Adult Neurology Residency

Adult Neurology Residency

Night Float

Introduction

The Night Float rotation was created in order to help ensure that on-service residents are adequately rested during the regular work day by relieving them of overnight call duties. It is a senior-level rotation, with more independence in clinical decision-making as compared to on-service junior residents. When indicated, the resident will admit patients to one of the inpatient neurology services. He or she will provide cross-coverage for the neurology patients already hospitalized. Independence in clinical decision making will be fostered, but supervising faculty will remain available.

Goals

The main education goal of the Night Float rotation is for the resident to advance his or her independence and skills in the acute evaluation and management of a variety of neurological conditions.

Objectives and Evaluation Matrix

Because the night float resident is covering the general neurology, consult, stroke, and pediatric neurology inpatient services, the specific objectives for this rotation are essentially the same as for those rotations. At the end of the night float rotation, the attending faculty on the stroke / neurohospitalist service, who staffs most of the off-hours cases with the night float resident, fills out the evaluation form.

Rotation Objectives
Upon completion of the curriculum, residents will . . .
#DescriptionMilestones
1Evaluate and manage changes in clinical status that arise on cross-covered patientsPC1, PC2, PC3, PC5, PC6, PC8, MK1, MK2
2Quickly and accurately determine eligibility for endovascular and other advanced treatments stroke patients transferred from outlying hospitalsPC1, PC2, PC3, PC6, PC8, MK1, MK2
3Evaluate and manage inpatients with neurological complications of systemic disease, surgery, and other treatmentsPC1, PC2, PC3, PC5, PC6, PC8, MK1, MK2
4Appropriately select and interpret neuroimaging studiesPC8, MK2
5Communicate effectively with requesting clinical services, nurses, and other members of the patient’s teamSP3, SP4, PR1, IC3, IC4
Milestones
Please grade the resident on any of the following milestones you were able to evaluate during this rotation:
PR2, PR3

Schedule

There are two residents on Night Float at a time, alternating nights on call. The resident’s day starts at 4pm with coverage of floor issues and patient phone calls, while the Day Float resident sees new consults. The Night Float resident starts seeing new consults at 8pm and works through the night. The shift ends at 8am, and the resident then has off until 4pm on the following day. Thus, the schedule during the week is 16 hours on / 32 hours off.

On weekends, the Night Float resident stays in the morning to round on whichever inpatient service does not have their usual resident. This lengthens the shift by a few hours, but it remains well under the 24 hour limit and obviates the need to draw off-service residents into the weekend rounding schedule. Residents on night float are excused from educational conferences and do not have continuity clinic.

Work Hours

On average, the Night Float resident will work 58 hours per week.

 

Suggested References

See the suggested references for the individual services covered by the night float: General neurology, stroke, consults, and pediatric neurology.

 

Latest revision: 05-14-2021

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