Do any current residents have comments regarding a night float system? What works, what doesn’t, does it suck? My institution is interested in implementing one and has asked me to put together a proposal. We are extremely busy on call and some of my co-residents have doubts. Any input would be greatly appreciated, thanks.

Nervous System - 19 February 2012 10:20 AM

Do any current residents have comments regarding a night float system? What works, what doesn’t, does it suck? My institution is interested in implementing one and has asked me to put together a proposal. We are extremely busy on call and some of my co-residents have doubts. Any input would be greatly appreciated, thanks.

We don’t have nightfloat, but anywhere I rotated the night residents were miserable. It takes away from education both from loss of operation e time and being a zombie for any scheduled conferences.  Also, the increased amount of sign outs both increased inefficiencies because of running the list or rounding again and made patient care “worse” because the residents did not know the list as well.

We have a night float system and everyone loves it.  It’s sucks a little while you are on night float, but it’s definitely worth it for the rest of the year.  Our current system is as follows.

Night float works 5 nights a week from 6 PM to 8 AM Sunday through Thursday (call ends at 6 AM, but resident leaves by 8 AM after conference).  That makes Friday night, all day Saturday, and Sunday morning the only days available in the call pool, so we only need to split up 8 days in the call pool per month (two residents work two 12 hour shifts per weekend).  If anything, I think we end up having less hand off errors because you usually have the same junior during the daytime and the same resident during night float (only exceptions are weekends). 

On certain days, it can get busy on call, especially if you have a surgical case come in.  That’s why we always have a chief on as backup in case something surgical comes in and the junior is too busy to take it to the OR.  If you have specific questions, feel free to PM me.

My Program did exactly the opposite, Residents were miserable on the night float system, it was from Sunday 7:00 pm to Friday 7:00 AM, with Friday Free and Saturday free, It was just horrible, I personally did 3 1/2 months last year, at the end i was yelling at people, things were getting past me. Remember Night Float is not the normal schedule of your body, I think it is easier for a Call system ( we have that Now) you get your post call day, charge your reserve and come the next day.  What happens with the night float is that you get off at say 7, go home and try to sleep and you cant and you wake up tire as hell and have to go back to the hospital. I think it is a very bad system.