Problem: Sleeping through pager/beeper

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I've missed a couple pages because I slept through them (mostly when I'm really tired, or sick). And I am deathly scared that this will happen again. I've been waking up multiple times in the middle of the night worried that I missed a page.

My pager will beep 8 times, and then silence itself. All of the ring tone options will beep for a brief 5 seconds or so. Anyone have any good ideas to help me?

Thanks a ton!
Contach
 
Does your pager have a vibration setting?

I had an intern who routinely slept through his pages, even when it was clipped to his scrub top. He ended up telling the nurses to call his cell phone if they couldn't reach him via the pager (ok I told them to call him on his cell because guess who ended up coming in one night when the intern was "unreachable"?).
 
You could contact whatever is the department that issues pagers at your insitution and see if they have hard of hearing options or a way for you to buy your own that can be patched into the system, potentially allowing you to buy some super loud pager.

Maybe you can look online and see if there is some device that if triggered by a certain number of decibels or vibration will screech at you
Or maybe an amplifier? Something to echo the noise but much louder

There are special alarm things online that will electronically shock you or vibrate you and are loud that you could see if you could modify/trigger this way

is this home call? are you in the call room?
 
Clip it to your collar, on your chest when you sleep. It's easy for it to be too distant and muffled if it's at your waist.

But to be honest I rarely slept while on call during residency (there usually wasn't time and I always felt worse if I couldn't get at least a good 3 hour chunk of sleep, and I have a hard time sleeping with the adrenaline of the situation pumping through my blood). You can stay up 24-30 hours; the hour or two you might get aren't worth looking bad at work. I've seen people get in big trouble for missing repeated pages on call (and everyone being suspicious that maybe they weren't even in the building).

Alternatively if you antagonize the nurses they will find a way not to let you sleep. 🙂
 
I sleep though a page once on ICU. Well not really...I saw the page and for some reason just didn't get up. Q3d 30 hour calls are dangerous I tell ya! It turned out to be a no-big-deal page...but it scared me enough to not get much sleep the rest of the rotation.
 
j4pac said:
I sleep though a page once on ICU. Well not really...I saw the page and for some reason just didn't get up. Q3d 30 hour calls are dangerous I tell ya! It turned out to be a no-big-deal page...but it scared me enough to not get much sleep the rest of the rotation.
Click to expand...

I nicknamed the resident pager that we used at our VA site in residency "the defense against the dark arts pager" because the damn thing would constantly break and have random problems no matter how many times we replaced it with a new one.

There's nothing more fun than being woken at 3AM by the overnight AOD who had to come and knock on your call room door to tell you there are 3 patients in the ED waiting to be seen because your pager decided to de-calibrate itself sometime between when you went to sleep two hours ago and that present moment.
 
WingedOx said:
I nicknamed the resident pager that we used at our VA site in residency "the defense against the dark arts pager" because the damn thing would constantly break and have random problems no matter how many times we replaced it with a new one.

There's nothing more fun than being woken at 3AM by the overnight AOD who had to come and knock on your call room door to tell you there are 3 patients in the ED waiting to be seen because your pager decided to de-calibrate itself sometime between when you went to sleep two hours ago and that present moment.
Click to expand...

At least you got two solid hours in!
 
Set to vibrate, tie to wrist. Sounds crazy, but worked every time for me
 
b2b_advisor_ii_lg_us-en.jpg

duct-tape.jpg

s-l300.jpg

Problem solved. Thank me later. In all seriousness, I really worry about this when residency hits, I'm a very deep sleeper. Maybe I can use some velcro straps to attach the pager to my ear directly...
 
Contach said:
I've missed a couple pages because I slept through them (mostly when I'm really tired, or sick). And I am deathly scared that this will happen again. I've been waking up multiple times in the middle of the night worried that I missed a page.

My pager will beep 8 times, and then silence itself. All of the ring tone options will beep for a brief 5 seconds or so. Anyone have any good ideas to help me?

Thanks a ton!
Contach
Click to expand...
set the pager with a vibrate mode and place the pager on your hip bone...the vibrations will transmit though the bone and you will feel it...
the other is (if your place has the capabilities) to have the pager forwarded to your cell phone...
finally tell the paging operator that if they get 2 repeated pages to call you on your cell phone...
 
Mad Jack said:
In all seriousness, I really worry about this when residency hits, I'm a very deep sleeper. Maybe I can use some velcro straps to attach the pager to my ear directly...
Click to expand...

I am a very deep sleeper as well. But there's something about the weight of responsibility for patient care. By the time I was a senior, I had the mildest, least obnoxious pager beep setting we had. Yet it would still wake me right up, even if I'd left it at the bottom of my bag.
 
My big worry with having it various location on my body and sleeping with it is that I'll roll over on it in such a way as to hit the buttons scrolling through the page so it no longer beeps. I think my body turned the pager off once that way, luckily no missed pages.

Otherwise the various "attach to your body" scenario sound like a plan. If it were me I would look into loud tech like I said or the paging office.
There was the hip idea, if you're a lady you could clip it your bra so it's right on your sternum, nothing like a little sternal rub to get the wake juices flowing.

Also, I wonder if your pager or any options available have a headphone jack to plug in earphones you could sleep with in your ears, then it's a question of securing those while you're asleep.

Another miserable option is to set an alarm and wake up and check your pager at least hourly. You're not going to catch emergent stuff that way and it's still long turn around time on less urgent pages but it's better than totally missed pages.
 
My own personal tried-and-true solution: never sleep on an overnight call shift.

(It works - really.)

I started doing this after a colleague slept clean through a code during an ICU rotation - he stumbled out of the call room only to find some totally unstable pt being wheeled past toward the ICU with the nurses going 'this is your next patient, chump'.
 
dozitgetchahi said:
My own personal tried-and-true solution: never sleep on an overnight call shift.

(It works - really.)

I started doing this after a colleague slept clean through a code during an ICU rotation - he stumbled out of the call room only to find some totally unstable pt being wheeled past toward the ICU with the nurses going 'this is your next patient, chump'.
Click to expand...

That's probably the most effective way.
I've heard some programs will have you get drug tested if you sleep through a code page.
 
galactus said:
What about the opposite problem, when you're off a pager-heavy rotation and you're getting those phantom pages!
Click to expand...
I haven't carried a pager in 4 years. I take call but only as a consultant, and there is absolutely nothing I get called about that can't wait an hour or 4 for my call back.

But I still wake up at the slightest noise on the street when I'm on call. And I feel my phone vibrate in my pocket about 100x more often than it actually does.
 
22031 Alum said:
I am a very deep sleeper as well. But there's something about the weight of responsibility for patient care. By the time I was a senior, I had the mildest, least obnoxious pager beep setting we had. Yet it would still wake me right up, even if I'd left it at the bottom of my bag.
Click to expand...
This. A thousand times this. I was in the army and i can sleep on hard surfaces and in uncomfortable positions whenever, but on call i awaken with minimal stimulus now (and if too many hours go by with no call i will wake up to check that all is in working order). Most people adapt in this way, but for those that don't vibrate on a bony surface plus beep helps or vibrate on the nightstand right next to your face is good too.
 
Set your pager to vibrate and then build a very tall and very tenuous Jenga tower over the top of it, with the pager serving as a vital load-bearing beam. Do this on a bedside table right next to your head so that it'll fall down on top of you.
 
sacrament said:
Set your pager to vibrate and then build a very tall and very tenuous Jenga tower over the top of it, with the pager serving as a vital load-bearing beam. Do this on a bedside table right next to your head so that it'll fall down on top of you.
Click to expand...

bwahahahaha!
 
I always put my pager on the night stand next to my bed. The vibration on the wood wakes me up. I wouldn't ever trust leaving it on my hip....
 
sacrament said:
Set your pager to vibrate and then build a very tall and very tenuous Jenga tower over the top of it, with the pager serving as a vital load-bearing beam. Do this on a bedside table right next to your head so that it'll fall down on top of you.
Click to expand...

You could use some dominoes and that Mousetrap game plus an actual mousestrap, duct tape, and you could MacGuyver quite the contraption.
 
22031 Alum said:
I am a very deep sleeper as well. But there's something about the weight of responsibility for patient care. By the time I was a senior, I had the mildest, least obnoxious pager beep setting we had. Yet it would still wake me right up, even if I'd left it at the bottom of my bag.
Click to expand...

Agree with above. I'm a super deep sleeper ever since residency began but being on call is a whole different story. If there is quiet time I'll nap on a recliner instead of the bed with my in-hospital phone and pager in each hand and on my chest. If there are labs to follow up on or repeat scans that need to be seen, I'll set my alarm clock for 15-30 minutes and check. Just remember, when we're on call, we aren't actually there to sleep. It's a bonus and it's really nice and I'm really really good at it, but that's not what we are at the hospital to do. Cheers.
 
dozitgetchahi said:
My own personal tried-and-true solution: never sleep on an overnight call shift.

(It works - really.)

I started doing this after a colleague slept clean through a code during an ICU rotation - he stumbled out of the call room only to find some totally unstable pt being wheeled past toward the ICU with the nurses going 'this is your next patient, chump'.
Click to expand...

That strategy worked for me until I was doing a q3d ICU month and fell asleep not once, but twice, behind the wheel (at a light thank goodness). There was one morning that I searched the small parking lot for my car over an hour because I was so delirious.
 
We all know sleep deprivation is a serious problem. Both across the country but in our own little communities. Yet, we macho on up to the bar mimicking John Wayne and say "I'm not gonna sleep another day pilgrim!"

Why oh why do we demonize ourselves on this forum, and in the hallways when we're tired. We know that sleepy driving is drunk driving and j4pac has admitted falling asleep behind the wheel.

I truly do not understand this.
 
j4pac said:
That strategy worked for me until I was doing a q3d ICU month and fell asleep not once, but twice, behind the wheel (at a light thank goodness). There was one morning that I searched the small parking lot for my car over an hour because I was so delirious.
Click to expand...

Shikima said:
We all know sleep deprivation is a serious problem. Both across the country but in our own little communities. Yet, we macho on up to the bar mimicking John Wayne and say "I'm not gonna sleep another day pilgrim!"

Why oh why do we demonize ourselves on this forum, and in the hallways when we're tired. We know that sleepy driving is drunk driving and j4pac has admitted falling asleep behind the wheel.

I truly do not understand this.
Click to expand...

I agree with both of you...I've had the postcall encephalopathy and have regularly told interns about how driving after 24h of no sleep is directly comparable to having a BAC of 0.1 in various studies.

My ultimate solution: match rheumatology so that I never have to work these types of hours again. I probably came off as 'hardcore' or whatever in that post, but in reality I've hated call shifts and I look forward to never having to work them again in a few months.

I've always been bothered by the assertion that we need to 'train people how to think when they're tired' - complete ****ing bull****. Every other mission-critical profession has gotten the hell away from this because worse outcomes have been demonstrated repeatedly when their practitioners are fatigued. We don't train pilots to 'learn how to fly when they're tired'...we get them the hell out of the cockpit after a defined timeframe because studies clearly show that commercial pilots crash planes more often when they're exhausted. Why we can't grow up as a profession and move towards this is completely beyond me. Instead, we get asinine studies like that Hopkins surgery trial where they tried to demonstrate that 'performance doesn't degrade when doing complex tasks while tired'...I'm sorry but wtf. Sounds like a bunch of surgeons trying to rationalize their own sadistic scheduling traditions.
 
dozitgetchahi said:
I agree with both of you...I've had the postcall encephalopathy and have regularly told interns about how driving after 24h of no sleep is directly comparable to having a BAC of 0.1 in various studies.

My ultimate solution: match rheumatology so that I never have to work these types of hours again. I probably came off as 'hardcore' or whatever in that post, but in reality I've hated call shifts and I look forward to never having to work them again in a few months.

I've always been bothered by the assertion that we need to 'train people how to think when they're tired' - complete ****ing bull****. Every other mission-critical profession has gotten the hell away from this because worse outcomes have been demonstrated repeatedly when their practitioners are fatigued. We don't train pilots to 'learn how to fly when they're tired'...we get them the hell out of the cockpit after a defined timeframe because studies clearly show that commercial pilots crash planes more often when they're exhausted. Why we can't grow up as a profession and move towards this is completely beyond me. Instead, we get asinine studies like that Hopkins surgery trial where they tried to demonstrate that 'performance doesn't degrade when doing complex tasks while tired'...I'm sorry but wtf. Sounds like a bunch of surgeons trying to rationalize their own sadistic scheduling traditions.
Click to expand...
To be fair, military pilots are trained to fly tired because it isn't always feasible to just not fly or have someone else do it. Surgery has similar issues with cancellations or having someone else operate.
 
Totally unacceptable to sleep through a page but when I call about an admission to the on-call attending it's alright if they're snoozing it up on the line 😉

I sleep with the pager next to my head... oh wait... there's always an intern on overnight the second half of the year so I say, "Pager, go **** yourself." 😎
 
Bacchus said:
Totally unacceptable to sleep through a page but when I call about an admission to the on-call attending it's alright if they're snoozing it up on the line 😉

I sleep with the pager next to my head... oh wait... there's always an intern on overnight the second half of the year so I say, "Pager, go **** yourself." 😎
Click to expand...
One of the chief residents one year wanted to be called with any admission (they took home call every other night while an intern and a 2.5 plus year resident were in house) so one time I called about an incarcerated but not strangulated umbilical hernia. She asked me what the spinal exam showed and I didn't understand why, but as a dutiful resident I had the patient roll over and did a quick exam and relayed the results. She said fine and to go ahead with the admit. The next morning I found out she had no recollection of that discussion and was likely not actually awake while we talked.
 
dozitgetchahi said:
I agree with both of you...I've had the postcall encephalopathy and have regularly told interns about how driving after 24h of no sleep is directly comparable to having a BAC of 0.1 in various studies.

My ultimate solution: match rheumatology so that I never have to work these types of hours again. I probably came off as 'hardcore' or whatever in that post, but in reality I've hated call shifts and I look forward to never having to work them again in a few months.

I've always been bothered by the assertion that we need to 'train people how to think when they're tired' - complete ****ing bull****. Every other mission-critical profession has gotten the hell away from this because worse outcomes have been demonstrated repeatedly when their practitioners are fatigued. We don't train pilots to 'learn how to fly when they're tired'...we get them the hell out of the cockpit after a defined timeframe because studies clearly show that commercial pilots crash planes more often when they're exhausted. Why we can't grow up as a profession and move towards this is completely beyond me. Instead, we get asinine studies like that Hopkins surgery trial where they tried to demonstrate that 'performance doesn't degrade when doing complex tasks while tired'...I'm sorry but wtf. Sounds like a bunch of surgeons trying to rationalize their own sadistic scheduling traditions.
Click to expand...

As a PD, I completely agree. I have worked to remove all 24 hour shifts from my program. There's only a few left, and they usually involve time for sleep. Interestingly, the greatest resistance comes from the residents themselves. The downside is that dropping 24 hour call (and switching to NF) tends to result in less weekends off and less elective time, so it's a balance.

Will be a hot topic of discussion soon, since the FIRST trial results are due to be presented next week at the surgery PD meeting.
 
My solution is fitbits. My fitbit vibrates when I get a phone call or when an alarm goes off. It wakes me every time and never wakes my wife, which is a big plus.

Given that our hospital 'requires' (health insurance premium and deductible reduction) us to have them, might as well put them to good use.
 
ive recently started a Q3 24 hr call schedule (without any sleep during the call)and it takes me 2-3 days even after the last call night to feel somewhat normal in terms of mood and concentration (almost like a jet lag for a few days). Is this routine for most people, or are most people able to recover on the post-call day or day after? Am i just more susceptible to this than others?

Any tips to survive this type of schedule?
 
thepretender67 said:
ive recently started a Q3 24 hr call schedule (without any sleep during the call)and it takes me 2-3 days even after the last call night to feel somewhat normal in terms of mood and concentration (almost like a jet lag for a few days). Is this routine for most people, or are most people able to recover on the post-call day or day after? Am i just more susceptible to this than others?

Any tips to survive this type of schedule?
Click to expand...

guys like @SouthernSurgeon & @Law2Doc I expect to have the best input

I can't say how to structure your sleep. I can give you tons of ideas for how to make that sleep better, after others weigh in

http://forums.studentdoctor.net/threads/night-float-weekend.1147541/

At some point in thread we discuss in detail the hours and how people structure the time
 
SouthernSurgeon said:
One of our Chiefs was notorious for doing this. Usually his plans were totally normal, but in the morning he would have no recollection. Always led for amusement on rounds when he would ask why the intern did such and such and got the response..."uhhhh cuz you told me to?"
Click to expand...

I used to give one of my chiefs grief for this. I would talk about the patients I saw on call overnight, and he would be be like, "You do what!? Why did you do that?" Because we had a 5-10 minute conversation about it last night...

We also take "buddy call" with the junior residents for the first few times they're on-call overnight -- they run patients by you, ask for help in a procedure if they haven't done it before, etc. I was horrified one morning to check my phone and see that I had multiple conversations with the junior resident on call, and I didn't remember any of them.
 
VisionaryTics said:
I used to give one of my chiefs grief for this. I would talk about the patients I saw on call overnight, and he would be be like, "You do what!? Why did you do that?" Because we had a 5-10 minute conversation about it last night...

We also take "buddy call" with the junior residents for the first few times they're on-call overnight -- they run patients by you, ask for help in a procedure if they haven't done it before, etc. I was horrified one morning to check my phone and see that I had multiple conversations with the junior resident on call, and I didn't remember any of them.
Click to expand...

haha the equivalent of blackout drunk dialing your ex... only it's the practice of medicine
 
Winged Scapula said:
Does your pager have a vibration setting?

I had an intern who routinely slept through his pages, even when it was clipped to his scrub top. He ended up telling the nurses to call his cell phone if they couldn't reach him via the pager (ok I told them to call him on his cell because guess who ended up coming in one night when the intern was "unreachable"?).
Click to expand...

I think I'd rather be one of Michael Vick's dogs than the intern who forced WS to come in at 3am because he was sleeping

Sent from my SM-N910P using SDN mobile
 
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