Nocturnist Job yay or nay

[vagabondattending]

Hi all,
Considering a nocturnist job in a very popular but HCOL coastal city…
188 nights per year 10p-6a
Rate is $215 per hour
W2 with run of mill benefits provided

Seems like a lot of nights… it’s a partially academic site with a community satellite campuses. We cover all at same rate.
Main campus is level 2 trauma. Daytime is three attending coverage, overnight is one attending with several PA/NP and a resident.

Never been a nocturnist before. Just wondering if this is a decent gig! Looking for others input.

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[turkeyjerky]

That’s a **** job unless you really want to work there for some reason. It’s also too many shifts/mo.

 

[cyanide12345678]

Don’t do it if you have a spouse and children.

 

[TeddyBoomBoom]

Good god that sounds terrible.

 

[sylvanthus]

Hi all,
Considering a nocturnist job in a very popular but HCOL coastal city…
188 nights per year 10p-6a
Rate is $215 per hour
W2 with run of mill benefits provided

Seems like a lot of nights… it’s a partially academic site with a community satellite campuses. We cover all at same rate.
Main campus is level 2 trauma. Daytime is three attending coverage, overnight is one attending with several PA/NP and a resident.

Never been a nocturnist before. Just wondering if this is a decent gig! Looking for others input.

Too many shifts. I do less than that in the ICU and have alot more downtime than the typical ED shift. Dont do it.

 

[Brigade4Radiant]

You would be better off with locums and doing fewer shifts

 

[johhnybgood]

sounds like horrendous job

 

[bravotwozero]

Were non nocturnist gigs not available in your area?

 

[CoolDoc1729]

Hi all,
Considering a nocturnist job in a very popular but HCOL coastal city…
188 nights per year 10p-6a
Rate is $215 per hour
W2 with run of mill benefits provided

Seems like a lot of nights… it’s a partially academic site with a community satellite campuses. We cover all at same rate.
Main campus is level 2 trauma. Daytime is three attending coverage, overnight is one attending with several PA/NP and a resident.

Never been a nocturnist before. Just wondering if this is a decent gig! Looking for others input.

Specifically as a nocturnist myself
1) I’m only contracted for 12/month so 144. I have room to pickup a little but being forced to 16/month would be a lot
2) 10p-6a - when does your relief arrive? If it’s at 6 I wouldn’t take that because you know you will get things you don’t want to sign out at 430.. idk .. I hate to sign out, so I leave sometime between 7-930 depending on what’s going on. I get paid my hourly rate over the official end of my shift at 8
3) do you like nights? Or is your goal to get your foot in the door and transition to day shift? I much prefer nights and have worked it out so I can have dinner with family and tuck my kids into bed before I go, and I sleep while they’re in school, but it is hard because everything fun happens when you’re sleeping during weekends .. if I was not a night owl it would definitely not work, you have to be one of us that sleeps like a baby during the day for it to work long term IMO

 

[emergentmd]

Did I really see 323K/yr for a nocturnist job working close to 16 shifts/mo? The misery factor is worth about 200K, so you are essentially getting paid 125K/yr.

 

[GonnaBeADoc2222]

$215 / hr? Lord.

The more I see on here and the more I look around in my local market, the more I appreciate my dysfunctional ER.

I get paid more than this for days in a HCOL area.

 

[RustedFox]

$215 / hr? Lord.

The more I see on here and the more I look around in my local market, the more I appreciate my dysfunctional ER.

I get paid more than this for days in a HCOL area.

Me. Too.

... as a nocturnist.

 

[Janders]

Thats a pass from me.

 

[GonnaBeADoc2222]

Let's hear the city

 

[emergentmd]

$215 / hr? Lord.

The more I see on here and the more I look around in my local market, the more I appreciate my dysfunctional ER.

I get paid more than this for days in a HCOL area.

For realz. I got a great gig, high pay and still we have a hard time covering shifts paying 2x as much.

 

[RustedFox]

Let's hear the city

D-d-d...

 

[Rekt]

D-d-d...

Too high for Denver. You're looking at 160/hr in Denver. Along with daily sodomy by USACS.

 

[GonnaBeADoc2222]

D-d-d...

he said coastal

 

[WilcoWorld]

he said coastal

don't go costal on me, man

 

[gruemd]

he said coastal

D-D-D-Diego, San

 

[Apollyon]

don't go costal on me, man

Well, it is the INTERnet!

 

[NYEMMED]

Hi all,
Considering a nocturnist job in a very popular but HCOL coastal city…
188 nights per year 10p-6a
Rate is $215 per hour
W2 with run of mill benefits provided

Seems like a lot of nights… it’s a partially academic site with a community satellite campuses. We cover all at same rate.
Main campus is level 2 trauma. Daytime is three attending coverage, overnight is one attending with several PA/NP and a resident.

Never been a nocturnist before. Just wondering if this is a decent gig! Looking for others input.

This is a horrible gig, resident hours for non physician provider pay

 

[vagabondattending]

It sounds like a resounding hell no… I was having doubts but this sounds like a definitive consensus.
Keeping the locale confidential, but it’s definitely a trendy place that I thought may be fun to live at. Probably better to get paid well and just visit time to time though.

 

[RustedFox]

It sounds like a resounding hell no… I was having doubts but this sounds like a definitive consensus.
Keeping the locale confidential, but it’s definitely a trendy place that I thought may be fun to live at. Probably better to get paid well and just visit time to time though.

So, word to the wise about working in these "trendy places"... the patient population is often insufferable and impossible to reason with.

 

[pollyspockets]

For realz. I got a great gig, high pay and still we have a hard time covering shifts paying 2x as much.

You hiring 😬

 

[Mount Asclepius]

For realz. I got a great gig, high pay and still we have a hard time covering shifts paying 2x as much.

You aren’t paying $430/hr at a FSED, and especially aren’t having a hard time covering shifts at that rate.

 

[Tiger26]

Ugh I'd rather work in the Midwest for 40/hr more only working 1/3 nights and just vacation on the coast

 

[DeadCactus]

A dedicated nocturnist position should be contracted for fewer total shifts and I would add you should get scheduling priority. There are nocturnist positions that treat a nocturnist like a valued resource that should be recruited and retained and there are nocturnist positions that are just looking to churn and burn through the desperate. This sounds like the latter.

The pay comes down to what the local market is paying and how much you want to live there. To me, there's a threshold salary above which location is way more important to me than adding more income.

 

[Kryptocoin]

.............Daytime is three attending coverage, overnight is one attending with several PA/NP and a resident.

Never been a nocturnist before. Just wondering if this is a decent gig! Looking for others input.

*Might* not be a bad gig, if the midlevels and residents are seeing all the pts and you're just chilling. I make a lot more working nights but it's solo coverage. No midlevels or residents.

The big red flag I see is the number shifts/month. 16 nights/month is way too many, even with help. I work 8 nights/month and even that is too much for me. I can't imagine working twice as much.

 

[Mount Asclepius]

Agree with majority of comments.

A nocturnist position should offer you scheduling and financial advantages. This doesn’t seem to be the case for this position.

Compensation seems low. Even when factoring in a popular location. However, I don’t know what the volume is for this specific position at the various sites, or what you should expect for an academic position in general. Compensation is low though for a nocturnist position with average volume in the community.

In my opinion, the gold standard day or night is $150/patient, $300/hour. Then add on differential pay for working nights. Far too many people are taking employed or CMG positions thinking $200/hour is a decent deal when seeing/supervising a total of 2-5 patients/hour. It might be fair if you work in a slow critical access ED and that’s what you want. It’s not though in a busy ED when you want to make money.

Only you can determine the number of hours you want to work. This job is on the higher side and may not be sustainable over time. 188 8-hour nights/year is 15-16 shifts per month. I’ve worked more shifts/hours per month at times in my career. I think 12-14 scheduled 8-hour shifts is probably a better number.

 

[alpinism]

Honestly I don't think the pay is as horrible as other people are saying.

According to OP the job offer is for a full time academics position in a popular big city.
These positions have traditionally always paid terribly and its common for the new faculty hires to start at less than 200/hr until they move up the ranks in academics which allows for decreases in clinical shifts and high paying leadership positions. Its also likely to be much slower at night with a fast track to see the BS so you'll only see the high acuity cases with residents which isn't too bad for more than 200/hr to be honest.

Now that being said being forced to do that many overnights sucks and likely isn't sustainable unless you're the type of person who enjoys staying up late regardless and doesn't need to flip back to days. If not you'll likely be miserable constantly switching back and forth and won't have anything resembling a normal life that allows for regularly spending time with friends outside of medicine.

 

[WilcoWorld]

In my experience, an overnight shift costs you two days of your life at minimum. The day of the shift is spent preparing & then working, the day after the shift is spent recovering. That day off is often referred to as a "DOMA" (day off? my ass!)

So, by my reckoning, this job is offering you zero days off per year. I doubt you'll make it 6 months before you start looking for a different job - any job.

 

[RustedFox]

In my experience, an overnight shift costs you two days of your life at minimum. The day of the shift is spent preparing & then working, the day after the shift is spent recovering. That day off is often referred to as a "DOMA" (day off? my ass!)

So, by my reckoning, this job is offering you zero days off per year. I doubt you'll make it 6 months before you start looking for a different job - any job.

Nocturnist here.
Heed these words.
At present, I only work 10 shifts/month AND they're batched together. I win the "free time" game... for now.

 

[dchristismi]

In my experience, an overnight shift costs you two days of your life at minimum. The day of the shift is spent preparing & then working, the day after the shift is spent recovering. That day off is often referred to as a "DOMA" (day off? my ass!)

So, by my reckoning, this job is offering you zero days off per year. I doubt you'll make it 6 months before you start looking for a different job - any job.

This. So much this.

Have also been a nocturnist, but not in the purest sense of the word. The right gig is everything. The wrong gig risks your life. Driving sleep deprived will kill you.

Have you taken care of a coworker who crashed their car driving home? I have. I will never forget defending that secretary to the trauma team because we knew damn well she wasn't drunk. She fell asleep at the wheel. But she lived.
Do it for years and you do incur actual health risks.
The DOMA pain is real.

 

[Tenk]

Nocturnists should get minimum $250-$300/hr and thereby work less and make their own schedule. God I miss ours.

 

[Dred Pirate]

A dedicated nocturnist position should be contracted for fewer total shifts and I would add you should get scheduling priority. There are nocturnist positions that treat a nocturnist like a valued resource that should be recruited and retained and there are nocturnist positions that are just looking to churn and burn through the desperate. This sounds like the latter.

This is the thing where most management has a disconnect with staff.
I worked nights for years (again a different profession) but we got $13k a year shift differential, plus we worked 7 on 7 off - worked 70 hours, get paid for 80 - for me another ~19k a year - plus we can use our PDO on top - 320 hours a year for me. I worked 1500 hours and considered full time. Base salary for me was $145k for comparission

So mgmt came in- took away the work 70 get paid for 80- was going to limit you to 150 hours of PDO a year (sell the rest back)- and since your FTE dropped to <0.9, you lost a week of vacation.

We had 6 rphs - 5 of us had a combined 105 years of experience. Guess what - 2 retired earlier, 2 changed hospitals, and one changed to a day shift position.

We were replaced with people all with <5 years experience, 2 where new grads. Now do you really want a new grad to work a shift where you have less resources/support?

 

[emergentmd]

You aren’t paying $430/hr at a FSED, and especially aren’t having a hard time covering shifts at that rate.

I call it fat cat syndrome.