Night Float Guide as a Surgery Intern
Guide to Night Float:
6:30–9pm: DOCTOR, can the patient eat? What is the diet order doctor? Doctor why is this patient NPO?
9pm: Rounds with Dr. O. 4 new consults on complicated cancer patients who are DNR and may be dead by the time your shift ends. Overhead announcement that visiting hours are over.
9–10pm: DOCTOR can the patient have ativan/ambien/benadryl?
10–11pm: Call from H. to discuss the plan of care for his patients tomorrow. Code Gray (violent patient) ED room 9.
11–12pm: DOCTOR can you come to the room on the floor to discuss this extremely complex patient (who you know nothing about) with his third cousin?
12–1am: Doctor, the patient’s third cousin is still waiting! Also, patient has fever to 37.3, would you like blood cultures?
1am: Dr. T’s patient has just arrived from Cherry Hill. He is tachycardic to 180, BP is 70/20 and he has a large pulsatile abdominal mass on exam. There are no notes or orders in the chart. We tried reaching Dr. T, but she is unavailable. Please come see the patient and put in orders STAT.
1–3am: Doctor I see that this order from 4 weeks ago that no one has been doing is in the chart, do you want me to start doing it? OR Doctor, the results of the CXR ordered 4 weeks ago just resulted, would you like me to draw blood cultures? Also, what did the colonoscopy from 1998 show?
3am: Doctor, the Calcium is 7.9, would you like to replace?
3–4am: Pullups/situps. Second call from H.
4–5:30am: Platelets are over 1,000,000. Platelets are greater than one million. Platelets are 99999999999999999. BEEP BEEP BEEP.
5:30–7:00: Doctor, what is this patient having done today? The other doctor said he would order this thing, why isn’t it ordered yet? What do you anticipate our next steps with this patient are?
7:00–7:30: Please come to the board and draw Chouinard’s segments. [Awkward silence… Gunner answers] List all the steps of the Kreb’s Cycle. [Awkward silence… Gunner answers] Describe the blood supply of everything in the human body. [Awkward silence… Gunner answers]
I can’t take credit for this guide. My co resident Dr. B. came up with this. What an accurate depiction of my night float experience.