On calls

Video telling the exact same thing that happen during our calls

One of the most important part of a houseman training are the calls. Only through this vigorous training, houseman would be competent, so they say. I’ve received a message from medical students asking about on calls. Among issues around this tricky thing called on calls are:

1. Quantity of calls in a month – in the hospital where I work, 6-8 calls a month is considered normal amount. With about 400+ houseman roaming around the hospital and about 80 each department, this is considered quite sufficient. Some departments like surgery only limit 2 houseman per ward, making it very difficult to reach amount of 6-8 calls a month. Sometimes only 3-4 calls a month in surgery department. But in medical department, they put 5 houseman oncall per ward each night, because they want all houseman to have at least a total of 24 calls throughout the posting. In pediatric, they don’t allow EOD (every other day) calls and wont allow more than 7 calls a month. There are differences in each department on the policy of houseman calls.

 2. Weekends and public holidays – this is a very tricky thing to be managed by houseman leaders who are making the rosters. That’s why there’s a great thing called the census, to divide calls equally among the houseman so that nobody makes more or less weekend or public holiday calls. Some headache also revolve around some houseman wants to do less or no calls (especially the ones who are extended), and there are also some who considers friday calls as weekend call!

3. Workloads – this depends on whether you are doing active calls, passive calls or periphery calls. And this also depends on whether you are jonah or antijonah.

4. Jonah and antijonah – Well, among us the medical people, we are quite superstitious. Some doctors we label “jonah” or jinxed or black cloud who on the day of his or her call will attract loads of admissions, who will have patients deteriorating during his or her call, or so much of workloads. To be honest, although I label myself as strong “antijonah” or a doctor who whenever I oncall, patients behave themselves not deteriorating when I oncall, I can sleep for quite some time (even the other HOs who oncall with me said they slept longer during their calls with me), no sudden loads of admission and all, I still dont believe in jonah or antijonah.  All of us have had good and bad calls one way or the other. It’s only the matter of how we perceive and handle the problem. I have been oncall with superbad jonah MO that I had to attend three back to back operations when I was in surgery and didnt sleep that whole night. I also have been oncall with another superbad jonah MO in peds, which turned out not to be so bad because she is only “kalut” or “gelabah”. Plus it’s quite unfair to label someone jonah and antijonah. All houseman should do equal number of calls no matter jonah or antijonah.

5. Firstline – Houseman are the first of people the nurses call whenever there are new cases to clerk, whenever patient deteriorates, whenever no IV line (venofix required), whenever patient complains of headache, chest pain, can’t pee, vomiting and not behaving themselves, whenever BP and Dxt reading is too low or too high, whenever the paperworks and documentations are not correct, whenever needed to prescribe some medications, whenever patient is about to be transfused, whenever needed to review xrays or blood investigations. Nurses will not call MOs and specialists for such trivialities. Sometimes, you are in the middle of your sleep and the nurses will call you for IV line insertion on a very difficult set of veins. That’s how a houseman call looks like. And that’s a hard doc’s life for us, like this music video…



3 thoughts on “On calls

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