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  • What's it like to work nights?

    I've put in all the hard work for subspecialty training, making good money and saving well, but feel like I don't have enough time for the things I want to do.  I'm considering moving to a night position which would be 7 on with shift of 10pm to 7am, then 14 days off.  Salary is basically the same with opportunities to pick up extra day shifts.

    The lure of all the time off is very tempting.  I've spoken to several other docs who seem to enjoy the time to workout, read, enjoy their families, etc.  I've also heard it ages you, and of course have read many of the studies about other health issues.

    Has anyone done nights successfully?  I would assume ED docs have this down to a science.  The 7 on/14 off schedule appears to be significantly more manageable given that there is a predictable schedule and significant recovery time.

  • #2
    Have you ever worked 3 nights in a row, 4? 5?
    I wouldn't do it personally.

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    • #3
      I did a nocturnal schedule for a single month (getting about a 30% pay increase) and was told by my girlfriend at the time to "never, ever, ever" do it again.  I guess I was pretty grumpy.

      I now pay good money (or at least opportunity cost) to not work ANY nights any more--perhaps one of the better decisions I've ever made in my entire life.

      However, you're right--some folks thrive with a night schedule.  Perhaps you could sign up for a few month trial to determine if you're one of those people.

       

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      • #4
        14 days off in a row?? I could and would do that in a heartbeat.

        Can always give it a shot and go back to the traditional schedule if needed.

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        • #5
          I worked 6 nights in a row each month as a resident. Wouldn't want to keep that up for an entire career. But it doesn't bother some people that much. We have 3 or 4 Nocturnists in our group and they do almost all the nights other than a few done by the new hires who are required to work all shifts for the first couple of years. Try it and see how you like it. Nights really have five downsides:

          1) Makes you feel terrible

          2) Screws up the rest of your life

          3) Cardiac risk factor, eat crappier

          4) Consultants are surlier and hospital services are much more limited (harder to get an echo, stress test, US, MRI, newbie lab techs etc)

          5) Different patient population, and not for the better. Less acuity, more psych, more drug stuff.
          Helping those who wear the white coat get a fair shake on Wall Street since 2011

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          • #6
            Haven't done it since residency a few years back.  However I found it took at least a week to really adjust my sleep schedule, both directions.  So that would be the main concern for me aside from the obvious family schedule concerns etc.  Perhaps some people either biologically or behaviorally are better able to manage the transition from days/nights.   What is your specialty?  7 on and 14 off does sound pretty sweet..

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            • #7
              I flip betweens nights and days all the time, working about 5-6 nights a month.  I don't find it to be a good thing.  The day you go to nights you can try to game the system, nap, sleep in but you're kinda spending the day waiting to go to work.  For me, after 3-4 nights my body has about fully adjusted to the night schedule.  My first day off nights I try to sleep for about 4 hours and then get up with the goal of going to bed at night.  It can take 1-2 days for the sleep cycle to improve so I'd say you lose the day before and the day after if you are going to to a run of 7 on...now if you are allowed to nap at work it is totally different.  Part of what I do is a stand alone ED and if I can catch 2-3 hours of sleep then the transition is much easier.  Otherwise I've heard all sorts of strategies ranging from limiting nights to 2 shifts at a time, white noise, blackout curtains, melatonin, ambien, beer, etc.  With all of the different strategies I've not heard of a clear winner.  I stick with some sort of white noise as my 2 year old isn't quiet.

              If your group or situation will let you try it for a couple cycles I don't see it as something to avoid completely.  You may be one of the folks that likes it, but overall I think WCI is right.

              1) The flip is sometimes like short term flu.

              2) The people in your life have to dance around your sleeping.

              3) I had to start taking salads with me to work because everything else is junk.

              4) Getting someone out of bed to help you is significantly harder than having them walk down the hall.

              5) You're just not getting the same practice of medicine.

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              • #8
                Some people seem to thrive working at night.  I really see a lot of nurses who work nights for years.  I did ob for 30 years.  The problem with that was going to office or doing scheduled surgery after a bad night.  This may change with hospitalists to a degree.  I would hate to work just nights but to each his/her own.

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                • #9
                  It is very unpleasant to work any significant number of nights in a month, but seven shifts in a row is cruel and unusual punishment. That schedule will not improve your quality of life unless you work at a very low volume hospital where you can spend much of your shift sleeping. Even then, I probably wouldn't do it.
                  Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                  • #10
                    Everyone has very good points here. Its not worth it, you'll spend the first several days getting onto a new cycle and itll be wasted time off. I did 24 on/off for months on end in residency, it is a zombie state and I was never able to make use of 50% of days off, and I dont even remember it now to top it off!

                    Then you'll be doing the opposite when you go back to work nights, awful.

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                    • #11
                      I know a IM nocturnist who did Su-Th nights and off F-Sa night x 2, then 2 weeks off. The way the group worked, that was full-time. He had interns and residents who would answer all the overnight routine pages, basically would just have to roudn on acute issues and do all the admissions. Pretty good gig I'd think.

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                      • #12
                        It was much easier to sleep all day after a night shift 10-15 years ago.  It now takes longer to recover from a night shift and they have become more difficult.

                        If I were in you shoes I would be tempted.  Be aware the transitions and other factors others have mentioned will wear on you and your relationships.  Some people may be better suited for nights, but for most of us, sleeping at night leads to a healthier, happier life.

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                        • #13
                          I'm a nocturnist and have been for almost 5 years by choice and it works well for me and my family.

                          There are many caveats though:

                          1) I am a natural night owl and have been since I was a kid. I naturally tend to fall asleep around 3-4 am so becoming a night shift worker has only required me to shift a little bit from what appears to be my natural sleep cycle.

                          2) I typically work no more than 3 nights in a row. I've done 4 nights in a row and that can feel rough.

                          3) I often am able to manage 1-3 hours of sleep scattered through the night when at work.

                          4) I have older kids who are in school while I'm sleeping during the week and who are able to let me sleep on the weekend or summer days. I can't imagine having tried to work all nights when they were infants or toddlers.

                          5) I have a stay at home spouse who is able to get the morning routine done for our younger child who still needs help to school and is able to pick her up in the afternoon when I'm usually still asleep

                          6) I don't try to flip back to a typical sleep schedule on days off. I just revert back to my usual routine of going to bed at 3 or 4 am and waking up at 11 or noon so the adjustment isn't as harsh.

                          So, I think it's doable for the right type of person with the right life set up. Only you know how you respond to being up several nights in a row, how well you are able to sleep during the days, and whether you have other people in your life that working all nights would inconvenience.

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                          • #14
                            If I was told I  had to work nights I would quit immediately and become either a part-time dog walker or underwear model. My guess is no one would actually pay me to be a model so dog walking it is I guess. Maybe house sitting, that seems rather easy...

                             

                            Working nights sucks. Humans were meant to sleep at night.

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                            • #15




                              I’ve put in all the hard work for subspecialty training, making good money and saving well, but feel like I don’t have enough time for the things I want to do.  I’m considering moving to a night position which would be 7 on with shift of 10pm to 7am, then 14 days off.  Salary is basically the same with opportunities to pick up extra day shifts.

                              The lure of all the time off is very tempting.  I’ve spoken to several other docs who seem to enjoy the time to workout, read, enjoy their families, etc.  I’ve also heard it ages you, and of course have read many of the studies about other health issues.

                              Has anyone done nights successfully?  I would assume ED docs have this down to a science.  The 7 on/14 off schedule appears to be significantly more manageable given that there is a predictable schedule and significant recovery time.
                              Click to expand...


                              I have the opposite experience. I hated "working" nights so much as a medical student that I told myself I would squeeze every drop out of my Step 1, kiss whatever tushy I needed to kiss, and charm my way into a specialty where the notion of working at night is met with a hearty chortle.

                              My limited experience working nights (6 nights on, Thurs night off, 2 weeks at a time, 8 weeks total since my program loved to screw the prelims) lines up with what everyone else seems to be saying:

                              - I was always in a foul mood (I remember angrily driving to work while others were just starting happy hour on Fridays, I eventually had to change my route to work to avoid seeing that)

                              - I couldn't sleep well during the day and even with less hours spent sleeping, didn't find myself very productive. I think I vaguely remember sitting on my couch and miserably counting down the hours to when I had to pick myself back up and go to work

                              - I would either skip meals or eat terrible meals (M&Ms and gatorade for breakfast, breakfast sandwich from the "food" cart outside the hospital for dinner)

                              - As a lowly intern, I felt like I was just the punching bag for everyone in the hospital. Attendings / fellows / residents / fellow interns / heck even the nursing staff was in a foul mood all the time when awoken by the intern for a consult / assistance

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