Any other nocturnists here? Do u think nightshifts has affected u negatively?

[Meerkatology]

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I've been an IM nocturnist for the past 5 years, first job out of residency. I work a relatively light shift 18 shifts/month ~avg 2 admits per shift - though the patients in my hmo group are generally fairly sick/complicated

theres two issues that i'm not sure are actual issues, want to know what other people's experiences are

1. Do you think working nights chronically has affected your health at all?
-I've generally been trying to keep a regular sleep schedule by sleeping during the day time. like between 8am to 4pm. I have no issues sleeping during the day, although I do adjust cycles often for the off days with family, i do get enough hours of sleep overall. However, lately i feel like my short term memory is getting worse, its not super obvious so i might be imagining things, i didn't find much reliable scientific research on how/if there's any effect of sleeping during the day time vs night could affect ur health overtime. maybe its a part of getting older? i don't know if being 34 should feel a difference vs being in ur 20's.

2. Do you feel like your learning enough on the job?
-since its very hard to really measure one's clinical skills, our shifts, even the busier ones generally have less clinical work compared to dayshift. alot of times i feel like i'm having to look up stuff that i should know. though other times i look at what some of the other physicians do and be like , wtf? - mostly the ER though

 

[Trogghunter]

Not a full time nocturnist but I work nights often in week long segments. I am early 30s as well, and the shock to my circadian rhythm affects me significantly, despite that I sleep well from about 8am-3pm. I actually get more sleep working nights vs days, but I don't feel as rested. My medical decision making seems comparable, but my non-medical function takes a hit. I do have some of the short term memory issues that resolve, and I also have a flatter affect on nights. It seems to effect people differently, but it does not seem to be something sustainable long term for you maybe. Come to the light!

 

[blub1212]

I am on my first contract outside of residency. I have a split contract, a little over half is nights (in 7-day blocks) and the rest is days. I definitely underestimated how much all these nights would affect me (both mentally and physically). I only learn on nights when it is slow enough to read. Luckily I am going back to do a fellowship and won't have to continue doing this. I won't be signing a contract with nearly this many nights again.

Edit: also in my early 30s

 

[MD46]

I worked locum nights during fellowship during the research months.
It was physically and mentally taxing.

Had this lingering headache for a few weeks after. Needed melatonin to get back on track.
Not sure how people do it for a living, kudos to you.

I think over time it likely has permanent effects on the body.

 

[tantacles]

I obviously haven't done this as an attending, but I have always found nights much easier than days, even on the same schedule. I am the worst possible morning person, and if I wake up at 3 pm, I am absolutely good for 16 hours awake. If I wake up at 6 am, I am mentally asleep by 2 pm. Long stretches of nights are much more difficult than working 3 in a row with a day off in between.

In the practice I've accepted a position at, it's only 10 nights per month for 1.0 FTE. For that reason, I find your practice's model interesting (and maybe alarming?) as the number of nights you're doing in one week is almost equal to the number I would do in an entire month, and you would presumably still have day responsibilities a week after, no?

 

[blub1212]

I obviously haven't done this as an attending, but I have always found nights much easier than days, even on the same schedule. I am the worst possible morning person, and if I wake up at 3 pm, I am absolutely good for 16 hours awake. If I wake up at 6 am, I am mentally asleep by 2 pm. Long stretches of nights are much more difficult than working 3 in a row with a day off in between.

In the practice I've accepted a position at, it's only 10 nights per month for 1.0 FTE. For that reason, I find your practice's model interesting (and maybe alarming?) as the number of nights you're doing in one week is almost equal to the number I would do in an entire month, and you would presumably still have day responsibilities a week after, no?

Yeah, I basically do 7 on 7 off, with one week of nights and one week of days per month. Some months I just do 2 weeks of nights. The constant switching back and forth is part of the problem. This definitely isn't for me, oh well, you live and you learn.

 

[tantacles]

Yeah, I basically do 7 on 7 off, with one week of nights and one week of days per month. Some months I just do 2 weeks of nights. The constant switching back and forth is part of the problem. This definitely isn't for me, oh well, you live and you learn.

Honestly, it sounds pretty awful. 7 nights in my practice is the equivalent of 10.5 day shifts (in my contract, it is laid out specifically that 1.0 FTE is 120 night shifts or 182 day shifts), so it really sounds like you're getting a raw deal unless you're being paid exceptionally.

Admittedly, that is not the question you asked, but it seems germane.

 

[bronx43]

Nights was one of the big reasons why I left hospital medicine to do an outpatient based fellowship. I suffered significant insomnia due to disruptions in my circadian rhythm. It simply wasn't sustainable for my body.
For those who have no such problem, nocturnist is a good gig.

 

[xoggyux]

I think the constant switching is the real vampire of your performance and I think this is what's ultimately at the core of the additional burnout that those that work shift hours are experiencing (ED/Hospitalists). Those that work only 7/7 days and never night seem to be quite happy with their jobs, those that only do 7/7 nights also seem that way although this is really a short term arrangement as at some point people find themselves into the "create family/interact with friends/etc" situation and full-time nocturnist becomes a problem.