30

Thirty is the magic number this year. Our shifts are limited to 30 hours in length. Is that too much? Is that too little? That's the big debate for next year (which will be an upcoming post). For me, at least, 30 is pretty much the limit. If I don't get any sleep (or even if I get an hour or two), the clarity of my thinking, my response time, my memory all diminish after rounding hour 24. I take so much longer to finish notes, to make clinical decisions, to communicate my thoughts. And beyond hour 30, I really don't think it's appropriate for me to have primary patient care responsibilities.

That being said, 30 is an arbitrary number. Patients aren't nicely packaged by hour 30 for me to hand off to the next resident. Families are arriving, big decisions are happening, consulting teams are weighing in. It's really not ideal to have a hand-off on the second day of hospitalization, but hour 30 falls right in the middle of it. It will be interesting to see how things change over time.