7 on 7 off schedule in EM?

[MedGuy321321]

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EM is shift work so I don't see why the 7 off 7 on schedule hospitalists have isn't commonplace. I know 12 hour shifts are long but having every other week off is amazing. Are jobs like this available?

 

[e30ftw]

7 12s in a row is torture. I would never want to work at a place like that. If you volunteer to work 7 nights in a row twice monthly I'm sure you'd have no problem getting that schedule.

now if you have 9 or 10 hr shifts you can do 4 on 3 off 4 on 2 off 4 on 6 off etc very easily.

 

[SuckySurgeon7]

Why couldn't you just arrange your 3-day-per-week consecutive shifts back-to-back (three-in-a-row at the end of one week and three-in-a-row at the beginning of the next and then 8 off consecutively)?

 

[BoardingDoc]

EM is shift work so I don't see why the 7 off 7 on schedule hospitalists have isn't commonplace. I know 12 hour shifts are long but having every other week off is amazing. Are jobs like this available?

Are these jobs available? Maybe. Noone in their right mind would take them though. 12 hour shifts are very draining. Seven 12 hour shifts in a row sounds like insanity. I don't care how much time you get off after.

 

[SoCuteMD]

I'm so glad the 7-on/7-off template hasn't taken hold in emergency medicine.

Why couldn't you just arrange your 3-day-per-week consecutive shifts back-to-back (three-in-a-row at the end of one week and three-in-a-row at the beginning of the next and then 8 off consecutively)?

Because your schedule isn't always what you want. It takes into account what you want/need and what all your colleagues need as well. The people I know who have clustered/templated schedules are the people who work dedicated night shifts. If you're willing to do that, many groups will give you whatever schedule you want.

 

[NinerNiner999]

That would be a nightmare in my opinion.

 

[Mad Jack]

This isn't a bad idea. This is the worst idea.

 

[e30ftw]

I know one doc who works 4 days a week the same shifts every week.

Guess what she works?

thursday night, friday night, saturday night, sunday night.

If you go to a group and sign a contract for that schedule you could get hired anywhere..

 

[Birdstrike]

7 on 7 off in EM is murderous. Murderous. The intensity level is way to great in a busy, high acuity ED.

I've said it before, I'll say it again- 1 hr in the ED is equal to 1.5 hours doing anything else normal people do at work, including other doctors. This is affectionately known as the "Birdstrike Multiplier" much like other undeniable truths such as Einstein's E=MC squared, Sponge Bob's Krabby Patty recipe, and Big Foot.

Your 7 twelve hour shifts (which will be 7 thirteen hour shifts in reality since getting out on time on a twelve hour shift is difficult) will really equal and feel like 7 x 12 x 1.5 (Birdstrike Multiplier) = 126 hr per week, intersperse with 1 wk off. That's honestly what it's going to feel like. There's a reason EM doctors try to only work 33-34 hr per week. Because it's really 50 hours doing anything else.

 

[deleted6669]

I have seen these jobs advertised at slower community shops where you see <20 in 12 hrs.

 

[Hercules]

This is a terrible idea. My hometown ED is ~80k volume and was run by an independent group that tried that exact schedule. 7 twelve hour day shifts, 1 week off, then 7 twelve hour night shifts, 1 week off. Repeat. Shockingly they couldn't recruit very well and wound up losing the contract to a CMG.

 

[normtheniner]

I feel like it'd be more like 7 days on and then 7 days dreading being on again....

 

[WilcoWorld]

EM is shift work so I don't see why the 7 off 7 on schedule hospitalists have isn't commonplace. I know 12 hour shifts are long but having every other week off is amazing. Are jobs like this available?

I would burn out in under a year doing 7 day stretches of 12's.

 

[The White Coat Investor]

I don't want to do 5 eights in a row, much less 7 twelves. I'm burnt after 3 twelves. By the end of that third shift I don't care who lives or dies as long as I can get out of there. Okay, maybe not that bad, but it's definitely not fun.

Now, 7 12s then 3 weeks off? I could do that for a while. But why? I'd rather do 12 sevens a month than 7 twelves in a week.

 

[alpinism]

As others have explained EM shifts aren't comparable to other specialties (hospitalists/intensivists) or even other medical providers (techs/nurses).

When you're working in the ED, you're literally working 8-12hrs straight with no break. On busy shifts you barely have time to use the restroom let alone grab a snack. There's always a backlog of patients waiting to be seen and when a critical patient or trauma rolls through the door you've got to drop everything to deal with them. Even as a young person in their 20s or 30s you wouldn't want to work more than 4 12s straight max.

I just got off my 5th 8hr shift in a row and while it's still fun, it's also exhausting.

 

[WilcoWorld]

I don't want to do 5 eights in a row, much less 7 twelves. I'm burnt after 3 twelves. By the end of that third shift I don't care who lives or dies as long as I can get out of there. Okay, maybe not that bad, but it's definitely not fun.

Now, 7 12s then 3 weeks off? I could do that for a while. But why? I'd rather do 12 sevens a month than 7 twelves in a week.

#12x7's>>>7x12's

 

[Mighty Mouse]

I had a job where it was 7 on 7 off over 4 hospital sites. worked out to 5 8s and 2 12s in the week. All sites were crazy busy. Absolutely exhausting. Not as easy to make swaps if you needed a day off during your work week as you'd think. A swap would mean you or the other swapper was going to work 8-9 in a row, or would be working one of the weekends you typically had off. Our week was Wednesday - Tuesday. I didn't like it. I didn't think I could work at that clip for as long as I wanted to practice medicine.

 

[Apollyon]

I worked Saturday Sunday day, and Monday overnight for 2 years. That was GREAT.

7 in a row? Hell, with 5 in a row, like WCI said, I didn't care if they lived or died (we would do 5 in a row for Thanksgiving, Christmas, and New Year's - you got T and NW one year, and C the next).

 

[CajunMedic]

Are these jobs available? Maybe. Noone in their right mind would take them though. 12 hour shifts are very draining. Seven 12 hour shifts in a row sounds like insanity. I don't care how much time you get off after.

Could be worse, at one hospital in my service area, they work 7-24's. One doc drives in from 7 hours away and lives in the hospital, the other one lives in a trailer on the grounds for a week. Now, 4 low to mid acuity patients in 24 hours is a bad day, and the ED is only 1 bed with a 1 bed overflow. Just added on a brand new ED, believe it's 5 beds, they updated the lab and added a CT Scanner, but can't use any of it due to an issue with builder.

 

[BoardingDoc]

Could be worse, at one hospital in my service area, they work 7-24's. One doc drives in from 7 hours away and lives in the hospital, the other one lives in a trailer on the grounds for a week. Now, 4 low to mid acuity patients in 24 hours is a bad day, and the ED is only 1 bed with a 1 bed overflow. Just added on a brand new ED, believe it's 5 beds, they updated the lab and added a CT Scanner, but can't use any of it due to an issue with builder.

How exactly do they work 7 24s? E.g. they work 24 on, 24 off for 14 days? You obviously can't work 7 24s straight for practical (and I'm sure legal) reasons. Either way, I find it hard to believe that this actually happens unless they're paying these people obscene amounts of money.

 

[deleted6669]

How exactly do they work 7 24s? E.g. they work 24 on, 24 off for 14 days? You obviously can't work 7 24s straight for practical (and I'm sure legal) reasons. Either way, I find it hard to believe that this actually happens unless they're paying these people obscene amounts of money.

I work 24s sometimes. The volume is so low you can sleep 8+ hrs/24 most days. I see 8-12 pts/24 hrs and frequently none after 11pm.

 

[Arcan57]

I'm weighing a job that has 30 24s then 5 months off. Is lack of 401k matching a red flag? 🙁

 

[CajunMedic]

How exactly do they work 7 24s? E.g. they work 24 on, 24 off for 14 days? You obviously can't work 7 24s straight for practical (and I'm sure legal) reasons. Either way, I find it hard to believe that this actually happens unless they're paying these people obscene amounts of money.

They work 7, 24 hour shifts straight. I kid you not. The one physician that drives from 7 hours away is a Family Medicine IMG. He's a nice guy, but has said more than once "I'm out of my league here." He stays in the doctor's bedroom and they wake him up when we call in our report or a patient walks in. The other doc is a local IM physician, he stays in his trailer on the grounds and walks over when the nurses call him. It's a county-owned, critical access hospital, the money can't be that obscene.

Now, if you want obscene money, BC/BE EM physicians are desperately needed in some of the rural hospitals.

 

[deleted6669]

Now, if you want obscene money, BC/BE EM physicians are desperately needed in some of the rural hospitals.

Critical access hospitals for the most part can't afford be/bc em docs. the place I am at pays PAs 70/hr and docs(regardless of specialty) 105/hr. no production.
We staff solo PAs 75% of the time , FP docs a decent amount, and have 1 EM boarded doc-grandfathered em, actually boarded gen surg and took em boards in the 80s- (the chief).

 

[CajunMedic]

Critical access hospitals for the most part can't afford be/bc em docs. the place I am at pays PAs 70/hr and docs(regardless of specialty) 105/hr. no production.
We staff solo PAs 75% of the time , FP docs a decent amount, and have 1 EM boarded doc-grandfathered em, actually boarded gen surg and took em boards in the 80s- (the chief).

Sounds like the next county up. Semi-retired MD Plastic Surgeon, one day out of every 3. NP's the other 2. Occasionally, no coverage and a sign on the door to keep going down the road or call 911.

 

[Alejandro]

Funny how people say you need an iron bladder for surgery. Work in a busy ED for 12 hr shifts and you'll hafta have a titanium bladder.

 

[TooMuchResearch]

Funny how people say you need an iron bladder for surgery. Work in a busy ED for 12 hr shifts and you'll hafta have a titanium bladder.

Take time to pee. Find time to eat. Every shift.

 

[Tri4thlete]

How exactly do they work 7 24s? E.g. they work 24 on, 24 off for 14 days? You obviously can't work 7 24s straight for practical (and I'm sure legal) reasons. Either way, I find it hard to believe that this actually happens unless they're paying these people obscene amounts of money.

I worked at a small hospital in a town of 7,000 people and the emergency physicians did exactly this. There were two ER docs, and they each basically were on for 1 week straight (24 hours in the hospital) then off for 1 week. The urgent care and ER at the hospital were owned by the two ER docs so it was considered a separate entity even though they were both located in the hospital. Not exactly sure how that worked, but it did. The doc who was on would live in the hospital (they had a living area for them). He would work the ER and urgent care area during the day 8a.m. to 5p.m. and then would just do the ER 5p.m. until 8 a.m. the next morning when he would do both. A few other family practice docs helped in the urgent care area during the day just in case he had to go over to the ER.

The ER was tiny, 2 beds. Getting more than 5 patients in one night was considered "busy." So even though they "work" for a week straight, they aren't really seeing patients constantly. I worked at the order entry desk after school from 3 p.m. - 11 p.m. and would give the ER doc a call either when his pizza arrived, or if a patient was coming in. After 11 p.m, there was a buzzer at the entrance that would buzz up to the nurses station and they would come to let patients in to the ER as the doors were locked. I also worked as an EMT when not at the hospital and we didn't get too many high acuity patients, so it was manageable.

 

[UnderwaterDoc]

EM is shift work so I don't see why the 7 off 7 on schedule hospitalists have isn't commonplace. I know 12 hour shifts are long but having every other week off is amazing. Are jobs like this available?

I work five 12s in a row and then rest 7-8 days. Rinse and repeat. I work in a busy-as-balls place with 2.5-3 pph, and I do all nights. My coworkers keep telling me I'm crazy and I'm not gonna lie, that 4th and 5th shift are rough. However I've found that I can tolerate it quite well. I've been doing it for 8 months now and so far so good.