What is a Nocturnist and Why are They
Important in Your Hospital Care?
“There is nothing more important to me
as a physician than your cancer treatment.
I’ve been in practice for over two
decades and have had the privilege of
telling many patients that there is life
beyond cancer. As president of The Center
for Cancer and Blood Disorders, I want to
lead by example, practicing a firm belief
that all patients should receive the finest
medical care available, with the same
concern and compassion as a cherished
member of the family.”
Ray Page, D.O., Ph.D.
President and Medical Oncologist
The Center for Cancer and Blood Disorders
When I talk with our young physicians who are internal medicine
residents in training at Medical City Weatherford, I find most of them
are trying to figure ways to have a rewarding career as a physician and
yet protect some of their personal time. I always remind them that
people don’t get sick just from 9-5. Physicians need to have availability
all hours of the day, night, weekends, and holidays.
Although I view being a physician as a calling, and not a job, where we
should always be there, 24-7 availability is simply not achievable.
Sick people get admitted to the hospital 24-7. Nowadays, when people
get admitted to the hospital, they are really sick, with high acuity
illnesses. They can turn critically ill in a heartbeat without appropriate,
timely, physician intervention.
Enter the Nocturnist. A nocturnist is a hospital-based physician,
board certified, usually in internal medicine or family medicine that
covers the hospital through the night. Many larger hospitals will have
nocturnists that are obstetricians who do labor and delivery through
the night, as well as pediatrician nocturnists at the pediatric hospitals.
They take in all the hospital admissions from the ER to make sure
everything is ordered appropriately and medical services are put in
place. They are able to pay much more attention to patient detail than
what can be achieved in the emergency room. This allows more
thorough and comprehensive delivery of care.
Furthermore, if any patient has a change in status or a crisis in the
middle of the night the nocturnist is right there to triage the problem,
transfer to the ICU, administer timely changes in treatment, order
and interpret emergent diagnostic tests, and call in further physician
support if required.
Furthermore, we have physician residents in the hospital all night also
taking calls. These physicians also provide a high level of patient care
throughout the night, and they are fortunate to have the direct
supervision of the nocturnist who is on site also. This is far different
when I was a resident in the hospital all night where my only seasoned
physician support was with the attending physician on the phone that
I just interrupted their sleep.
Many, many years ago, I had a young patient admitted from the ER
with symptoms of sepsis. It was instructed to admit her to the ICU.
She got “tucked away” for a few hours in the middle of the night
between the ER and ICU. When she finally arrived in the ICU she was
in full blown septic shock and died shortly thereafter. Having resident
physicians and nocturnist to triage and manage these kinds of patients
saves lives and improves outcomes.
Support services provided by:
To learn more about cancer care issues or to consult with a physician
about a cancer diagnosis, contact us at 817.596.0637.
Schedule appointments by calling
817-596-0637 or online at
www.thecentertx.com
We are fortunate at Medical City Weatherford hospital to still have a
nocturnist program which I believe provides the highest level of care
from a physician being available 24-7.
It is unfortunate that many hospitals, in order to save a dime, are
removing physician nocturnist coverage through the night. What
a travesty for hospitals to replace physician nocturnists with other
support personnel.
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