Perceptions of a night float system of resident call within an obstetrics and gynaecology residency training program

Abstract

Objective: To determine the attitudes of residents, attending obstetricians, and nursing staff members towards night float resident call, compared with a traditional 24-hour call system.

Methods: In June 2012, obstetrics and gynaecology residents at the University of Toronto who had participated in both a night float and a 24-hour call system were asked to complete an electronic survey. Attending obstetricians and nurses in the labour and delivery unit at two tertiary care hospitals with a night float system of resident call completed electronic and paper surveys, respectively. Questions asked respondents to compare the two systems of call with respect to resident morale, fatigue, and continuity of care, and to indicate which system of call they preferred.

Results: Surveys were completed by 20/24 residents (83%), 24/39 attending obstetricians (62%) and 47/58 nurses (81%). Most residents reported less fatigue (17/20, 85%) and improved continuity of care (15/20, 75%) while doing night float call, but morale was mixed. Overall, 14/20 (70%) residents preferred the night float system. Staff perceptions of resident night float call were mixed in all areas, and most reported no difference in resident morale (17/24, 71%). Nurses found residents were less fatigued (32/47, 68%) and easier to work with (34/47, 72%), and felt that night float call improved continuity of care (37/47, 79%).

Conclusion: Resident attitudes towards night float call are mostly positive. Attitudes of attending obstetricians are mixed, but nurses prefer this system of resident call.

Keywords: continuity of care; resident duty hours; resident wellness; residents.