Anatomy of Night Float

I am on my third night float rotation this year and I am starting to notice some patterns....

The phases of night float...by Christi Bartlett

1.  The Mauling Phase
 - This phase begins as I walk through the door of the Med 3 room.  The respective members of the Med 3, Hematology and Oncology teams wait, perched, ready to pounce on me, much like fresh meat.  Then the mauling begins as upwards of 50 patients are handed off to me at a dizzying rate.  I am left bruised and beaten.  I also get to hear about the stuid thing I did the night before and how the staff couldn't believe that I gave a patient 60mEq of K instead of 40......ahem.

2. The Nursing Shift Change Phase
 - This typically happens during or shortly after the Mauling Phase.  Night nurses start their shift and notice loose ends from earlier in the day that I HAVE TO ATTEND TO RIGHT NOW!  There is usually a patient with a blood sugar of 425 during this time, as well as a patient with a blood pressure of 200/98.  Inevitably, there is also a patient who has no admission orders.

3. The "I'm Starving" Phase
 - This phase is usually starts around 2300, and involves a trip to the all night cafe downstairs.  I typically look at the same 3 meal options (frozen pizza, fettuccine and macaroni and cheese) and contemplate their nutrition facts before ultimately opting, again, for the fettuccine.  Then I have to talk myself out of chocolate milk...never easy. 

4. The "I Need More Coffee" Phase
 - This is more of a chronic issue, rather than an acute phase, but not until the "I'm Starving" Phase is over, do I typically act on the "I Need More Coffee" Phase.  During this phase I take the steps up to the 6th floor....to burn off my fettuccine....and I sneak into the nutrition room and snatch some coffee, 2 creamers and 3 sugar packets.  Heaven knows how long that coffee has been sitting there. 

5. The "Code Blue and/or Rapid Response" Phase
 - Just as it seems things have settled down, we hear the infamous beep of the code pager.  Expletives are muttered under the breath of the night team.  We grab our coats, stethoscopes and walk swiftly to the coding patient.  Usually anesthesia and the ICU team have already arrived, so we (the interns) stand against the wall and try to look like we are contributing...the whole time thanking the good lord that someone else got their first to run the darn thing. 

6.  The "Let's Try to Learn Something" Phase
 - This phase involves choosing a previously recorded lecture from a list of podcasts and trying to stay awake long enough to try to sort out ILD, UIP, NSIP, ARDS, AIP, DAH and COP.  This lecture was discontinued early as we decided that our brains were too sleepy/overwhelmed/mushy to retain any of the information. 
*These lectures are often chosen based on the attractiveness of the attending....*

7. The Sleep Phase
 - Hahahahahahahahahahahahahaha...........

 - And when I do get to lay down, I typically have some obnoxious VeggieTales song stuck in my head.
 - And if I don't have a VeggieTales song stuck in my head and I do manage to nod off, my pager goes off 5 seconds later.  Then I lay back down, manage to fall asleep....pager goes off....repeat cycle x 50 bazillion. 

8.  The Check Out Phase
 - No doubt the best part of the shift.  This is where you inform the primary teams of the events of the night and hand off every bit of responsibility to them.  Then you hand off the code pager...such a fantastic feeling. 

9. The Breakfast Phase
 - Usually accompanied by my fantastic co-intern....the other CB.  Bacon is always consumed during this phase.  This is where I drink more coffee....usually to cover up my horrible morning breath.

10.  The Erroneous Post-Check Out Page
 - This is when a nurse calls you about an issue after you've already checked out to the primary team.  It begins with a bit of annoyance because, "why are they calling night float at 7:30????" but ends with pleasure as you return the page and ask the nurse, very nicely, to CALL THE PRIMARY TEAM!  FOR THE LOVE OF PETE!

11. The Car Ride Home
 - This is the part of the day that I don't really remember, but somehow I make it to my house every morning....with just enough energy to climb the stairs and curl up in bed.

Then Charlie starts whining. 

Then I yell "SHUT UP CHARLIE!  FOR THE LOVE OF PETE!"