I don't know. I have yet to figure out how my OB's schedule works. She had worked all day doing regular appointments and was in to check on me throughout the evening that day. She performed my c-section at 1am the next morning. I could tell she was super tired, but she did an amazing job. I find it really impressive.
Post by liverandonions on May 29, 2015 0:10:45 GMT -5
It's just part of the job. My dad is a doctor, he's not a surgeon but he stays up so late even when he could go to bed and still wakes up early. He just physically can't sleep that long after years of being on call etc.
Post by starburst604 on May 29, 2015 1:28:44 GMT -5
Residency trains them for it. By the time they become an attending, the times they are on call are so much less demanding in comparison. One doctor remarked that his daughter was born right after he finished residency, and the sleepless nights barely phased him because he was just used to that.
You do get somewhat used to the sleep deprivation. I naturally function ok on little sleep (it runs in my family), so I think I do have it a little easier than some people who get really grumpy when sleep deprived.
Obviously I haven't gone through the hell of it yet, but when I was on call as a student your body would just start functioning once you were woken up in the middle of the night or if there was an emergency situation.
I have seen doctors cancel non emergent surgeries in the morning if they've been on call all night and had a bad night with no sleep.
Physically it does take a toll on your body. The longest case I've been in so far I think was almost 7 hours. I don't mind standing on my feet all day, but the standing in one spot is what makes my feet and knees ache.
They prepare for it and understand that it's part of the job?
Right, but physically, if I get a shit nights sleep and then am called into work a 10 hour shift right before bed the next night- how do you physically make it work? Is the idea that many doctors work schedules like this incorrect? OBs are on call 24 hours and births can go on and on, how do you be sure to be clear headed with very little sleep.
Maybe I'm thinking about it more since I have shitty sleep.
Well every specialty and hospital and practice is different, so there is no hard and fast rule about call schedules. But typically for OB the attending will come in for sign out at 5pm and then stay until the next morning sign out at 7am. This is after they've worked in the office or been in the OR all day. Depending on your practice you might take that call every 4-5 days.
Right, but physically, if I get a shit nights sleep and then am called into work a 10 hour shift right before bed the next night- how do you physically make it work? Is the idea that many doctors work schedules like this incorrect? OBs are on call 24 hours and births can go on and on, how do you be sure to be clear headed with very little sleep.
Maybe I'm thinking about it more since I have shitty sleep.
Don't they train their bodies during their intern years? Â I think a shift is like, 30-48 hours on and then 10 hours off. Â Rinse and repeat.
Rules are different now so 24 hour shifts aren't typical at most places for residents.
Most places do night float so essentially there are residents that do the "day shift" from 6am-6pm (sign out varies depending on the institution) and then different residents come in from 6pm-6am. But the weekend varies and you could be working for like 2 weeks straight as people have to cover the weekends.
24 hour shifts for residents do exist at some hospitals, but most don't do it that way anymore.
My father has done it for 50+ years. It is just part of who he is now. He can wake from sleep in an instant and can go without sleep or food (but not caffeine) for days really. It's very weird but I am used to it now.
My father has done it for 50+ years. It is just part of who he is now. He can wake from sleep in an instant and can go without sleep or food (but not caffeine) for days really. It's very weird but I am used to it now.
That's how my husband is too. It blows my mind how he can be woken up from a dead sleep at 3am and go in to operate. I think physicians are a different breed and God bless them bc I couldn't even do a week of that! It becomes an autopilot thing for them I think.
Residency trains them for it. By the time they become an attending, the times they are on call are so much less demanding in comparison. One doctor remarked that his daughter was born right after he finished residency, and the sleepless nights barely phased him because he was just used to that.
I was joking to my husband the other day that since he is so used to the sleep deprivation from taking call that he should have no problem when our son is born just doing all the overnight shifts w/o any problem. For some reason he didn't go for that ha but I do know that it won't hit him as hard at all. Ahh if only I had the same feelings and desensitization.
They prepare for it and understand that it's part of the job?
OBs are on call 24 hours and births can go on and on, how do you be sure to be clear headed with very little sleep.
My dad was an OB/GYN and I won't lie, it was hard and even harder as he got older. He missed holidays and birthdays and other events because of being on call. But that man could fall asleep faster than anyone I know. It is like he trained himself to fall asleep as soon as he laid down.
He did say more than once that the key to surviving call then having to work all day was to get into a good, expanding practice so he didn't need to be on call more than once a week/on the weekend more than once every 2 months.
OBs are on call 24 hours and births can go on and on, how do you be sure to be clear headed with very little sleep.
My dad was an OB/GYN and I won't lie, it was hard and even harder as he got older. He missed holidays and birthdays and other events because of being on call. But that man could fall asleep faster than anyone I know. It is like he trained himself to fall asleep as soon as he laid down.
He did say more than once that the key to surviving call then having to work all day was to get into a good, expanding practice so he didn't need to be on call more than once a week/on the weekend more than once every 2 months.
Can you explain this better to me? My OB's practice has, I think, 4 physicians. They all take normal appointments in the office and all do deliveries/surgeries. I know on the day I delivered, my doctor was in the office all day, came in and chatted with me early evening, was back and forth between sleeping and checking in on me all night, and performed a c-section on me at 1am the next morning. So, obviously she was on call that day/night. Was I just lucky to get my OB as opposed to another doctor in the practice? How often does she likely do these shifts? And if she's not on call, but knows one of her patients is in labor, does she come in anyway or just let another doctor handle it?
isabel Not sure how it worked in other practices, but in his practice but if one of dad's patients went into labor in the middle of the night and he wasn't on call, the doc on call handled the delivery. And conversely, if he was on call and one of the other doc's patients went into labor, he handled the delivery since he was on call.
TBH, not sure how it was handled if a patient went into labor during the day since he always had a full schedule of patients to see every day, so being out of the office would have meant that all those appointments would have had to be cancelled since all the other docs had full schedules too. Maybe they had a Day Call doc and a Night Call doc? I guess I didn't notice since he would have been gone during the day either way.
By the time he stopped doing OB, there were 12 (or 14) docs in the practice so he was only on night call during the week once every 2 weeks and on call all weekend once a quarter. He said that was much better than when he joined the practice and there were only 4 docs so was on call much more often. They also rotated holiday night call so no one was stuck working all the holidays.
My OB practice back home had 7 doctors I think? When I went into labor I called the emergency line and got one doctor. She told me what to do and when I got to the hospital another doctor delivered him so I think they rotate duty and the on call doctor for the phone is different from the doc thats on call for deliveries. I can't imagine how it's done in small practices.
I would hope the surgeons rotate shifts so the same guy isn't on call all the time.
NOT THE SAME but DH has been on call as an IT guy at several jobs and he was able to get up and work. He's a very patient person, nothing phases him. I would cry lol. But he just shrugs and puts his shoes on and goes to the office. He's much better suited for that than I would be.
SIL (vascular surgeon) says the adrenaline keeps you focused. As soon as the surgery is done, she crashes. But if she gets another one an hour later, she is back on adrenaline. The funny thing is when she is not working, she randomly falls asleep everywhere and never looks fully awake.
I've always wondered this about my midwife. I was going into labour with sofia when she was just getting back from a 12 hour birth, then my 12 hours in labour, then she had patients to deal with all day. I was like, you are a machine.
My dad was an OB/GYN and I won't lie, it was hard and even harder as he got older. He missed holidays and birthdays and other events because of being on call. But that man could fall asleep faster than anyone I know. It is like he trained himself to fall asleep as soon as he laid down.
He did say more than once that the key to surviving call then having to work all day was to get into a good, expanding practice so he didn't need to be on call more than once a week/on the weekend more than once every 2 months.
Can you explain this better to me? My OB's practice has, I think, 4 physicians. They all take normal appointments in the office and all do deliveries/surgeries. I know on the day I delivered, my doctor was in the office all day, came in and chatted with me early evening, was back and forth between sleeping and checking in on me all night, and performed a c-section on me at 1am the next morning. So, obviously she was on call that day/night. Was I just lucky to get my OB as opposed to another doctor in the practice? How often does she likely do these shifts? And if she's not on call, but knows one of her patients is in labor, does she come in anyway or just let another doctor handle it?
@wandering, maybe you can weigh in, too?
Yes you probably were lucky that you got your doctor. Although sometimes doctor's will come in to be their patients if they're free, have a special bond with that patient, etc. But often whoever is on call will handle the births.
Also, remember that the doctor also is covering gyn patients as well, it's not all OB. So any gyn patients on the floor or gyn patients that come in to the ER, the attending has to handle. That's on top of OB patients in triage and active labor. It's definitely a lot!
So when women say their doctor didn't push with them and only came in for the last 5 minutes it's often because they are taking care of a million other things at the same time, but are well aware of what's going on with each and every patient.
Typically with a group practice everyone just takes call every X night. So depending on how many people are in your practice you might do call once a week, or once every 4 days.
So a typical day would be to have office hours or OR all day, then take sign out at 5pm, then you're on call until the next morning sign out typically around 7am.
More hospitals are going to the OB hospitalist system too, which means that they hire strictly OBs that do 12 hour shifts for a week on and a week off typically. So if you deliver at that hospital you will be delivered by the hospitalist.
I did spend some time with an ob/gyn who still does private practice by himself and he would obviously always go in for the births of his patients. That is very rare these days. I do believe he did a lot of inductions to keep his sanity, but he was upfront with his patients about it and they could chose whether or not they wanted to be induced if they were 39+ weeks.
As a student I wouldn't dare sit down, look like I was in pain or scrub out to pee lol, but as an attending you can pretty much do what you want. Sitting down happens. Scrubbing out happens.
As a student I wouldn't dare sit down, look like I was in pain or scrub out to pee lol, but as an attending you can pretty much do what you want. Sitting down happens. Scrubbing out happens.
Yep. I was ferrying around a faculty candidate once and I asked her if she needed a bathroom break. She said "I am a surgical resident, I can hold it for at least 8 hours. If I can't, then I shouldn't be in the OR.". LOL.
Post by lexxasaurus on May 29, 2015 9:52:29 GMT -5
I know it gets trained into you, but I think some people were just meant for the job.
I have a sleep disorder similar to narcolepsy so I take a 'waking' medication. I'm used to being tired all.the.time so it feels easy for me to function at any hour and power through it, and then sleep when I can. It made life in bail bonds (I was on call 24/7) much easier for me because I woke right up, spent hours on the phone handling the bonds, and went right back to sleep. I imagine the adrenaline for them makes that period of surgery easy, and then they crash immediately.
As a student I wouldn't dare sit down, look like I was in pain or scrub out to pee lol, but as an attending you can pretty much do what you want. Sitting down happens. Scrubbing out happens.
Yep. I was ferrying around a faculty candidate once and I asked her if she needed a bathroom break. She said "I am a surgical resident, I can hold it for at least 8 hours. If I can't, then I shouldn't be in the OR.". LOL.
Yeah, that's where I'd be screwed. I pee about 57 times a day, I'd be the worst surgeon!