Resident work hour regulations are a major concern in residency training programs. Previous studies have noted the risks inherent in daytime sleepiness during the post-call period, including potential adverse patient outcomes.
Residents' self-perceptions of their degree of physiologic sleepiness were poor and that levels approached those of clinical sleep disorders.
Additional studies have shown the negative impact of sleep deprivation and the effects on decision making and memory.
Due to these concerns, the American College of Graduate Medical Education (ACGME) has mandated limits for resident work hours.
A night float system has been implemented in many institutions to address these concerns and to help in achieving this goal.
The daytime physicians are relieved by a night team that admits patients and takes care of patient-related tasks. The day team then returns the following day to continue the care of the patients. Thus, the extended hours of the post-call day are avoided.
Although NF is a potential solution, it has generated a number of concerns. Residents feel that NF does not provide adequate teaching and view the rotation as more of a “service” rotation rather than as a learning opportunity.
Another concern is the discontinuity of care, which may result in poor patient satisfaction and adverse outcomes.
Many studies examining the perceptions of residents towards the NF system have been limited by small sample sizes ranging from 10 to 24 residents, brief surveys consisting of 10 to 30 questions, experiences of a group of residents in a single hospital or a single post-graduate year, and a lack of comparison between a NF and a non-NF system.