Taking extra call for department transition to night float.

[Boyle]

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I'm in my second year of residency that is currently planning on transitioning from traditional call to a block-style night float system. Because of ACGME rules, our residency is not big enough to support a whole year of one class taking overnight call. My class has taken overnight first call this year with the expectation that we will be finished with first (primary) call on July 1. With the new night float system we will need to continue taking first-call overnight for another 10-12 weeks into the next academic year to cover for the partial year. The debate at this point is not really whether or not do make the transition, but how to make the transition.

I am happy to help my department. I love my job, my classmates, my department and my residency. I worry about the quality of patient care, amount of stress among the residents. I also need to think of my wife who is very tired at the end of the day and could really use some help putting our 2 sub-2-year-olds to bed when I'm oncall and then post call (I'm usually asleep or delirius). Frankly I don't blame her. She was planning on more help after July 1 and now had the rug pulled out from under her. This has, of course, created a lot of stress. This is my story. I'm sure my other classmates have similar tales.

My question is this: has anyone here been part of a transition like this were they end up picking up a significant amount of call? How did the transition go? Problems, unforeseen benefits? Hand-off problems? Continuity of care issues? Was there any incentive or compensation?

Any help would be appreciated.

Thanks

 

[jdh71]

I'm in my second year of residency that is currently planning on transitioning from traditional call to a block-style night float system. Because of ACGME rules, our residency is not big enough to support a whole year of one class taking overnight call. My class has taken overnight first call this year with the expectation that we will be finished with first (primary) call on July 1. With the new night float system we will need to continue taking first-call overnight for another 10-12 weeks into the next academic year to cover for the partial year. The debate at this point is not really whether or not do make the transition, but how to make the transition.

I am happy to help my department. I love my job, my classmates, my department and my residency. I worry about the quality of patient care, amount of stress among the residents. I also need to think of my wife who is very tired at the end of the day and could really use some help putting our 2 sub-2-year-olds to bed when I'm oncall and then post call (I'm usually asleep or delirius). Frankly I don't blame her. She was planning on more help after July 1 and now had the rug pulled out from under her. This has, of course, created a lot of stress. This is my story. I'm sure my other classmates have similar tales.

My question is this: has anyone here been part of a transition like this were they end up picking up a significant amount of call? How did the transition go? Problems, unforeseen benefits? Hand-off problems? Continuity of care issues? Was there any incentive or compensation?

Any help would be appreciated.

Thanks

Look man, the rules changed. The universe rolled the dice and you and everyone else PGY2 training came up snake-eyes. Everyone was promised less call starting PGY3, but that was under the OLD paradigm. It's just the way it is. All of the bumps in the road cannot be seen and will have to be worked out as they come up, no else has made this transition because it doesn't start until July 1. Good luck.

 

[Law2Doc]

I'm in my second year of residency that is currently planning on transitioning from traditional call to a block-style night float system. Because of ACGME rules, our residency is not big enough to support a whole year of one class taking overnight call. My class has taken overnight first call this year with the expectation that we will be finished with first (primary) call on July 1. With the new night float system we will need to continue taking first-call overnight for another 10-12 weeks into the next academic year to cover for the partial year. The debate at this point is not really whether or not do make the transition, but how to make the transition.

I am happy to help my department. I love my job, my classmates, my department and my residency. I worry about the quality of patient care, amount of stress among the residents. I also need to think of my wife who is very tired at the end of the day and could really use some help putting our 2 sub-2-year-olds to bed when I'm oncall and then post call (I'm usually asleep or delirius). Frankly I don't blame her. She was planning on more help after July 1 and now had the rug pulled out from under her. This has, of course, created a lot of stress. This is my story. I'm sure my other classmates have similar tales.

My question is this: has anyone here been part of a transition like this were they end up picking up a significant amount of call? How did the transition go? Problems, unforeseen benefits? Hand-off problems? Continuity of care issues? Was there any incentive or compensation?

Any help would be appreciated.

Thanks

Agree with the prior poster. You are the property of your residency to the tune of up to 80 hours/week average. So don't expect any incentive or compensation -- you aren't entitled under your contract. Honestly, if this extra call still fits within the 80 hour requirements, you have been getting off easy up to now. Will there be growing pains which are bad for patients? Will there be handoff errors? Absolutely. Does that mean your program has much choice in the matter? Probably not. Somebody has to be the transition year, and you are that lucky person. Grin and bear it and be thankful that it's a finite kind of thing.