8-Hour Shifts

[dradams]

I ran into a 4th year EM resident yesterday who told me that most EM jobs these days are not doing the 12-hour shifts but instead are offering 8-hour shifts something like four days per week. Is this really true?

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[Apollyon]

Anyone who talks about "most" this or that often does NOT have the information that is even nearly globally correct (and that goes for people on SDN, including some residents that purport to speak for all of EM).

12 hour shifts are alive and well in the community EM world. There's just not enough EM docs to staff 8 hour shifts in some (?many?) places.

 

[Powdermonkey]

I think the docs where I work pull 9 or 10 hour shifts. But there are a bunch of them, so... ?? They usually end up staying over a bit to finish up their last patients, but not a bad shift at all.

 

[DrQuinn]

We do 8s, but we are at an 80k Level 1 academic center.

There are no hard and fast rules.

People still do "24s."

Q

 

[Hawkeye Kid]

People still do "24s."

Q

i know of a guy who recently (past 3-4 years) signed on to work 7 24s/mo in a medium-sized town in iowa--medium-sized for iowa, that is; small by conventional standards. >200k/yr with ridiculously low cost of living for basically being on in-house call q4. not a horrible gig, unless you like seeing patients or having city-like social outlets.

 

[dradams]

We do 8s, but we are at an 80k Level 1 academic center.

There are no hard and fast rules.

People still do "24s."

Q

Quinn, can I ask where you are working now. I was thinking of looking at the USF program, What did you think now that you are done?

 

[RockfordWF]

I ran into a 4th year EM resident yesterday who told me that most EM jobs these days are not doing the 12-hour shifts but instead are offering 8-hour shifts something like four days per week. Is this really true?

I've seen shifts vary from 8 hours to 24 hours. Most of the ones I have seen are 12 hours, however. It may be a regional thing or an academic vs. community hospital thing.

 

[Jeff698]

Our faculty at the 'mothership' do 8s while the residents do 12s. The attendings at our community hospital down the road do 12s with no residents.

Both of my moonlighting gigs do 12s with 24s available if you want them.

Take care,
Jeff

 

[kungfufishing]

residency 12/faculty 8's/moonlight 9's and 12's

This really is variable. You can probaby find what you want if you look.

 

[doctawife]

I do 8s on weekdays and 12s on weekends in the Pedi EC.

 

[dradams]

Thanks for the info.

 

[edinOH]

I'm doing 12's in my community gig. I would prefer shorter shifts but I like the money for time trade 12 hour shifts gives me vs shorter shifts.

 

[Arcan57]

Just got done interviewing and saw 12's and then a bastard mix of 8,9, and 10's.

 

[dradams]

I'm doing 12's in my community gig. I would prefer shorter shifts but I like the money for time trade 12 hour shifts gives me vs shorter shifts.

Is there a big difference in the money between 8 and 12 hour shifts?

 

[turtle md]

Is there a big difference in the money between 8 and 12 hour shifts?

8 x 1.5 = 12

y$ for 8 --> y(1.5)$ for 12

 

[dradams]

8 x 1.5 = 12

y$ for 8 --> y(1.5)$ for 12

So an ER doc is paid an hourly rate then?

 

[Jeff698]

What are y'all seeing as the typical minimum number of shifts required vs guaranteed for 12s vs 8s and 9s?

Take care,
Jeff

 

[DrQuinn]

What are y'all seeing as the typical minimum number of shifts required vs guaranteed for 12s vs 8s and 9s?

Take care,
Jeff

Jeff-

I think it has more to do with how many hours are in your contract. Some places may ask 1200 hours. 1400 hours. 1600 hours. Etc. I know a fellow reisdent who took a community job who is supposed to do 1480 a year, but he does 24s and 12s, so he does indeed have quite a bit of time off.

Q

 

[DrQuinn]

Quinn, can I ask where you are working now. I was thinking of looking at the USF program, What did you think now that you are done?

I think the USF program is very solid nad I am glad the chance it gave me. Can I compare it to another program? No.

Because I only went to one program, so its hard to compare.

But as the first chief resident there, I had a good look "behind the scenes" and really did find the PD and the rest of the staff to be 100% resident friendly and woul dback us up no matter what. Which was nice for a new program at the time. You definately should give it a look! Let me know if you interview there.

Q

 

[dradams]

I think the USF program is very solid nad I am glad the chance it gave me. Can I compare it to another program? No.

Because I only went to one program, so its hard to compare.

But as the first chief resident there, I had a good look "behind the scenes" and really did find the PD and the rest of the staff to be 100% resident friendly and woul dback us up no matter what. Which was nice for a new program at the time. You definately should give it a look! Let me know if you interview there.

Q

Thanks, Quinn.

 

[Jeff698]

I think it has more to do with how many hours are in your contract. Some places may ask 1200 hours. 1400 hours. 1600 hours. Etc.

Well, in that case, what are people finding as the minimum number of hours a week/month/year in their job hunts.

I understand that additional shifts may be pick-up-able but I'm wondering what the baseline is.

Thanks and take care,
Jeff

 

[Jeff698]

Just to add to that (and do a little post-padding)...

I know there is tremendous variability around the country. I'm just trying to get a feel for what others are finding.

Take care,
Jeff

 

[GeneralVeers]

I've been trying to convince our PD to switch us to 12-hour shifts, however he says that there's no way to do it and stay within work hours rules by the RRC. Mainly it's an issue of people working a shift before conference, and after conference who won't get their 8 hours off between shifts.

How do the programs that do 12 hour shifts manage to stay within RRC guidelines?

At MLK we did 12-hour shifts, but it was easy to schedule, as the management simply ignored the RRC requirements.

 

[Jeff698]

How do the programs that do 12 hour shifts manage to stay within RRC guidelines?

We do 12s and are easily in compliance with duty hour restrictions. As for conference, we just schedule our people to work that day like any other. If they're on during conference, staff covers for them and they go to conference.

As an example, our conferences are every Thursday from 7a - noon. Our shifts are from 6a - 6p and 6p-6a. If we're scheduled for the day shift that day, staff gives us a break and we just show up at 7 for conference. After conference at noon we walk to the other side of the ED and start working in the middle of our shift.

Take care,
Jeff

 

[Greenbbs]

at my hospital, we do 8's. I think we do 4 or 5 8's a week, and the usual after time is about an hour (we don't pick anyone up the last hour of our shift because we have overlapping residents for every shift).

I've never worked more than 5 8's a week, and never more than 21 8's a month.

We work less than some of our attendings, but it's all what you make of it. We have 7-3, 11-7, 3-11 and 1030-7a shifts, plus the fast track 11-7 and 3-11 coverage every day in our ER. When you're on, you're busy because you see the lions share of the patients during your shift, unless you're the midday shift who then splits with the other two residents. I think on an average day, i see about 18-20 patients in my 8, with a good mix of medical and surgical patients.

Today, i saw 18, including a fairly large trauma, and a patient in septic shock. Rest were CP rule outs, rashes, and orthopedic types.

 

[GeneralVeers]

We do 12s and are easily in compliance with duty hour restrictions. As for conference, we just schedule our people to work that day like any other. If they're on during conference, staff covers for them and they go to conference.

Since I have to make the schedule, I hear nothing but bitching from everyone about having to work too many days. I think our interns do enough (twenty 8-hour shifts) however our PGY-2s do 20 as well, and the seniors do 19.

If I could get 12 hour shifts, it would mean 3-4 extra days off in the month for everyone.

The problem is that our PD is extremely literal-minded when it comes to RRC guidelines. There must be 8 hours off between shifts (including conference). Example: If you worked 7 PM to 7 AM, then went to conference the next day until noon and had to work again that evening, you would only have 6-7 hours off, which is a violation. Likewise, working a 12-hour shift then going to conference is an 18-hour shift, which apparently is a violation.

I personally don't think attending conference/journal club is the same as clinical duties.

 

[Dr. Will]

We usually have many off service residents who cover the intern area during conference. Staff covers everywhere else. As interns, we work 12's, while the 2's/3's work 8's. Those that worked the night before aren't required to show up to conference, especially if they have to return that night. Those of us working 12's have what we call "princess shifts," which mean you are scheduled during conference and just show up once it's over and work the rest of your shift, which is only 6 hours. We work 20-22 12's, btw, so I'm looking forward to switching to 8's next year.

 

[BADMD]

So an ER doc is paid an hourly rate then?

It depends on the group. When I'm moonlighting in the ED, I'm hourly, so I much prefer it when I'm scheduled for an 11 hour shift than when I'm the unlucky 6 hour guy.

Where I was a resident, the attendings were paid by the shift. The day shift was 9 hours, the afternoon 8, and the overnight 7. So you could make the same money and work fewer hours, if you were willing to do the night shift.

 

[GeneralVeers]

We usually have many off service residents who cover the intern area during conference. Staff covers everywhere else. As interns, we work 12's, while the 2's/3's work 8's. Those that worked the night before aren't required to show up to conference, especially if they have to return that night. Those of us working 12's have what we call "princess shifts," which mean you are scheduled during conference and just show up once it's over and work the rest of your shift, which is only 6 hours. We work 20-22 12's, btw, so I'm looking forward to switching to 8's next year.

I think you've found our stumbling block. At MLK we did 12's and did not have to show up for conference if we worked at night. Our PD insists that everyone goes to conference every week regardless of what shift they have worked - hence the problems. If I could convince him to let the 2 night people avoid conference we could probably implement this.

 

[DrMom]

I think you've found our stumbling block. At MLK we did 12's and did not have to show up for conference if we worked at night. Our PD insists that everyone goes to conference every week regardless of what shift they have worked - hence the problems. If I could convince him to let the 2 night people avoid conference we could probably implement this.

We have 12s (7a, noon, 7p). On the days before our bookclub (at 7a), the noon shift becomes a 10am shift. That way we have a chance to get some sleep between the shift and bookclub. Doesn't eliminate all issues, but does help.

 

[ERMudPhud]

In my area we've got attendings working, 6,7,8,9,10,11,12 and 13 hours shifts depending on the hospital. One of the nearby rural hospitals just sent me a letter advertising 12,24, and 36 hour shifts.