Back to work program

I'm in the self-imposed jet lag that is the day before a night shift after time off. I stayed awake late last night, slept late this morning to the consternation of the household, and I plan to nap this PM. I work from 10 PM to 8 AM for the next 2 nights, then 1 AM to 8 AM for the next two nights. Repeat out for 7 night shifts in a row. Then 4 day shifts and off to South Africa.

The 6 first-year on-call interns admit from 1 PM to 1 AM, then there are three 2nd or 3rd year "float" residents (2 night and 1 day floats -- called NATO and DATO by our program) who cover the admissions from 1 AM to 1 PM. This can be a very, very busy shift and people generally hate it. Where you may take 5 fresh admits in 12 hours as an intern, you may take 5 fresh admits in 6 hours as NATO. One night float gets there early (10 PM) to serve as a modicum of backup for interns who are there alone and may need help with procedures or other stuff. The night floats admit to 7 AM and then signs out their patients to the interns; day float admits from 7 AM to 1 PM.

I'm not looking forward to it. First, there is the issue with switching my schedule around, which I am kind of used to. Second, it absolutely wreaks havoc with me helping out around the house at all. The kids wake up 6-7 AM, and need to get ready for school at 9 AM. They will be leaving the house a few minutes before the earliest possible time I can get home. I'll sleep sometime in mid-day, and I never sleep effectively so I end up sleeping too much during the day. Say 11 AM to 5 to 7 PM. Kids get picked up between 3 and 5 PM so I'm useless for helping with pickup duties as well. Then they are home right as I am getting up, so I'm all groggy and useless with making dinner or cleaning or playing with them.

The third reason it stinks is it is can be extremely busy, with no good time to do good workups, you just hope to admit and to stabilize patients as fast as humanly possible. You then dump them off as fast as possible to the post-post-call interns who hate NATO admissions. It's a great way to ruin your reputation as a thoughtful and complete senior supervisor to these interns. As a senior resident, you carefully supervise and critique their admissions. You review the presentation yourself, spend lots of time carefully examining and questioning the patient yourself, reviewing the literature, and then discussing it carefully with the attending and consultants. It's easy to accept the intern's adoring gazes on you as the Role Model Doctor. That all goes to hell as NATO, when you shovel a hastily thrown together pile of crap right on their head, worse than any admission that they ever would dare to bring to your god-like visage when you were running the team last month...