Typical amount of day/evening/nights?

[LiamNeesons]

Is it likely that one could split shifts evenly between days, afternoons, and nights?

I know more coverage is needed at night. However, is this dilemma commonly alleviated by extra mid-level coverage, physician coverage, or both?

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[Hercules]

Everyone in my group works an even mix of days, evenings, and nights.

 

[SoCuteMD]

My site has 2 overnight shifts, 3 day shifts and 3 evening shifts. So 25% of the shifts are nights. I end up working about 25% nights, 50% evenings, and 25% days. The imbalance between days and evenings is mostly due to academic commitments during the day (which not everyone has).

 

[Killa Beez MD]

My site has 2 overnight shifts, 3 day shifts and 3 evening shifts. So 25% of the shifts are nights. I end up working about 25% nights, 50% evenings, and 25% days. The imbalance between days and evenings is mostly due to academic commitments during the day (which not everyone has).

What is the breakdown of shifts for the rest of the ED docs at your institution that don't have academic duties?

 

[The White Coat Investor]

Our physician shifts are all 8 hours:
6a-2p (the only real day shift)
11a-7p ( a swing shift that if you stay late, lasts until the kids are in bed)
2-10p (evening)
7p-3a (night)
10p-6a (night)

So, 80% of our shifts are in the evenings and nights at some point. Even if you look at the "hours of coverage," 65% of them are after 5 pm. My personal mix is about 80% of my shifts are in the evening or at night, but some in my group rarely work after midnight (and make less because of it.)

 

[Janders]

We have 4 shifts, and you get 25% of each:
7a-3p
noon-9p
3-11p
10p-7a

Our PAs work a variety of shifts to provide coverage in the roughly 9a-midnight range.

 

[Killa Beez MD]

Are the different shifts bundled together (for example: day shift, day shift, day off, evening shift, evening shift, day off, night shift, night shift, 2 days off, repeat) or are you switching shifts back and forth more randomly(example: day shift, night shift, evening shift, day off, night shift, day off, evening shift, day off, day shift, night shift, etc)?

 

[Arcan57]

Are the different shifts bundled together (for example: day shift, day shift, day off, evening shift, evening shift, day off, night shift, night shift, 2 days off, repeat) or are you switching shifts back and forth more randomly(example: day shift, night shift, evening shift, day off, night shift, day off, evening shift, day off, day shift, night shift, etc)?

Generally the scheduler is going to try and create the most Circadian friendly pattern possible given the number of docs and their off requests. It's extremely difficult (or really easy depending on the crew) to pull off consistent block scheduling. Every group I've worked with has prioritized time-off over Circadian friendliness with the result that most docs are working about 0.5 DOMAs per month. You should expect that the vast majority of the time you'll be advancing forward in your shifts and you have a couple of days off in between nights and switching back to days. This won't work for every group for every month but it's probably the bare minimum in terms of targets for the scheduler. Of note, 2 days isn't really enough time to recover from working nights but we all pretend like it is because we don't want to use up our off requests just for Circadian purposes.

 

[KinesiologyNerd]

Group I scribed for (and hope to one day work for haha) does 4 months of days/evenings and then 2 months of nights. Week on/week off. Some of the docs will trade for nights only. Seemed like a really agreeable schedule that everyone liked.

 

[QuackaDO]

Group I scribed for (and hope to one day work for haha) does 4 months of days/evenings and then 2 months of nights. Week on/week off. Some of the docs will trade for nights only. Seemed like a really agreeable schedule that everyone liked.

Sounds like a dream job, lol!

 

[Greenbbs]

Days and evenings only. I haven't worked a night shift since residency (~4yrs)

 

[emergentmd]

Days and evenings only. I haven't worked a night shift since residency (~4yrs)

We have 6 shifts

6a-1p
9a -4p
1p-8p
4p-11p

Our physician shifts are all 8 hours:
6a-2p (the only real day shift)
11a-7p ( a swing shift that if you stay late, lasts until the kids are in bed)
2-10p (evening)
7p-3a (night)
10p-6a (night)

So, 80% of our shifts are in the evenings and nights at some point. Even if you look at the "hours of coverage," 65% of them are after 5 pm. My personal mix is about 80% of my shifts are in the evening or at night, but some in my group rarely work after midnight (and make less because of it.)

Our shift are very similiar. All 8 hrs but really end up being 7hrs as the guy leaving only picks up sore throats the last hr.

Most do not do nights anymore and the ones that do nights gets a big bump in pay. I would say 70% of our docs have not done nights in over 10 yrs.

So, about 40% of my shifts end before 4p, 40% end at midnight. and 20% end at 3am. Not bad

 

[Pinner Doc]

At one of my gigs, we have lots of day/evening shifts and one true overnight shift.
6a-2p, 8a-4p, 10a-6p, 2p-10p, 4p-midnight, 6p-2a.. and 10p to 6a.
There are 3-4 doctors in the group who actually WANT the overnight shift. So basically, everyone else doesn't have to work it. You do end up with a handful of 6p-2a shifts - maybe once or twice a month. The better shifts are given by seniority, so if you've been around the longest (20 years) you get all 8-4 shifts, basically.

At my other gig, it's single coverage, and just three shifts: 7a-3p, 3p-10p, 10p-7a. It's pretty equitable among providers who gets what.

I also moonlight at our local VA. They try to give the weekend and overnight shifts to their moonlighters, which is great for their full-time and even part-time docs.

 

[Hercules]

In my SDG that runs a 40k community ED with 20 beds we have a 7a-5p, 2p-12a, and 8p-7a physician shifts and two mid level shifts from 10a-7p and 5p-2a.

I also moonlight at another ED in town thats owned by a CMG. I only agree to work the 6a-4pm and occasionally the 10a-8p on non-holiday weekdays. Why would the moonlighters agree to work the worst shifts? My thought process is that I work my share of the undesirable shifts at my main sight. Why would I want an extra helping of those? I think you would have to triple or quadruple my rate to get me to pick up a moonlighting night shift

 

[Pinner Doc]

In my SDG that runs a 40k community ED with 20 beds we have a 7a-5p, 2p-12a, and 8p-7a physician shifts and two mid level shifts from 10a-7p and 5p-2a.

I also moonlight at another ED in town thats owned by a CMG. I only agree to work the 6a-4pm and occasionally the 10a-8p on non-holiday weekdays. Why would the moonlighters agree to work the worst shifts? My thought process is that I work my share of the undesirable shifts at my main sight. Why would I want an extra helping of those? I think you would have to triple or quadruple my rate to get me to pick up a moonlighting night shift

I agree with you. It's bassackwards. I work with them right now because I'm transitioning from a place I've been for 2-3 years to a new job closer to home, but I've been moonlighting at the VA for a couple of years and it's the one steady I have right now. At first it was about equitable for good shifts with the regulars who work there, but they've been making the moonlighting shifts less and less desirable.