How call rooms reflect the personality of residency programs

   Katie Lockwood, MD | Physician | September 27, 2015

   An intern pushed open the call room door so that twelve medical students
   could crowd their eager faces together to see where we might sleep for the
   next three years. Only a few months away from medical school herself, the
   intern acted as if sleeping in such quarters were second nature. She
   gestured to the fluffy quilts the residents had brought from home to adorn
   their beds and giggled about how chilly the hospital nights were. Tiny
   white Christmas lights dangled from the top bunk. A sheet with a medical
   algorithm was taped to the wall above the desk phone and was decorated
   with doodles of flowers. And although this may have been the bed I slept
   in every fourth night for the next three years, the tour of it lasted no
   more than two minutes and needed no more than two seconds.

   Although I had worked long hours as a medical student, I had only seen one
   call room while on my sub-internship, a rotation designed to simulate
   intern year for a medical student’s chosen area of specialization. My
   room, closet-sized with white walls and starched white hospital sheets on
   bunk beds, was an afterthought in both the minds hospital facilities
   management and my supervisors, who rarely let me see it. After returning
   home from my first night there, my husband asked if it was part of a
   larger lounge with flat screened TVs, leather couches, and a masseuse, as
   doctor lounges appear in TV and movies. “It can’t be that bad,” he said in
   disbelief after I described the white, windowless room I managed to lie in
   for a whole twenty minutes that evening.

   Along the interview trail I saw many other call rooms, some as plain and
   bare as the one of my home institution and others as personalized and
   decorated as the one the intern had proudly displayed on my first tour. I
   began to see that these rooms were either a source of pride for some
   residents (a “home away from home”) or a means to an end (“a place to
   reapply your deodorant and brush your teeth” another told me). They became
   reflective of how my time on call would be viewed by each program. Either
   I was there to soak up every moment of learning and shouldn’t be sleeping
   much or naps were deemed a patient safety issue and required. Some
   programs saw the call room as a place for socialization with peers,
   individualized reading, or office space for work, while others saw it as a
   brief, resting post on a marathon call that focused on direct patient care
   as the primary purpose and means for learning. While call rooms never
   factored into how I chose my residency program, in retrospect I realized
   that I could easily have used them as a guide to the program that best
   suited my learning style.

   Throughout the course of my residency, I spent varying amounts of time in
   call rooms, none decorated, but each with its own idiosyncrasies. My call
   rooms were a luxury, but not luxurious. There was one on the oncology
   floor that was positioned beneath the hospital’s tubing system, so you
   were equally likely to be awakened by a rattling tube of blood shooting
   across the hospital as you were your pager. There was another on the
   cardiology floor that it took me three weeks to find. In the meantime, I
   rested my head in my hands beneath the telemetry monitor and called that a
   nap. On the endocrine floor the room uniquely had its own bathroom, but
   was so cold that you had to remember to grab extra patient blankets on
   your way there or risk frostbite. And there was the one on a general
   pediatrics floor that was sometimes inappropriately occupied by a
   maintenance worker taking a break.

   On a good night, I felt relaxed enough to take off my shoes and pagers and
   actually get some sleep. The kind of sleep where you need to set your
   alarm clock and that actually feels restful. More often though, I simply
   lay down fully dressed so that if a pager alarmed I could stand and run
   without having to look back. I purposefully kept myself in a light sleep
   and mostly just pondered my patients over and over, resting my body but
   not my mind. Occasionally as a bonus, a colleague from the night before
   may have left behind hospital tapas, a spread of snacks from the nutrition
   room: saltines, apple juice, ginger ale. If I was particularly lucky, I
   would get one of the rare rooms with a window and see the sunrise over the
   city.

   Years later, as an experienced resident, I gave tours of our call rooms to
   prospective medical students. I opened the door and let the room speak for
   itself. Their usual responses were a disappointed collective “oh.”
   Occasionally someone would ask if they could bring in decorations from
   home, and I nodded, knowing that person wouldn’t be decorating a room at
   my program. This was a room for rest, regrouping, refuge, and hygiene. It
   was not a place for learning, for that came from patient care and
   colleagues. And it certainly was not my home away from home. Although my
   residency and hospital did feel like home to me, it was the people, the
   patients, and the medicine that felt familiar and familial, not the room
   that housed my body every fourth night.

   Would I have loved a swanky call room as appears on TV? Certainly. Would
   it have made me a better doctor? Certainly not. As residency duty hours
   and intern schedules have changed over the years, so have the utility of
   call rooms. Without making any judgments about how much sleep residents do
   or do not need, I can say that my memories of my call rooms are vivid and
   yet unimportant in my journey as a physician. I am sure there are
   residents sleeping under quilts currently receiving a great education, but
   I know that for me, it was the life outside the call room that made my
   hospital home.

   The opinions expressed above do not necessarily reflect those of my
   employer, the Children’s Hospital of Philadelphia.

   Katie Lockwood is a pediatrician who blogs at Mommy Call.

   https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-the-personality-of-residency-programs.html