night float for psych

[spaslam]

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i spoke with my program director today about adding night float at our program. he asked what other programs' night floats are like. does your program have night float and how do you make it work? do you suggest it?

 

[whopper]

Our program didn't have night float, though the internal medicine program that our residents worked in did.

I think its a good idea. Doing night float creates a different type of work environment. IMHO a key to better psychiatric training is mastering different clinical situations. It also allows the majority of residents to have a better quality of life, while allowing the residents stuck on night float to get those night hours out of the way while having their circadian rhythms adjusted for it.

The only problems I've seen is the resident going to night float is going to have a wierd adjustment for the first few days going in & out. If your program doesn't have too many residents, it won't be able to rotate this among a large amount--forcing residents to rotate this quite often. That'd be a negative for going to night float since you want residents doing it at a minimum.

Another problem is the night float residents have to have a very good plan of communication & safety planning in terms of who can handle the emergencies. E.g. 3 IM residents did night float, what if there were more than 3 emergencies at once? Rare--but it can happen. You have to make sure the number of residents on night float are of a number where the number of emergencies at once will not realistically overburden the residents on hand.

 

[masterofmonkeys]

our program has a 1 month weekday night float. 5 days a week at one site as a pgy-1, 4 days a month at a different site as a PGY-2. Weekend call is covered by PGY-1s (mostly) and pgy-2s (about 1/3-1/4).

I tend to like it, and even the PGY-1s have a fair number of weekends free of call.

The thing about night float is that it's only REALLY going to make a dent in call if you have a large program. With 12 slots a year, it works perfectly for us.

The only real downside is that there's some form of short call (only till 6 at our program), and that the 5 day a week night float is going to end up darn near 80 hrs. (about 70 at our program).

 

[luft]

At our program, our night float is one of our monthly rotations during our second year. We have a month where our only duty is to be on call for most of our locations Monday throgh Thursday, 4:30pm to 6:30am. Our program is middle sized with seven to eight residents a year on average, so most months of the year are covered by somebody. It does make a noticeable difference in the number of calls one takes when somebody is on nightfloat versus not. The nightfloat month is not fun by a long shot, but you get it done.

 

[MBK2003]

Our night float was a week at a time covering the psych ER (CPEP) from 9pm to 9am Sunday to Friday night during PGY-3. It was a pain to shift day-night, but by the 3rd night I was shifted and then had a weekend to readjust before resuming normal day shift on Monday.