Non-Residents On Call #3 – Staying Safe & Staying Sane
Non-Residents On Call are doctors covering part of a shift off-site, being available over the phone for advice or available to come in for emergencies. What is commonly referred to as being on call – taking referrals and dealing with emergencies during the day or at night, while based on site, is, in terms of NHS contracts, is being “on-take”.
This is the third in a three-part series. Read Part #1 here, and Part #2 here.
Back to Catchment Areas?!
There is nothing laid out in the junior doctors contract stipulating how far from their base hospital a doctors can be whilst non-residents on call. The consultants contract, however, states that they must be within 30 minutes of their main hospital – and this is generally considered a good rule of thumb for registrars, too. It certainly doesn’t make much sense to be on call in the night and have to travel more than 30 minutes for an emergency.
For trainees, with such large distances between the hospitals on their rotations, its very difficult to find one place to set roots and still be within 30 minutes of work. That’s why, for non-residents on call, having good quality on call rooms to stay in overnight is so vital.
Rooms for non-residents on call range enormously in quality. Think student halls for a good starting point, camping-style single bed, sink, chair and desk with a phone. I have stayed in some with water damage, dripping down walls, stained carpets and chairs and grim dirty mattresses with no working light. Others have been very clean even with en suite bathrooms.
Nothing beats living close enough to the hospital to be able to sleep in your own bed overnight and travel in if needed, but if you can’t stay at home overnight make sure you are prepared. Check out the accommodation facilities. I know a few people who bring their own sleeping bag to use rather than the hospital sheets and blankets. Often on call rooms wont have wifi so bring some sort of entertainment. Check out the cooking facilities and local shops and restaurants, you may well need to bring extra food to keep you fed through the night.
I took to bringing an “on call bug-out bag” when I stayed in on call rooms, this included phone chargers, a good book, a laptop or ipad with movies, wash bag and some emergency snacks.
Where Is My Mind?
NROC doctors will often not use a bleep or pager but instead use their own mobile phone, especially out of hours when they go off-site. From personal experience, the best advice I can give anyone starting or already on a NROC rota is to have a separate On call mobile phone.
Keep your on call switch off when you are not on call. Switchboard often operate on an old or innacurate rota and, if they don’t know who is on call they will start at the top of their list of numbers until they find out who it is. If you use your personal phone for on calls you may well be woken up in the middle of the night on your precious weekend off, or while on holiday and suddenly be connected to a referring doctor.
Dig out an old handset or go and buy a cheap brick phone and get a pay as you go sim card – check the coverage at your local hospital, somehow hospitals live in mobile signal black spots. This is now your dedicated on call phone. It is turned on when your shift starts and is turned off when your shift ends. Make sure switchboard have your on call phone number, and if you are concerned give them your personal phone number too in case they cant reach you on the on call brick. Your work colleagues, I’m sure, will all have your personal phone, so you can be reliably contactable and accessible – this is about making sure you’re appropriately contactable and your down time is protected – not avoiding calls!
Make sure you keep your on call phone on loud; you want to wake up when you get a call at night. Consider switching off your voicemail service too, I’d rather be woken up by someone calling me three times in a row than wake up to find I slept through a call and find a voicemail in the morning. Also you can be sure what information someone is leaving in the message. You don’t want to have any patient-identifiable data hanging around in your inbox.
Finally, when you finish your on call, you can feel the relief of handing the baton bleep onto someone else by switching off your on call phone and stashing it away for the next one.