at least once a day...there can be non patient related but program related issues that may need to be addressed.

Not during vacation. I check my email countless times a day and respond to all needed emails within seconds typically. On vacation we don't exist. Our program knows that and I would assume and hope all other programs feel the same.

 

[Gastrapathy]

Do not wake up other residents that are off. It's not an ACGME issue. You don't want to be that guy in your program.

 

[Siggy]

For example, what does ACGME says about IM residents/interns getting phone calls during the evening/night time from other residents about patients they take care of during the day?

I am just about to transition to PGY2 and would like to avoid screwing up by calling someone if its not allowed.

Thanks for your replies.

Don't worry about calling. You have to be a special type of a-hole to get mad about being called at a reasonable time in the evening about a patient you're taking care of if it's something that is patient specific.

"Can I give this patient a Tylenol?" Bad call.
"We think this person is going down hill, is XXX exam finding normal for this patient?" Good call.

 

[Light at end of tunnel]

For example, what does ACGME says about IM residents/interns getting phone calls during the evening/night time from other residents about patients they take care of during the day?

I am just about to transition to PGY2 and would like to avoid screwing up by calling someone if its not allowed.

Thanks for your replies.

Put the patient first.

Just make sure the pages/calls count.

Thank you @Siggy

 

[Siggy]

Put the patient first.

If that means you have to awaken a senior resident whose accepted role is to help you do that, so be it.

That is the whole point of progressive levels of supervision/independence.

Just make sure the pages/calls count.

I think you misread what the situation is. The question is, "Is it OK to call the day team at home when an issue with their patient comes up in the evening after they leave?"

 

[bannie22]

There is no problem. But ideally you shouldnt have to do it because you should know the patient well enough or have the clinical acumen to handle the situation or have on call higher level resident/staff be available to bounce ideas of.

Its kinda like if you were the day team would you want your night team calling you. Probably not very often at all.

 

[rokshana]

There is no problem. But ideally you shouldnt have to do it because you should know the patient well enough or have the clinical acumen to handle the situation or have on call higher level resident/staff be available to bounce ideas of.

Its kinda like if you were the day team would you want your night team calling you. Probably not very often at all.

there is a difference though....the day team is usually the primary team for these pts...the night person is not just taking care of one team's patients...typically they are covering 3- 4 teams worth of pts overnight...and generally your job at night is to keep everyone alive until the morning. The info you have on these pts is pretty much what you get in signout. Sure after a couple of days on NF you know a but more about these pts (esp those that you get calls on every night), but the day team knows the details...

not saying the night service should be calling at midnight, but earlier in the evening it shouldn't be that big a deal to call or text about a pt and get info in a few seconds that potentially could take much longer otherwise.

 

[LucidSplash]

I always end my signouts with "and call if there are any questions." My colleagues can handle things but if there is truly a question that I can answer that will improve care of the patient, I don't know any of us that would refuse that phonecall. This has been modeled for me by my attendings; they always answer calls from their partners for the same reason. We don't call people at home for nothing but there have been times I needed to know something that no one else around can tell me and then I don't hesitate to call them at home. To me this is just how professionals work.

 

[cbrons]

Don't worry about calling. You have to be a special type of a-hole to get mad about being called at a reasonable time in the evening about a patient you're taking care of if it's something that is patient specific.

"Can I give this patient a Tylenol?" Bad call.
"We think this person is going down hill, is XXX exam finding normal for this patient?" Good call.

I mean, really.

 

[LucidSplash]

I always end my signouts with "and call if there are any questions." My colleagues can handle things but if there is truly a question that I can answer that will improve care of the patient, I don't know any of us that would refuse that phonecall. This has been modeled for me by my attendings; they always answer calls from their partners for the same reason. We don't call people at home for nothing but there have been times I needed to know something that no one else around can tell me and then I don't hesitate to call them at home. To me this is just how professionals work.

Case in point: I'm on call today and taking all day call so the chief of the service can have the holiday off. I just had a rather complex phone call with the attending of another service explaining why we are not operating emergently on the stable patient with hemorrhagic pancreatitis. After I settled them down, I called the chief at home and recounted the conversation while it was fresh in my mind so she didn't walk in blind to controversy tomorrow morning. It was too complex for a text message. It took 5 mins and she appreciated the information. I don't think it ruined her holiday with her son and husband and made tomorrow an easier day for her.