The night float system of resident on call: what do the nurses think?

Area of Science:

• Medical Education
• Resident Training
• Healthcare Quality Improvement

Background:

• Internal medicine residency programs traditionally used a one-in-four on-call system.
• St. John's Episcopal Hospital transitioned to a night float system in 1989.
• The impact of resident on-call scheduling on performance and nurse perception was evaluated.

Purpose of the Study:

• To assess nurses' preferences between standard and night float resident on-call systems.
• To determine the effect of the night float system on medical resident performance.
• To evaluate nurse perceptions of resident performance under the night float system.

Main Methods:

• A confidential questionnaire was administered to medical nurses.
• Nurses were surveyed on their preference for on-call systems.
• The questionnaire assessed the impact of the night float system on resident performance and interactions.

Main Results:

• A significant majority of nurses preferred the night float system.
• Nurses reported fewer resident errors and improved resident collaboration with night float.
• Nurses did not perceive residents on night float as more knowledgeable.
• Night float did not cause confusion regarding resident contact for patient issues.

Conclusions:

• The night float system is preferred by nurses over the traditional one-in-four on-call system.
• Resident rest afforded by night float may reduce medical errors and improve teamwork.
• Night float implementation can enhance the residency training environment without compromising resident knowledge or communication clarity.