The Hours

Like every fourth day last month, I was Post-Call yesterday.

That means I went into the hospital in the morning two days ago, took care of the patients I already had under my care, spent the afternoon and night admitting new patients, took care of the new and old patients yesterday morning, and returned home. So I spent between 26-30 hours on that shift.

In the hospital, there is a cafeteria, where I eat when I can. I have a call room, where I sleep when I can. This is the mantra. Eat when you can; Sleep when you can. (If you will permit me to have a semicolon in my mantra.)

This is how the four day cycle works in the Medical Intensive Care Unit:

• Day one: Work 6 am- 7pm
• Day two: Show up at 9 am, work through next morning
  
• Day three: Leave by noon
• Day four: Work 6 am-1 pm
• Every other cycle, I had day four off

Eighteen months ago, an act of congress severely cut back the hours we are permitted to work. The new regulations set the following rules:

• No more than 80 hours per week.
• No longer than 30 hours per shift.
• No less than 10 hours between shifts.
• No more than 12 new admissions per 24 hours.
• No more than 24 patients under my care.
• One guaranteed day off per week.

What makes this doable, and it is doable, is that some months are not this intensive. This month I am working outpatient clinic, where things are considerably more relaxed. I am working simple 7:30-5:00 Monday through Friday, with two day weekends, for the most part.

There is much debate if the guaranteed day off means one calendar day (midnight to midnight) or 24 hour period. Our program has interpreted it as one 24 hour period. This means that some weekends this month I get off Friday 5 pm, work Saturday night 7 pm-7am, then return back Monday 7:30 am.

Anyway, some people sensed I was getting a bit crusty last week, even on the blog. So thought I would let you know that I’m likely to relax some in the coming days.