Day in the Life: Inpatient Service Night Float

Hello and welcome to another Medical Mondays! What is night float, you ask? It probably varies per program, but for ours, it means we do 2 weeks of night shift (Sunday night to Thursday night) instead of having a random night shift every couple days!

This was the first time I was ever on nights (and how fitting that it occurred as my very last rotation of intern year?!). Thankfully, I wasn’t alone! At the beginning of the week, my senior resident imparted these pearls of wisdom with me:

• “Waves” of admissions usually occur around signout (6-7 pm), 9pm, 11pm.
• Try to get some sleep between 9-11 pm if possible, or whenever possible.
• Try to get lists printed at ~5am.
• Check AM vitals for signout w/ day team.
• Check vitals, labs, notes from consults.

“Why am I telling you all of this now? It’s because I’m about to try to take a nap. But if you need anything, I’ll be in the next room! Don’t feel bad if you need to wake me up!”

Day in the Life: Inpatient Service Night Float

6 p.m. – 7 p.m.

The day team stops taking admissions after about 5:15 p.m. unless it’s Wednesday/Friday when we have morning report. (We’re supposed to have a 10-hour break in between shifts so sign-out usually starts later on those days since we finish later due to morning report from 7-8.

In any case, we’d usually come in by 6 p.m. to find out what happened to our patients during the day, the things that got done, things that need to be followed up on, what to be on the lookout for during the night (especially for our more unstable patients).

7 p.m. – 8 p.m.

Unless we had a bunch of admissions that came in during sign-out time (which unfortunately does happen fairly frequently), we’d usually see our patients at this time to introduce ourselves (if they hadn’t met us before) see how they were doing, and check in with their nurse to see if they needed anything from us.

8 p.m. – 7 a.m.

This time is usually spent…

• Checking vitals/labs/imaging/consult notes on patients
• Covering the answering service for our office/the nursing homes our attendings cover (for any patients/staff calling in for issues/concerns)
• Trying to sneak in some sleep (the best window was usually somewhere between 12-4 a.m., although there would often be interruptions in between)
• Catching up on office notes
• If it’s reallyyyyy quiet, I tried to spend the time that I was awake prepping future presentations and writing/scheduling blog posts while my senior resident worked on a video slideshow tribute for our graduating third-year residents.

Our call rooms are located are located in the basement of the hospital. It is cold af, but thankfully we can pile up on blankets and I also took to sleeping in several layers (when there was time to sleep). We also have rogue space heaters. Huh? What?

A snippet from graduation dinner! :P

My/my senior resident’s last names rhyme, so that sometimes made for amusing situations with our patients. I also had one patient whose daughter-in-law apparently looks just like me and is from California as well, so when she first saw me walk into the emergency room, she did a triple-take.

Fun fact: I’ve heard mention that the call rooms are also located right next to the morgue. Did you really have to know this? Probably not, but if I have to chill here with that thought going through my head, I might as well share.

On one of the nights, it was my senior resident’s birthday, so we had a pizza “party” in the call room to celebrate.

7 p.m. – 8 a.m.

Sometimes, we’d have a “late” admission and would be off finishing that up before heading up (much more doable when there are two people on, but starting second year and on, we’re on our own on night float! :[ ).

We’d use this time to grab breakfast and meet up either in the call room or the cafeteria to sign out our patients to the day team!

• What do you consider to be an “urgent” call?
• Check out previous Day in the Life’s!