Night Float vs q4

[Dr Lyss]

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Hi everybody

It seems like every peds program I visit has a different way of handling their call system. Almost every place has night float for interns due to the duty restrictions, but for pgy2/pgy3 it seems like everyone has a different way of doing it.

I'd love to hear everyone's thoughts/experiences with night float vs q4 or any other variation you've seen. Also, what does it mean a program says "modified" q4 (my home program has night float system so I haven't worked with it at all).

Thanks! Gd luck everybody

 

[mvenus929]

I know the most about my home program, so I'll describe that system to you.

For wards, there is a night float system in place. However, the night team only works Sun-Thurs. So, on Friday night and Saturday night, the wards senior (there are two, so they alternate days) does a 28-hour call (24+rounds). The interns either cover weekend nights or the senior is alone--been a while since I've been on wards, so I can't remember.

For PICU, the residents (no interns in PICU) do Q4 28-hour call. When there is only one peds resident assigned to the PICU (our EM and anesthesia people also rotate through), one does Q4 coverage on an elective month, so they'll admit after 5 til 7am the night morning, when they sign all the patients out to the residents in the PICU the next morning.

I'm not entirely sure how it runs in the NICU, but my impression is that seniors do 24 hour call, while interns do a certain number of night shifts during their block.

I've seen some places that have night float everywhere, some places that the seniors do 24-28 hour call and the interns do night float, and every combination thereof.