NIGHT FLOAT
Contacts: Michael
Ornes
Subspecialty
Clinic: none
Resident
Continuity Clinic: Thursday AM
Performance expectations:
The
shift is from 10:00 PM to 8:00 AM Mon-Fri and 6:00 PM – 8:00 AM on Saturday or
Sunday nights. The resident on this rotation will only cover Saturday or Sunday
night, not both. Sign-outs from the residents on the wards to the moonlighter
covering the evening can begin at 5:00
PM on Mon-Fri and the sign outs to the nightfloat
resident may begin 6:00 PM on Sat and Sun.
The
night float resident receives sign out from the M1 moonlighter at 10:00 AM and
then signs out to the teams at 8:00 AM. No extra vacation may be taken during
this rotation but there is some scheduled vacation time during the rotation.
Educational goals and objectives:
|
|
Educational
objectives |
Assessment
method |
|
Patient
Care |
1)
Patients on the resident services will covered by the resident on this night
float rotation from 10 PM to 8 AM 2)
Experience in cross covering these patients including seeing patients with
acute changes in status (topics noted below) and call the senior resident or
staff with any questions and update the staff with any significant changes in
patient status 3)
The G1 night float will have a session with a chief resident from 8-8:30 AM
on weekdays to discuss any questions or concerns regarding
patient care, any challenges with systems including staff contact, and
questions regarding transitions/sign-outs/hand-off. This session with the chief
resident may also be utilized to review the case conference from that day. |
Global
faculty assessment by one of the chief residents |
|
Medical
Knowledge |
1)
Review core topics noted below using patient care, and didactic opportunities
and supplement with independent reading 2)
The G1 night float will have a session with a chief resident from 8-8:30 AM
on weekdays to discuss the case conference and/or discuss care questions from
any previous nights |
Global
faculty assessment by one of the chief residents |
|
Practice-Based
Learning and Improvement |
1)
Demonstrate insight into knowledge deficiencies and limitations 2)
Use information technology to answer clinical questions 3)
Chart review with the chief residents as needed 4)
The night float will have a session with a chief resident from 8-8:30 AM on
weekdays to discuss care questions from any previous nights |
Global
faculty assessment by one of the chief residents |
|
Interpersonal
and Communication Skills |
1)
Refine the skills necessary to present patients and topics informally and
formally to another physician |
Global
faculty assessment by one of the chief residents |
|
Professionalism |
1)
The resident is expected to answer all pages promptly and go to the bedside
to evaluate patients as necessary. 2)
Documentation is necessary in some patients to communicate status changes and
new or changing plans |
Global
faculty assessment by one of the chief residents |
|
Systems-Based
Practice |
1)
Understand the differences in how to access necessary medical care outside of
daytime hours |
Global
faculty assessment by one of the chief residents |
Topics to be covered by patient care or independent reading include the
evaluation, diagnosis and treatment of:
Chest
pain
Shortness
of breath and hypoxia
Electrolyte
disturbances
Delirium,
other changes in mental status, and restraints
Hypotension
Hypertension
Volume
status and oliguria
Hyperglycemia
Thrombosis, bleeding, and anticoagulation
New
fever and neutropenic fever
Arrhythmia
Pain
management
Sleep
aides
Falls
Lab
result triage
Death pronouncement and post-mortem autopsy request