12h shifts?

[pinipig523]

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Hey fellas,

Doing 12h shifts (13 in a month) in a low volume place. What do you think? It's only for a year, they will switch to 8-10 when the volume picks up.

Opinions and thoughts are appreciated.

Thanks.

 

[EctopicFetus]

Just depends on patients per hour and system. Where I work I choose 12's. I do 12-13 12s per month. I avg about 1.9 patients per hour in a highly efficient system (meaning admits dont sit there forever, labs/ct etc come back fast).

I think it is totally doable especially when young. The old guys do more of the 8-10s but the younger guys do the 12s.

 

[la gringa]

i hate them... i'd rather have at least some of the day to do something. even w/ a short commute and perfect signout it eats up your day. yeah you work fewer days, but all you do is work those days. i like to at least be able to work out, have some social or family/friend time, etc... some of the days that i work.

totally variable though - obviously some people love them - and it sounds like you already took the job, so i guess you'll see how you like 'em!

 

[EctopicFetus]

i hate them... i'd rather have at least some of the day to do something. even w/ a short commute and perfect signout it eats up your day. yeah you work fewer days, but all you do is work those days. i like to at least be able to work out, have some social or family/friend time, etc... some of the days that i work.

totally variable though - obviously some people love them - and it sounds like you already took the job, so i guess you'll see how you like 'em!

Agree with Gringa.. 1) in my job I show up 10 mins early and leave almost all the time right on time. Thats our culture here. The beauties of 8 hour shifts is you can do a slew of stuff before or after your shift and this is really hard when you work 12s.

 

[pinipig523]

i hate them... i'd rather have at least some of the day to do something. even w/ a short commute and perfect signout it eats up your day. yeah you work fewer days, but all you do is work those days. i like to at least be able to work out, have some social or family/friend time, etc... some of the days that i work.

totally variable though - obviously some people love them - and it sounds like you already took the job, so i guess you'll see how you like 'em!

not yet... the contract is not yet signed.

 

[pinipig523]

Agree with Gringa.. 1) in my job I show up 10 mins early and leave almost all the time right on time. Thats our culture here. The beauties of 8 hour shifts is you can do a slew of stuff before or after your shift and this is really hard when you work 12s.

I asked the medical director about this - because we work on guaranteed reimbursement per the hour, we should sign out the entire board at the end of the shift. She told me that there should be no reason to stay a period of time after the 12h shift - that would be painful.

 

[EctopicFetus]

Some places those 12s are 13s or more thats insane. Honestly, 12s arent too bad but it is hard to have a life around those 12s.

 

[pinipig523]

Some places those 12s are 13s or more thats insane. Honestly, 12s arent too bad but it is hard to have a life around those 12s.

I totally agree... 12s with sign out and quickly out the door seems a lot better than those 12s that become 13 and 14.

 

[EM_Rebuilder]

I totally agree... 12s with sign out and quickly out the door seems a lot better than those 12s that become 13 and 14.

As an FYI, at our shop, we do not see any patients over the last hour to hour and fifteen minutes. Its rare we sign anyone out. We have an hourly wage, and a small RVU bonus on top of that so its in your best interest to not sign out patients as the signer of the chart gets the bonus credit.

The first month or so, I was having to stay after a bit (not more than 30 mins to an hour). After I have been here a few months, I dont really stay after nor does any of the senior docs. I could probably count on both my hands how many signs outs I recieved in the last ~4 months...

Leaving early actually happens on occasion; I left 45 minutes early yesterday as I had my patients all dispositioned; early is more typically a 10-15 minutes thing though. We just leave a note for the oncoming doc about the consults still in the dept...

 

[Mighty Mouse]

not seeing a patient in the last hour only works if there is multiple doc coverage. if you're single coverage (in what i would assume is a small, relatively low volume ED if its being covered single doc with 12s), its not realistic to say you're going to leave a patient sitting there for an hour.

i moonlight in single coverage ED, 12s. hourly rate. their marketing campaign is as an express care ED, so nobody is waiting. if someone comes in at 645, i'm left with the dilema of either seeing patient and having signout that isn't tied up, just ordering stuff to get things going but letting the next guy see the patient, or doing nothing. depends on the complaint and acuity for me.

in the end, its very difficulty to be walking out the door immediately at the end of my shift. even if you sign out the second the next guy gets there, you're still looking at walking out the door at 715. add on 30 minute commute there and back. its quickly a 13 hr day. if i'm batching a few shifts in a row there, i find that i'm doing very little besides working, eating dinner, and watching tv for an hour before going to bed.

12s are a personal preference. but i agree, i'd rather work 8s, 9s, or 10s and have time to do other things that day. makes it seem more like i'm not a slave to my job. my full time job i have shifts between 6 hrs to 10 hrs, with the majority being 9s. much better.

 

[pinipig523]

not seeing a patient in the last hour only works if there is multiple doc coverage. if you're single coverage (in what i would assume is a small, relatively low volume ED if its being covered single doc with 12s), its not realistic to say you're going to leave a patient sitting there for an hour.

i moonlight in single coverage ED, 12s. hourly rate. their marketing campaign is as an express care ED, so nobody is waiting. if someone comes in at 645, i'm left with the dilema of either seeing patient and having signout that isn't tied up, just ordering stuff to get things going but letting the next guy see the patient, or doing nothing. depends on the complaint and acuity for me.

in the end, its very difficulty to be walking out the door immediately at the end of my shift. even if you sign out the second the next guy gets there, you're still looking at walking out the door at 715. add on 30 minute commute there and back. its quickly a 13 hr day. if i'm batching a few shifts in a row there, i find that i'm doing very little besides working, eating dinner, and watching tv for an hour before going to bed.

12s are a personal preference. but i agree, i'd rather work 8s, 9s, or 10s and have time to do other things that day. makes it seem more like i'm not a slave to my job. my full time job i have shifts between 6 hrs to 10 hrs, with the majority being 9s. much better.

I asked the director about this. The response was that everyone had to be seen but you can start the workup superficially. Like ordering some pain medicine or getting some labs started. You need not write up a note. You just tell the patient that another doc is coming in 30 minutes, but I'd like to get things started.

But yes, I can definitely see how this'll blur the line into a 12+h shift.

Main thing is this 12h shift is temporary.

 

[Mighty Mouse]

not trying to piss in your pool because i clearly don't know much about your actual job offer or work environment...but my advice is this....

don't assume anything is temporary. if the director says he's going to change shifts to 10s and add more coverage, thats predicated on a few things....patient volume increasing to anticipated numbers, having more docs to staff the increased shift load, and more money to pay for it all.

one of our satellites worked 3 shifts per day (7a-7p, 12p-10p, 7p-7a) and changed to 4 shifts per day and less hours. now the patient volume hasn't picked up, and he's begging moonlighters to cover the extra shifts. I really think in the end, he won't be able to sustain it.

you need to be willing to take the job assuming 12s are the life you are looking at for as long as you work there. if the hours change, so be it. its a bonus. but you can't predict the future, can only decide on the job as presently offered, not projections.