Nightfloat vs q4 overnight call??

[chef]

My intern yr program allows us to choose NF vs. q4 o/n call during 2 ICU months.. they say at the end the # of overnight calls are the same, but which is usually less taxing on the body? is NF easier?

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[indiamacbean]

men vs. boys
women vs. girls

pick the one where you are actually going to learn (q4).

 

[jdh71]

men vs. boys
women vs. girls

pick the one where you are actually going to learn (q4).

I kind of like q4 in the unit, but how do you figure you won't learn doing a NF system?

 

[tacrum43]

men vs. boys
women vs. girls

pick the one where you are actually going to learn (q4).

Granted I'm still just an MSIV, but I've experienced both systems. I made sure to do my sub-I at a site that used q4 as I thought this was better as you get to see your patients from start to finish and learn more than with NF. However, 30 hours shift are LONG. At least for me, I really don't learn anything after I hit my "wall" at about 2-3am when on-call. And rounding on the Sunday morning of your black weekend is just so painful.

I feel like I've been "hardcore" long enough. I'm tired of hearing this you're not man/doctor enough if you don't take 30 hour call on a regular basis. I'm very happy that my future residency uses a nightfloat system. I know I would feel better as a patient if my doctor hadn't already been awake for 24+ hours when s/he was making medical decisions for me. I think the key issue here is making sure that sign-out is complete and accurate every time.

Just my $0.02.

 

[ResidentMD]

Granted I'm still just an MSIV, but I've experienced both systems. I made sure to do my sub-I at a site that used q4 as I thought this was better as you get to see your patients from start to finish and learn more than with NF. However, 30 hours shift are LONG. At least for me, I really don't learn anything after I hit my "wall" at about 2-3am when on-call. And rounding on the Sunday morning of your black weekend is just so painful.

I feel like I've been "hardcore" long enough. I'm tired of hearing this you're not man/doctor enough if you don't take 30 hour call on a regular basis. I'm very happy that my future residency uses a nightfloat system. I know I would feel better as a patient if my doctor hadn't already been awake for 24+ hours when s/he was making medical decisions for me. I think the key issue here is making sure that sign-out is complete and accurate every time.

Just my $0.02.

I think the OP was asking about ICU months. Does your future residency have nightfloats on your ICU month as well? That would be nice.

From most people, I have heard that nightfloat on the floors, and q4 in the ICU is the best combination. I can only comment in a few months from now

 

[tacrum43]

I think the OP was asking about ICU months. Does your future residency have nightfloats on your ICU month as well? That would be nice.

From most people, I have heard that nightfloat on the floors, and q4 in the ICU is the best combination. I can only comment in a few months from now

Oh, my bad. Dang it, I keep doing that lately in these SDN threads. I must be getting senile being an MSIV post-match and have forgotten how to read properly.

I couldn't say personally for the ICU as I wasn't able to do a rotation during med school. I've heard a lot of people say they thought q4 worked well for the unit. I know some places still have q3 which would be intense.

To answer your question, I'm going to Virginia Mason (yay!) and they haven't had any 30 hours shifts at all since 2007. Or at least that's what they told us on the interview day, so hopefully it's true. Of course, call schedule wasn't the main reason I chose VM, but it was a factor.

 

[LukeWhite]

http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=16899877