Would this constitute a work hour violation?

[Noroomforlogic]

Regardless of what feedback I get there is no way I would report or ask this to be changed. More hassle than it is worth.

A rotation where you come in, see inpatients starting at, say...6 AM, round at 9, stay to take call until the next crew arrives and you hand off your pager at 6 am the next day, but you stay, taking on existing inpatients you may not have ever owned for the purposes of rounds and present them at 9 for rounds and leave at around noon.

Where I think the problem is is in the "no new patients after 24 hours. Turn overs only". Well we are not doing new H&Ps after 24 hours, but we are taking new patients by covering patients who have been on the floors, but who we have never taken care of/presented before.

What interpretation do you guys have of this?

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[surg]

Based on the initial discussions of the way the rule was intended, I would say not a violation, but not efficient use of anyone's time. Why have someone who is leaving in 6 hours take over a patient when someone who will be there all day could do it? That increases the number of handoffs unnecessarily.

The no new patient rule was intended to prevent people from having to work continuity clinics or continue to have to take unworked up patients. Carrying out a plan on a previously worked up patient was to be considered within the rules based on the understandings that I had from those that drafted the rules in the first place. This allows surgical residents to operate on patients that they haven't worked up before they go home so long as they were previously worked up at another time (e.g. they are coming in from home for an elective hernia repair).

 

[Noroomforlogic]

Thanks for the reply!

 

[lowbudget]

I don't think it's a violation either. I always thought they were referring to doing new admit H&P's or new consults.

 

[SoCuteMD]

Correct me if I'm wrong, as most of what I know about work hour rules is from NY State which is slightly different on some points. Aren't you not allowed to write orders after 24 hours - only sign out patients?

 

[Ashers]

Correct me if I'm wrong, as most of what I know about work hour rules is from NY State which is slightly different on some points. Aren't you not allowed to write orders after 24 hours - only sign out patients?

We're allowed to write orders up until 30 hours in Wisconsin with the universal rules, and they're being super strict about any sort of work hour violation at my program.

At NY you're not allowed to stay beyond 27h are you? I seem to remember that from interviews.

 

[SoCuteMD]

We're allowed to write orders up until 30 hours in Wisconsin with the universal rules, and they're being super strict about any sort of work hour violation at my program.

At NY you're not allowed to stay beyond 27h are you? I seem to remember that from interviews.

Yeah, it's 27h in New York. Many NY programs just gave up and went to night float in order to stay within the rules. Pretty much all of the surgery programs disregard them entirely.