Night float
Night float is a schedule in which a resident or physician works a run of consecutive night shifts, covering patients handed over by the day teams.
Night float is a system in which one person or team works a run of consecutive night shifts, taking over patients from the day teams in the evening and handing them back in the morning. The ACGME glossary defines it as a rotation designed either to eliminate in-house call or to assist other residents during the night: residents on night float work on-site evening or night shifts, admit or cross-cover patients until morning, and have no daytime assignments. Attending groups use a similar model with nocturnists, physicians who work nights as their regular job.
The ACGME does not count night float as in-house call. Instead, the Common Program Requirements say night float must fit within the 80-hour weekly limit and the one-day-off-in-seven rule, both averaged over four weeks, and each specialty's Review Committee may set the maximum number of consecutive weeks of night float and months per year. For hourly staff who work nights, federal law does not require extra pay for night work; any night differential comes from an agreement or policy.
Pitfalls: rushed handovers at shift change; too many consecutive nights without recovery time; treating the morning a night run ends as a day off, although the ACGME defines a day off as one continuous 24-hour period free of all duties; and leaving night float weeks out of the fairness counters.
Common questions
How do ACGME rules apply to night float?
The ACGME treats night float separately from in-house call. Night float must occur within the 80-hour weekly limit and the one-day-off-in-seven rule, both averaged over four weeks, and the specialty's Review Committee may further limit consecutive weeks of night float and months per year. Check your specialty's program requirements as well as the Common Program Requirements.
What is the difference between night float and a nocturnist?
Night float usually describes a rotation: residents or physicians take turns covering nights for a set number of weeks, then return to days. A nocturnist is a physician, often a hospitalist, whose regular job is working nights. Both need the same scheduling care: rest after a run of nights, clean handovers, and nights counted in fairness totals.
How Momentum handles it
In Momentum, rules such as a minimum rest between shifts or a cap on consecutive nights are applied every time the schedule is generated, and validation lists every rule a draft breaks before it goes out.