Nighttime Calls, Pages, and Interruptions to the On-Call Surgery Resident

Background Communication is a keystone to good medical practice. At night, as physician numbers decrease, frequent, nonurgent interruptions have shown to disrupt patient care and impact resident/physician wellness. Potentially, interruptions can lead to an increase in medical errors. The frequency and activities interrupted during night calls have not been fully described. Methods For a period of 44 days (August through September), all calls and pages received during the 12-hour night call session were documented. Calls were analyzed by caller, urgency, need for intervention, and resident interrupted by the communication. Results A total of 494 communications were identified with a mean of 10 calls per shift (IQR 7-14). Communications lasted a mean of 2.7 +/− 2.9 minutes. Direct calls occurred in 78% and pages in 22% of the cases. From the non-ED calls (n = 335), most of them came from nursing staff (85%), followed by other specialties (12%). Five percent of the calls were directed to the wrong service. Communications occurred during charting (41%), patient assessment (33%), interrupted resident’s sleep (12%), or during a surgical procedure (6%). Communication required no action in 47% of the cases. A physician order was needed in 41%, while bedside clinical assessment was required in 12% of the calls. Conclusions Communications are common at night, but most did not require clinical assessment. A large portion of communications interrupted direct patient care. An opportunity exists to eliminate nonproductive communications and improve the quality of medical education.

The Lost Art of Reading for Pleasure

Diving into a book and losing yourself in a world peopled by your imagination is a joy that lovers of literature have reveled in for as long as there have been stories. Whether people seek to be excited, terrified, challenged, entertained, or informed, it begins with the pleasure of reading a book. Learning to read is a cornerstone of educational achievement. How to encourage a passion for reading so children want to engage is poorly understood. The role parents play and how support is offered to parents to ensure inclusive, respectful, and responsive strategies that support all families requires investigation. The “read to your child every night” call is no longer enough. Teachers need the support of parents to look to innovative solutions. This chapter investigates how teachers can support parents by asking five diverse and geographically remote parents what works for them.

Dark Side of Corporate in Chetan Bhagat’s One Night @ Call Centre

The purpose of this article is to show case the corporate life style with the living ambience in society with the perspectives of social, economical, legal, and political and so on and so forth. The story was about six people working in a call center. The present paper focuses on the living style of people especially in a corporate world with the characters such as Vroom, Isha, Radhika, Syam, Bakshi and Priyanka. The setting of the novel One Night @ Call Centre is a resemblance of the posh culture of the 21st century. All these characters make the readers to be in a comfort zone by showing the contemporary issues such as work stress, love, night shifts, friendship, In-laws restrictions, Luxurious life style, Craze for fanciful life. In a nutshell it is a story of almost lost love, thwarted ambitions, negligence of family affection, stress of a patriarchal set up, an insight on the lifestyle of youth of this country and the work ambience of a globalized office. Chetan Bhagat succeeds in representing such an advanced as well as corporate style of life through all these characters by narrating the real life situations among this group of people practically. The novel also stresses on the love affairs as well as increasing rate of the divorce as well as break ups in love which are become a common issues now a days. There are certain other aspects where the writer showcases the elements of exploitation of the educated employees in call centers in this novel of One Night @ Call Centre, which are mainly highlighted in this article with few relevant examples.

Night Call in a Teaching Hospital: 1979 and 2019

No matter the era, few aspects of residency are more defining or memorable than overnight call. Nights can be a time of growth and learning but also of fear and uncertainty, as residents take on the responsibility of managing sick patients on their own. One of us (ASD) started his residency in 1978 at the Massachusetts General Hospital in Boston; the other two (ST and BCY) started theirs in 2016 and 2017, respectively, at the University of Toronto. In this essay, we reflect on our experiences of night call separated by 40 years, highlighting what has changed and what has stayed the same.

Maternal–Fetal Medicine Workforce Survey: Are We Ready for Regionalized Levels of Maternal Care?

Objective To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal–fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers. Study Design All regular SMFM members in the United States were invited to answer a 26 question survey by email. The survey queried demographic characteristics, practice type, night call arrangements, and whether the respondent's hospital was currently equipped with the services and personnel described in the requirements for level III or IV centers. Results Of the MFM specialists working full time in what would be considered a level III or IV maternity center, only 47.5% took in-house call. Of those taking only call from home or back-up call, the majority reported that during call hours, MFM antepartum and laboring patients are cared for by generalist obstetrician gynecologists; only 6.4% work with MFM hospitalists. Respondents from level III or IV centers also reported that many of their centers did not meet the criteria for nursing support, anesthesia support, or intensive care services. Conclusion These data, if confirmed, indicate that work needs to be done to upgrade services and achieve appropriate staffing to meet the proposed level III and IV criteria for maternity care.

Salivary alpha amylase in on-call from home fire and emergency service personnel

The effect of working on-call from home on the sympatho-adrenal medullary system activity is currently unknown. This study had two aims, Aim 1: examine salivary alpha amylase awakening response (AAR) and diurnal salivary alpha amylase (sAA) profile in fire and emergency service workers who operate on-call from home following a night on-call with a call (NIGHT-CALL), a night on-call without a call (NO-CALL) and an off-call night (OFF-CALL), and Aim 2: explore whether there was an anticipatory effect of working on-call from home (ON) compared to when there was an off-call (OFF) on the diurnal sAA profile. Participants wore activity monitors, completed sleep and work diaries and collected seven saliva samples a day for one week. AAR area under the curve with respect to ground (AUCG), AAR area under the curve with respect to increase (AUCI), AAR reactivity, diurnal sAA slope, diurnal sAA AUCG and mean 12-h sAA concentrations were calculated. Separate generalised estimating equation models were constructed for each variable of interest for each aim. For Aim 1, there were no differences between NIGHT-CALL or NO-CALL and OFF-CALL for any response variable. For Aim 2, there was no difference between any response variable of interest when ON the following night compared to when OFF the following night (n = 14). These findings suggest that there is no effect of working on-call from home on sAA, but should be interpreted with caution, as overnight data were not collected. Future research, using overnight heart rate monitoring, could help confirm these findings.