nightfloat

A nightfloat is a medical training rotation during which a resident physician is responsible for admitting new patients to the hospital and responding to patient care issues during the overnight hours. This rotation is common in internal medicine and other residency programs. The primary goal of the nightfloat service is to provide continuous patient care coverage while allowing the daytime teams to focus on scheduled patient management and procedures.

Residents on nightfloat typically work in shifts that span twelve to twenty-four hours, often working several consecutive nights per week. During their shift, they are the primary point of contact for a designated set of hospital floors or units. This involves evaluating patients presenting with new symptoms, making diagnostic decisions, initiating treatment plans, and managing acute changes in patient condition. They also handle cross-cover for patients admitted by other teams when those teams are off duty.

The nightfloat experience is designed to enhance a resident's skills in independent decision-making, acute problem-solving, and efficient patient management under pressure. It can be demanding due to the inverted sleep schedule and the constant need for vigilance. Many programs structure nightfloat to include a senior resident or attending physician who is available for consultation and supervision, ensuring patient safety and providing educational opportunities. This rotation is often a rite of passage for residents, contributing significantly to their development as competent physicians.