Call during PM&R Residency

[J-rod]

Hello,

I have a quick question concering call. For those of you with inpatient call, how painful is it? What are you called for most frequently? Can I expect to get a lot more sleep than I do during internship year?

Thanks,

J-rod

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[Stinky Tofu]

I can't speak for any other program other than my own. That being said, I don't think PM&R call in general is bad at all. I think your level of "pain" is also dependent on which program you are at. At our program, we take call at the following locations:

1. Spaulding Rehabilitation Hospital (overnight call)
2. Massachusetts General Hospital (overnight call on the Neurology service)
3. VA Hospital (home call and usually pretty quiet)

Most programs do not require their residents to rotate through Neurology and this is the busiest call at our program. I'll go over common calls at SRH and the VA:

1. Fever (these are usually the most annoying calls because it can involve a lot of detective work to make sure this hasn't already been addressed).
2. Blood pressure issues (commonly from the SCI, TBI, Amputee, and Stroke floors)
3. G-tube clogged/pulled out/site looks infected
4. Follow-up imaging studies (X-ray, MRI, CT)
5. Seizures (typically TBI, but not very common)
6. Agitation (TBI, Stroke)
7. DM Management (Amputee)
8. Pain (Pain, Amputee, MSK)
9. Electrolytes (these calls are also really annoying, but it happens everywhere)
10. Mental status changes
11. Difficulty sleeping
12. Urinary retention
13. Constipation
14. Talk to family member.
15. Nurse is unable to start an IV or insert a foley.

You can definitely expect to get more sleep than you did during internship. We typically do not get calls after 11PM. Nurses must call the nursing supervisor first to make sure it is appropriate to call us.

 

[drusso]

Our call is from home which has its advantages and disadvantages. Regardless if we come in to see a patient at 2AM or not, we work the whole next day...no leaving early "post call." That said, the issues are pretty bread and butter medical stuff and can be generally handled over the phone. Although, I did have a hypotensive GI bleed that scared the crap out of me once...

 

[DigableCat]

I would say that perfectly sums up what our calls are like as well.

The biggest difference between programs will likely be whether you have in-house or home call. And believe it or not, both have their benefits and disadvantages.

Home call advantages:
Sleep in your own bed.
Sleep in your own bed.
Did I mention that you get to sleep in your own bed?

Home call disadvantages:
The "post call go home" benefit usually doesn't work.
If something happens at the hospital, there is only so much you can do over the phone...sometimes you'll have to go in. Sometimes at 4AM.

In house advantages:
Easy to put out any fires that may be brewing before you turn in.(This was key for me).
Night nurses bring you food and goodies.
Get some extra sleep by avoiding commute.
Go home early the next day.
You don't have to make your bed.

In house disadvantages:
The beds are never as comfortable as your own.
Nurses decide to not "think" as much, as you are readily available.
Depressing sometimes to wake up in a place you already spend so much time at.