As everyone in medicine knows, there are rules in place to keep tired residents from harming patients. When I was training (and perhaps still), you were not allowed to work for more than 30 hours in a row. Only 30 hours in a row. Because when you've been awake 29 straight hours, you're feeling fab and totally capable of caring for patients.
Home call is an exception to the rule. If you're taking call from home, you are not post-call the next day. Even if you had a really rough call and got zero sleep, you still have to put in a full day of work the next day. And if you're doing home call for a whole weekend, you could potentially get zero sleep the entire weekend and yet still be caring for patients (with very little back-up).
I was told by an administrator that there are some protections in place. If you're on home call, but you manage to spend 30 straight hours in the hospital, you must leave. But here's the catch:
If you leave the hospital during that time for any reason, the 30 hours restarts.
So say you run to the food cart outside to grab a sandwich, the 30 hours restarts. Say you step outside to vomit from exhaustion, the 30 hours restarts. The person literally said that to me.
Of course, this makes absolutely no sense.... the reason for the 30 hour rule is to protect residents (and thereby patients) against fatigue, so you're not less fatigued if you leave the building for five minutes. You've still been awake 30 hours. It's not like they're protecting us against some toxic chemical that's in the hospital that will kill us if we're exposed for 30 hours in a row, but if we get some fresh air we'll be okay.
For those of you residents who do home call, what happens when you've had a really rough call with no sleep?