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Discussion in 'Clinical Rotations' started by barb, Apr 28, 2002.
Forgive my ignorance, but what do these mean?
Literally, the term is used to specify the time between interval (for example "change dressing q8 hours), however, in the context that you ask the term refers to how often you are on call overnight in the hospital. For example a strict q2 schedule would mean that you are on call every other day (Mon, Wed, Fri, Sun, Tues, Thurs, Sat, etc.); a strict q3 schedule is every third day (Mon, Thurs, Sun, Wed, etc.); and so on.
As far as actual hours that this entails, in general a call day starts when you report for morning rounds on the day of call and ends 24 hours later in terms of taking admissions, etc.; Yet, in most programs you do not go home immediately after the 24 hours is up, but end up going home anywhere from noon that day on, depending on the specialty and type of program (the exception I believe is Anesthesiology which mandates a 24 hours maximum if I recall correctly, or maybe that is my hospital only)
Hope this helps you
I am SO glad you asked that! I was wondering exactly what it meant too, but I was too lazy to ask. I figured I'd find out eventally. <img border="0" title="" alt="[Wink]" src="wink.gif" />
The abbreviation "q" means "every"...if it's written by hand, it will have a line over top of it...
While technically the q is supposed to have a line over it, I very rarely, if ever, see it written that way.
The time in the hospital post-call varies WIDELY - it is true that my Anesthesia colleagues go home right after their 24 hour shift is done and I did as well on CT Surgery. However, the vast majority of Surgical rotations (at least here and most other places I know of) tend to keep you in the hospital until evening rounds - often 40+ hours after you started. Many times without a nap or other rest.
Hopefully things will change...
Thanks for the info all!
Wow, Kimberli, 40+ hours without a nap? Isn't that incredibly dangerous?
Incredibly dangerous? No. It's a widespread and longstanding practice. Famous cases aside, neither patients nor residents are dropping like flies.
Is it optimal for education or patient care? That's currently a matter of significant debate. (And there are strong arguments on both sides.)
I remember being in the hospital once for 42 hours. It was dark when I got there and dark two days later when I left. Such is the life of a 'tern. It won't change and hasn't, in spite of protests and strikes about just that, over the last thirty years. You'll survive. Horrible rite of passage, but you will make it.
PS: Incredibly dangerous? Of course it is! But not enough folks have died yet to have the rules changed. The only way the hours became "managable" in NY was because a famous person's daughter died (See: Zion vs. NY Hospital), and voila! The Bell Commission was formed.
Unfortunately, it's just the way things are. But usually the "checks and balances" of the system catch any egregious errors. When they don't, they become headline news. Most recently in NY: with a newborn getting ten times the dose of potassium. And again in NY: with an overworked intern covering 34 patients in a transplant unit - alone. One death later, the unit shut down. Truthfully, I wish there were a better way. There's no reason for the man-hours we work, and no one will convince me to the contrary.
Q4: What the "real world" thinks would be a hard life. "You mean you sleep where you work every 4th night?!"
Q3: Not all that tough, especially with that really nice day when you are not on call or post call. Also known as the "golden day."
Q2: Work work work worksleepeat work work work. For example: I was on call Thursday and now am on call today (Saturday). Actually, not all that bad since you get to eat hospital food which is both delicious and nutricious for over half your meals and get to sleep in the almost heavenly on-call beds with semi-cotton bed linens and on-so-comfy pillows.
Q1: What Dr. DeBakey used to make his CT fellows do for about 3 months at a time. That's right, live in the hospital! Oh, to dream of the good ol' days!