Residency Update: Night Shifts in PGY2

Dr. Chandler (here out referred to in true doctor's wife text as DrH, for Dr. Hubby) just finished five weeks of night shifts, a couple weeks delivering babies on his OB rotation and then moving to an in-patient care rotation on Purple/Yellow team (known among residents as PYT). Whenever he is on nights I end up getting very little sleep, because I prefer to distract myself with books and movies until I'm so exhausted I can't keep my eyes open.

When he was on PYT, DrH would typically arrive home around 8:00 AM, which is normally a time that I would have already been up and at 'em. But with the shift in Wisconsin's temperatures to somewhere in the neighborhood of 0 degrees with wind chill, I've opted to stay warm in bed until that time when he gets home and is doctor popsicle, so that he can cuddle and warm up as he drifts off to sleep.

On night shifts, DrH will sleep during the day and wake up in the afternoon to work out, shower, and look at which patients are in the hospital before heading off to work. He's one of those lucky people who can fall asleep any time, any where he wants and it doesn't take long for him to be fast asleep. It especially doesn't take long when he's exhausted from the previous night. Some nights at the hospital he's able to get anywhere between 2-4 hours of sleep, depending on how much help is on the floor and what cases need to be admitted. As a second year resident (PGY2, which stands for post-grad year two), I find that DrH prefers to ease the pain of interns (PGY1) a little by taking extra patients, letting the interns sleep if the floor is quiet, or helping to finish notes. He talks a lot about how he remembers how awful intern year was and that he wants to make it less stressful for the newbies. He mentioned having some good senior resident examples when he was an intern that made the journey more bearable.

I asked him this morning if he didn't think that put the new interns at a bit of a disadvantage, because he had to learn as an intern to be more efficient with his notes. His intern year also comprised of more case exposure from in-patient and ICU, which he commented at the time made a huge difference in recognizing what disease looks like when he saw it in the clinic.In answering my question, DrH thought that he wasn't crippling the interns by making one shift a little easier and having an ally on the floor to watch out for them, when he knew he could take the extra workload. It appears that he's also biased to giving the extra help to interns that demonstrate good knowledge and are enjoyable to work with, and he is less likely to help out the first years that show up late and don't contribute much to the team.

So far this year, I'd say there have been some better moments than intern year and some that are just as disgusting. Night shifts are near the top of my disgusting residency bits list. Taking pages at night makes me want to throw his pager against the wall, either that or kick him out to sleep in the living room. There have been several relaxed rotations though, where he has more time at home and is less stressed. It's that halo effect from the more relaxed rotations that I think had senior residents affirming to us at graduation that PGY2 would be much better than PGY1.

More thoughts coming soon on what we've learned in residency about the process for becoming a sports medicine fellow.