The basic rules observed while on-call are as follows:
• Call begins at 4:30 PM on weekdays, and 7 AM on weekends. Call ends at 7 AM the following morning.
• Inpatient teams (Stroke/General/VA) must sign out before the on-call resident can accept any cross-cover calls.
• Patients in critical condition must be signed out in detail. Patients in the Neuro-Critical Care Unit must be checked out in detail to both the Neurology cross-cover resident, as well as the Anesthesia resident in the NICU.
• Every consult (for patients on other services, or in the emergency department) must be staffed with the appropriate attending on service (General, Stroke, or VA). During weekday evenings, consult patients followed by a subspecialty attending should be discussed with that attending.
• Consults should be triaged first in order of acuity, then by the time the consult was called.
• All patients seen in consultation (on other services, or in the emergency department) should have a complete History and Physical note (typed or dictated) within 24 hours.
• Calls from other services (other than Neurosurgery) for emergent EEG studies (e.g. to rule out status epilepticus, to monitor burst suppression) must be evaluated by the resident on-call for appropriateness of an emergent study, prior to calling the EEG technician. A full consultation should be performed. The resident on second-call must evaluate nighttime EEGs.
• Consults are to be accepted from the VA and VU emergency departments, and from the inpatient services in both institutions. Consults are also accepted from the Vanderbilt Psychiatric inpatient services.
• The on-call resident must inform the consult (VU and VA) and in-patient (General, Stroke, VA) residents about all consultations and admissions seen on the following day.
• All in-house calls are strictly in-house.
• All calls missed should be made up – extra call may be given if a missed call is unexcused. Excuses for all absences must be provided in writing (or via e-mail) to the Chief Resident. Extra calls may be given the following month to repay missed call (the resident will be made aware of such an event).
• If a resident desires to exchange a call with another resident, that resident should initiate and complete such arrangements. The Chief Resident should be notified of such exchanges (preferably via e-mail), so that an accurate record of calls can be maintained.
• If a call is exchanged, the resident must remember to rollover his/her pager (by contacting the University Telecommunications Office).
Please note that this is not an inclusive list, and rules are subject to change.