Night Float

[(nicedream)]

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Can someone explain the ins and outs of night float? How is it decided who is on the night float team? Is the presence of night float something that is very attractive to residents? Etc.

 

[Solideliquid]

Can someone explain the ins and outs of night float? How is it decided who is on the night float team? Is the presence of night float something that is very attractive to residents? Etc.

I suppose it varies from program to program. For example, at a place I interviewed at two weeks ago, the night float is done for one month in the first year, and then another month during PGY2. During this month only one resident is on night-float, so everyone gets their chance.

You go in from 5pm-8am or so. Then you can go home. Sunday through Thursday. Its kinda nifty because you have the days to sleep and you get Friday and Saturday totally off. And at the place I interviewed the night float is home call...SWEETNESS.

 

[neilc]

dang, night float from home? that does sound sweet....

every program i was at had a different version of night float. most commonly, it was years 2-4, with a month or two of night float per year. basically, the night float team covered everything in house from 5pm or so til 8am or so. this allowed everyone else to go home in the evenings. the day teams rotated the weekend call, so there was still a small amount of overnight, in house call. but, night float really reduces that.

a lot of people highly recommend the night float system. i personally could go either way. with the overnight call, you get a large part of the post call day off, which is very nice as well. almost a day off in the middle of the week. i didn't really factor the call schedule into my decision, as all the places had me in house a similar number of hours per week.

 

[8744]

Night float is great for several reasons. First, you don't have to round. Don't get me wrong, you learn a lot on rounds but sometimes they can be grueling, particularly when you start at eight and are only two-thirds of the way done by 2 PM.

Second, you get to go home at a well described time. No hanging out wondering if you should go, no waiting around for anybody. You sign out your patients and you go. On this particular rotation night float is from 7 PM to 7 AM and we are always on the way out by 7:15.

Additionally, you get a little more autonomy on night float.

Did I mention that while you are on night float you don't do call? Sure, your schedule is reversed but you at least get a good night's (day's I mean) sleep.

 

[(nicedream)]

So basically when a hospital has a night float program, that means nobody ever has call? If you are not on the current night float team, you work days and are off at night, and if you are on the team you work nights and are off for the days? Basically theres a day shift and a night shift, rather than everyone working days and taking turns being on call for nights?

 

[neilc]

So basically when a hospital has a night float program, that means nobody ever has call? If you are not on the current night float team, you work days and are off at night, and if you are on the team you work nights and are off for the days? Basically theres a day shift and a night shift, rather than everyone working days and taking turns being on call for nights?

for the most part, it is shift work, sunday through thursday. traditional call on the weekends. keep in mind that most programs with night float still have some traditional call rotations. so, it does cut down a LOT on overnight call, but you still will have some.

 

[AznTrojan]

i'm at the university of miami program.. currently an intern doing the night float system at the VA.. 14 shifts in one month.. 😀

i'm one of those lucky interns that has 2 night float months.. so i have an extra 4 weeks off.. 😀

basically.. you end up doing scut the entire time.. e.g. following up labs (cardiac enzymes, BMPs, etc).. every now and then the nurses will page you for stupid crap (pt. is constipated)..

 

[blue2000]

Night float can be great, but I have to admit that I think I like traditional call (at my institution, q4) better. With call, you get the post-call afternoon off, which is usually devoted to sleeping, but makes the evening longer & more enjoyable. Plus, signing in & out for night float can be painful and tedious, especially if you're waiting for someone else to sign out to night float. But everyone's different. Pros and cons to everyone's system, and all of it has pain involved.

 

[madcadaver]

My IM program has a traditional q4 call system with two teams on each night, both capping at 10 new patients. There is a single resident acting as "night float" on weekdays to briefly work up/stabilize any additional patients ("overflow") from the ER once the long call teams have capped. These patients are then signed out to the next day's short and/or long call team. The night float hours are midnight-8am.

The resident that does night float is pulled from a consult/ambulatory rotation such that you have 1-2 night float nights per 4 weeks of consult/ambulatory. You of course get the next day off.

This allows the on call teams to get some rest but also allows the ER to get medicine patients onto the floors. We like it.

Confusing enough for you?

 

[mackie]

The downside of the nightfloat system IMO is for the day team members who come in the next morning. You never know how many new patients will come in overnight, and with many systems, the day folks will be expected to know them and present them on rounds that morning. This means coming in extra early because you not only have to pre-round on the folks you know, but you have to see usually 2-3 new folks also. 🙄

 

[Roadrunner]

I suppose it varies from program to program. For example, at a place I interviewed at two weeks ago, the night float is done for one month in the first year, and then another month during PGY2. During this month only one resident is on night-float, so everyone gets their chance.

You go in from 5pm-8am or so. Then you can go home. Sunday through Thursday. Its kinda nifty because you have the days to sleep and you get Friday and Saturday totally off. And at the place I interviewed the night float is home call...SWEETNESS.

I don't really see night float home call as sweetness. I don't really think that home call is all it's cracked up to be. Sure, if you only get called a couple times a night for cross cover issues then it's great, but as soon as you get admissions then you have to pack it up and head into the hospital. You might as well sleep in a call room and not have to make the drive. There are a lot of programs that are going to home call because those hours aren't counted as being in the hospital, but the truth is that you may still end up working just as much and sometimes even more because the hours are counted toward to 80hr week.

 

[DOtobe]

Night float in my hospital consists of an intern and a senior resident, in house from 8:30 pm to 7:00 am on Sunday-Thursday nights. The intern covers all of the floor calls and both the intern and the senior do admisisons. I can't imagine doing night float from home - we are so busy on night float we barely have time to sit down! We do admissions for the whole hospital, not just for a resident service. Being the intern covering the whole 200-some beds in the hospital is kind of nerve-wracking, but I learned a ton when I was on night float. It makes your future calls so much easier once you have had night float. And you definitely appreciate it the other 11 months of the year when your only overnight calls are Friday and Saturday nights! Our calls during the weekdays are from 4:30 - 8:30 pm.

The downside of night float is that you have no life. All I did was work, come home and sleep, watch a little TV, then go back to work again. And I didn't get to see my fellow interns, which stinks.

Night float sucks when you are on it, but I definitely give it a 👍