No ICU doctor at night

Advanced Practice Columnist / Guide · Aug 9

It is not uncommon in community hospitals. You have to clarify the statement - "They get the extra night shift pay to stay in house, but go home at night" - physicians are typically salaried. They have a week of ICU duties typically and is on call at night but do not necessarily mean they have to be present physically.

There are various ICU staffing models depending on the type of hospital. Some have residency and fellowship programs that have physician-in-training staff night shifts. Some have APPs staff the night shifts (NP or PA). Some use a combination of the two. Some use an eICU model where a remote physician or APP is called at night for issues. In high acuity ICUs there may be a full-fledged intensivist in house 24/7.

SnickRN BSN RN CCRN · Aug 15

We used to function without a 24/7 ICU provider when I first started at my unit. We used an eICU model at night as well as use of our in-house Anesthesiologist for intubation and lines. Our hospitalist group was there for our immediate needs (if eICU was taking to long). We assessed, studied, researched and critically thought and worked together well.

I miss our eICU as it gave the Staff more critical thinking. They thought through issues better and were more acutely aware of changes. We had eICU during COVID and brought out the fine-detail assessments that ICU is known for.

This is not to say that I don't appreciate our new program of 24-7 coverage but I have found that ICU has lost some of its critical thinking as they have someone to answer their minor questions that there is an order for (I.e. can I give 20 of K on a 3.7?), which takes time away from our provider to work on admissions and other patient care needs.

Anonnurse316 · Aug 16

When I worked in the ICU as a newgrad 17 years ago we didn't have a Doc at night. If there was a code the ER Doc would come up, run the code then leave and you had to make allll the phone calls to all the doctors. The docs on call never knew a thing about the patient. I hated it. I would have liked ICU had I been at a bigger teacher hospital with support.