Hopefully, unlike my situation, you’ll have time to prepare for your first night on call. It can be so stressful that many forget to bring some essentials with them. Here’s a list on what to bring with you.
Before the big day, make sure you know the operating hours of the cafeteria and places to find snacks in the hospital. Set an alert on your phone so you don’t miss snack time. I also recommend you look at what’s available in the vending machines. Ask around to know where to get the best coffee.
Check with your fellow residents. In my hospital, we would get together and order out (usually Cambodian food; my favourite). It was always the highlight of the evening. Well worth it.
Make sure your ID badge works with the door locking system. Mine didn’t and it led to an interesting evening. It’s so much easier to get that fixed during the day. You also want to know where the Call Rooms are, how to access that section and which room is yours. You don’t want to walk in someone else’s room in the middle of the night.
If you’re lucky, your seniors will have printed a list of important numbers and contact information. If not, I recommend you take time and gather that information, just in case. The operator usually has the numbers close by, but it’s more efficient to have them handy.
Often, there’s a “secret” on call document being handed from seniors to juniors. They often contain protocols as well as general advice on how to survive the night. Unfortunately, they usually contain copyrighted material and therefore cannot be mass printed or sold at the bookstore. Try to get your hands on it.
I’ve noticed that the best “first days information” is only discussed during the first few days of internship - residency. Unfortunately, many off-service residents will go through the “tougher” rotations later in the year and after the seniors have finished the “welcome to hell” introduction at the start of the rotation. You’re then supposed to figure out things for yourself. Instead, take a few minutes to ask them if they have any advice for you and if there’s a “secret book”.
Also, ask your seniors where the hospital protocols are located. For example, my hospital had an insulin sliding scale protocol, but the hospital where I attended medical school did not. If you’ve never written orders for an insulin sliding scale, you’d rather not give it a first try at 11PM. Ultimately, the goal is not only to know how to access them, but what is available in your center so you can be better prepared.
I strongly recommend having at least one “On Call” book or app on your phone. Make sure you know what it contains and the structure of it before you start. This shouldn’t take very long. At 3AM, you’ll want to find what you’re looking for fast. The main advantage of a book is that it can’t run out of batteries (see “charger” in the list above), which is unfortunately still a problem with today’s phones. If you carry a tablet, you’re probably going to be ok. On the other hand, books tend to be heavy. On top of that, I was never able to find one with the type of information I wanted. — That’s partly why I wrote MD on Call. Regardless of the tool you choose, make sure you know how to use it.
Have thoughts to share — email me Marc-Emile@messil.com
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