Average nights per month?

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3-4 night shifts (9p-7a), 3-4 swing shifts (2p-12a), and 3-4 day shifts (7a-5p) per month in my group.
 
Apologies, OP.

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Anyone else getting tired of seeing these threads? Its as if the OPs want to say - "Oh, I'm thinking about EM, but then you haaaaavee to work NIGHT-shfits. Zomg." Like there's not going to be nightwork and call in any other specialty (okay, there's derm/plastics... I'll give you that.)

Now, honest answer: Number of shifts per MONTH is highly variable, and dependent upon length/coverage. I work sixteen 8-hour shifts a month, about 4-5 of which are 'nights'.
 
In the United States per night? I don't know, thousands?

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Apologies, OP.

*

Anyone else getting tired of seeing these threads? Its as if the OPs want to say - "Oh, I'm thinking about EM, but then you haaaaavee to work NIGHT-shfits. Zomg." Like there's not going to be nightwork and call in any other specialty (okay, there's derm/plastics... I'll give you that.)

Now, honest answer: Number of shifts per MONTH is highly variable, and dependent upon length/coverage. I work sixteen 8-hour shifts a month, about 4-5 of which are 'nights'.

Wow, didn't know a question has to be so charged.

I struggle with nights and was just curious how many various people did per month.

I apologize if I asked in an inappropriate way or offended anyone. No worries though, forget I asked.

Thx Hercules.
 
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Wow, didn't know a question has to be so charged.

I struggle with nights and was just curious how many various people did per month.

I apologize if I asked in an inappropriate way or offended anyone. No worries though, forget I asked.

Thx Hercules.

[/I]

It's charged because it seems like you have already said you couldn't(which I think would probably be better stated as wouldn't want to) do "nights" for your entire career but only 5-10years in a previous post. Also it seems that some people forget that EM is truly a 365 24/7 speciality and only see it as 3x12hr shifts a week and making great $$$....
 
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Wow, didn't know a question has to be so charged.

I struggle with nights and was just curious how many various people did per month.

I apologize if I asked in an inappropriate way or offended anyone. No worries though, forget I asked.

Thx Hercules.

Cut him some slack. He could be post nights. LOL
 
[/I]

It's charged because it seems like you have already said you couldn't(which I think would probably be better stated as wouldn't want to) do "nights" for your entire career but only 5-10years in a previous post. Also it seems that some people forget that EM is truly a 365 24/7 speciality and only see it as 3x12hr shifts a week and making great $$$....

This... but, really....


Its more of a pervasive attitude of "ZOMG nightshifts, Yuxxorz... LOLZ." amongst junior posters who also have zero idea that most other subspecialties also involve a great degree of 'nightwork'.

OP: listen, man - I don't want to single-you-out. Its just that we've been getting a lot of these as of late, and people act like its poison to do a nightshift. That being said, its an internet forum, and a very public one at that, so any question is a fair one, especially if you're trying to get a broad overview of what's really going on by those rank-and-file docs who live it everyday. Good luck to yah.
 
[/I]

It's charged because it seems like you have already said you couldn't(which I think would probably be better stated as wouldn't want to) do "nights" for your entire career but only 5-10years in a previous post. Also it seems that some people forget that EM is truly a 365 24/7 speciality and only see it as 3x12hr shifts a week and making great $$$....

Fair enough, but I have seen EM attendings say they will pay the shift differential later in their career to avoid nights. So it's not a foreign idea. I always have enjoyed EM but just worked a week of nights back to days with no time off. I slept only 4 or5 hrs a day and felt like a zombie for 10 days. It was hard for me.

I have made no judgements on $ or 3x12 or whatever. I guess sharing weaknesses and honesty come back to bite you on the Web.

This... but, really....


Its more of a pervasive attitude of "ZOMG nightshifts, Yuxxorz... LOLZ." amongst junior posters who also have zero idea that most other subspecialties also involve a great degree of 'nightwork'.

OP: listen, man - I don't want to single-you-out. Its just that we've been getting a lot of these as of late, and people act like its poison to do a nightshift. That being said, its an internet forum, and a very public one at that, so any question is a fair one, especially if you're trying to get a broad overview of what's really going on by those rank-and-file docs who live it everyday. Good luck to yah.

I understand. Thanks for the help.
 
15... military nocturnist.


And to the OP... if you want to avoid some of the discontent, you could always ask your question more creatively...

"How many shifts a month do you work in your group... and of those, how many are days or swing shifts?"
Then just do the math and secretly get the answer to the question you really wanted to ask.
 
Fair enough, but I have seen EM attendings say they will pay the shift differential later in their career to avoid nights. So it's not a foreign idea. I always have enjoyed EM but just worked a week of nights back to days with no time off. I slept only 4 or5 hrs a day and felt like a zombie for 10 days. It was hard for me.

I have made no judgements on $ or 3x12 or whatever. I guess sharing weaknesses and honesty come back to bite you on the Web.

I understand. Thanks for the help.

You'll be expected to work nights. Period. If you can't deal with it, then it's a deal breaker. I am constantly rotating from nights to days to swings and back again. If you want to do EM, you'll have to suck it up and learn to deal with it. End of story.

Given the fact that your posts show interest in IM, gas, EM, etc.. I'd focus on picking something that you enjoy instead of trying to avoid sleep deprivation because that's one aspect of medicine that is rather ubiquitous among all the specialties to some degree.
 
No overnights; we have four nocturnalists that cover them all. They get fat diffs for doing it.

About 2-3 'swings' each month that are 3-3.

This is not the norm and is the rarity.
 
The way it works a lot of places is that you get paid more to do nights. Either you work less per month and are paid the same as the day guys or you make a higher dollar per hour usually with some way to even out the RVU's. I don't particularly like nights (actually don't mind them just the switching of schedule) but if you sit and look at the numbers, it's pretty tempting a lot of places.
 
You'll be expected to work nights. Period. If you can't deal with it, then it's a deal breaker. I am constantly rotating from nights to days to swings and back again. If you want to do EM, you'll have to suck it up and learn to deal with it. End of story.

Given the fact that your posts show interest in IM, gas, EM, etc.. I'd focus on picking something that you enjoy instead of trying to avoid sleep deprivation because that's one aspect of medicine that is rather ubiquitous among all the specialties to some degree.

Thx for advice.
 
do most of ya'll with nocturnists have a high rate of turnover? my group has a handful, but only 2 who have been on nights for any length of time.

the premium is, last i heard, $20-30/hour over base (employed situation with good benefits), plus ability to make one's schedule with caveat of same # of w/e shifts per month of 4.

i'm considering trying it - i work a mix of 8's and 12's so i could probably get away with 10, max 12 shifts/month and would probably do 2 long weekends. i'm tired of some scheduling issues and think that this may be the answer... i hate going on and off of nights so just doing it 2x/month and working fewer days for more $$ is certainly appealing. most of our sites are suburban so nights are typically not bad volume-wise.

fwiw, single woman, no kids. mid 30's, 4 years out of residency. in some debt so yes, money is a consideration.

anyway, any thoughts on turnover, whether this is "enough" to incentivize nights...?
 
This... but, really....


Its more of a pervasive attitude of "ZOMG nightshifts, Yuxxorz... LOLZ." amongst junior posters who also have zero idea that most other subspecialties also involve a great degree of 'nightwork'.

OP: listen, man - I don't want to single-you-out. Its just that we've been getting a lot of these as of late, and people act like its poison to do a nightshift. That being said, its an internet forum, and a very public one at that, so any question is a fair one, especially if you're trying to get a broad overview of what's really going on by those rank-and-file docs who live it everyday. Good luck to yah.

Yes many doctors work nights weekends and holidays. If an EM doctor is working that means someone has to admit patients . It seems that many think that only EM works nights for the rest of their career.
 
If you go into EM, you can expect to work evenings, nights, and weekends - and a lot of them. Most patients come in between 3pm and 2am. If this is going to bother you a lot, you shouldn't do EM. No one wants to hire a golden child who doesn't want to do the job the way it is. Most of the new hires at my job are doing nights and weekends. The senior staff with sweet schedules have been there >10 years.
 
If you go into EM, you can expect to work evenings, nights, and weekends - and a lot of them. Most patients come in between 3pm and 2am. If this is going to bother you a lot, you shouldn't do EM. No one wants to hire a golden child who doesn't want to do the job the way it is. Most of the new hires at my job are doing nights and weekends. The senior staff with sweet schedules have been there >10 years.

Thanks for making the decision easy for me.

Good luck all.
 
Yes many doctors work nights weekends and holidays. If an EM doctor is working that means someone has to admit patients . It seems that many think that only EM works nights for the rest of their career.

Not to rain on the EM parade (I've got a great float rolling down the street in the parade too), but EM is actually one of the only specialties where you will be up all night in the hospital. In academics and residency you get the mistaken impression that everyone else will be in the hospital overnight too. Outside of critical care and hospitalists in my community hospital, most specialties can count on sleeping through the majority of the night even when they are on call. If they do get their sleep interrupted its usually to return a page and go back to sleep.
 
Not to rain on the EM parade (I've got a great float rolling down the street in the parade too), but EM is actually one of the only specialties where you will be up all night in the hospital. In academics and residency you get the mistaken impression that everyone else will be in the hospital overnight too. Outside of critical care and hospitalists in my community hospital, most specialties can count on sleeping through the majority of the night even when they are on call. If they do get their sleep interrupted its usually to return a page and go back to sleep.

Pretty much my impression after working with docs in 4-5 specialities.

Funny to hear that it's normal to all specialties to expect to stay awake With no sleep From 12 am to 7am. Or to flip which is much worse than just regular overnight
 
do most of ya'll with nocturnists have a high rate of turnover? my group has a handful, but only 2 who have been on nights for any length of time.

the premium is, last i heard, $20-30/hour over base (employed situation with good benefits), plus ability to make one's schedule with caveat of same # of w/e shifts per month of 4.

i'm considering trying it - i work a mix of 8's and 12's so i could probably get away with 10, max 12 shifts/month and would probably do 2 long weekends. i'm tired of some scheduling issues and think that this may be the answer... i hate going on and off of nights so just doing it 2x/month and working fewer days for more $$ is certainly appealing. most of our sites are suburban so nights are typically not bad volume-wise.

fwiw, single woman, no kids. mid 30's, 4 years out of residency. in some debt so yes, money is a consideration.

anyway, any thoughts on turnover, whether this is "enough" to incentivize nights...?

I think the "market rate" to incentivize nights is far higher than $20-30 an hour. In my small democratic group where our hourly typically ranges from $200-275 an overnight shift pays 50% more than a day shift and 25% more than an evening shift. So if the evening pays $250 that month, then the day shift pays something like $215 per hour and the overnight pays something like $310 per hour. That's 4-5 times your $20-30 figure. As it is there are number of people working more nights than they'd like in my group. Try letting "the market" solve the night shift issue and you'd be surprised how much more it takes to get people to voluntarily work more nights.

I'm headed into my 3 overnights for the month starting tonight and I kind of dread them. The higher pay definitely matters to me. If the differential were much lower I'd drop them completely.
 
I think the "market rate" to incentivize nights is far higher than $20-30 an hour. In my small democratic group where our hourly typically ranges from $200-275 an overnight shift pays 50% more than a day shift and 25% more than an evening shift. So if the evening pays $250 that month, then the day shift pays something like $215 per hour and the overnight pays something like $310 per hour. That's 4-5 times your $20-30 figure. As it is there are number of people working more nights than they'd like in my group. Try letting "the market" solve the night shift issue and you'd be surprised how much more it takes to get people to voluntarily work more nights.

I'm headed into my 3 overnights for the month starting tonight and I kind of dread them. The higher pay definitely matters to me. If the differential were much lower I'd drop them completely.

I guess it makes sense for your group, but from the outside that looks insane. $1000 is that kind of shift bonus (assuming 10 hr shifts) that get handed out for unfilled holidays or last minute cancellations. If I tried to trade a night shift for somebody's day shift + $1000 I'd be told to f%^$ off. If there are still people working more nights than they want, I'd suggest that the dedicated nocturnists in your group are screwing over the rest of you. Unless you're working no nights, I don't understand how that pay structure is tolerated (or tolerable).
 
Not to rain on the EM parade (I've got a great float rolling down the street in the parade too), but EM is actually one of the only specialties where you will be up all night in the hospital. In academics and residency you get the mistaken impression that everyone else will be in the hospital overnight too. Outside of critical care and hospitalists in my community hospital, most specialties can count on sleeping through the majority of the night even when they are on call. If they do get their sleep interrupted its usually to return a page and go back to sleep.

Depends on the call arrangement. My wife has a pretty cush gig with pediatrics, but when she's on call, she takes roughly 20 calls overnight. Waking up 3x per hour does not make you feel rested at night, and she works the day before and the day after. Sure, she never has to go in, but I still sleep in a different room on call nights.
More and more places are going the hospitalist route, and the number of "admission" cals will decrease with that, but the clinic patients still want to know what to do when molly has a fever at 2am.

And that's not counting the amount of grief you get working in the community when you actually do need to call ENT/GI/Ortho. Plenty of people take call, just not that frequently and as you said, when they're on they aren't bothered much. But the specialists are the ones that have to actually come to the hospital when they get called.
 
do most of ya'll with nocturnists have a high rate of turnover? my group has a handful, but only 2 who have been on nights for any length of time.

We go through nocturnists fairly regularly as well; myself and two others have been the only consistent night people. Since I've been at my current shop there have been 6 other nocturnists who have come and gone (they still work here, but they work the regular circadian shifts now).

Of us three consistent nightfolk...
one is over 60, no kids at home...
one is mid-30's, mom with 2 kids and a stay-at-home husband
I'm early 30's, 2 kids at home, stay-at-home wife.

We're a military institution so there's no pay differential. We all do it because for various reasons, we prefer it for our home lives.
 
We go through nocturnists fairly regularly as well; myself and two others have been the only consistent night people. Since I've been at my current shop there have been 6 other nocturnists who have come and gone (they still work here, but they work the regular circadian shifts now).

Of us three consistent nightfolk...
one is over 60, no kids at home...
one is mid-30's, mom with 2 kids and a stay-at-home husband
I'm early 30's, 2 kids at home, stay-at-home wife.

We're a military institution so there's no pay differential. We all do it because for various reasons, we prefer it for our home lives.

i'm having a terrible time coming off of nights... migraines, sleeping at wrong times. this is a new problem the last few months, wasn't a problem when i worked nights 1 time a month. if i can't arrange that to be the case again, i may do the nocturnist thing for a bit to be able to work 2 big blocks... see if that helps. i'd then basically be week on/week off.
 
i'm having a terrible time coming off of nights... migraines, sleeping at wrong times. this is a new problem the last few months, wasn't a problem when i worked nights 1 time a month. if i can't arrange that to be the case again, i may do the nocturnist thing for a bit to be able to work 2 big blocks... see if that helps. i'd then basically be week on/week off.

This is pretty much what I want to do too when I get out, work nights and in blocks. We do our night shifts this way in residency and it is much easier to handle for my circadian rythm than the random night shift here and there.
 
I think the "market rate" to incentivize nights is far higher than $20-30 an hour. In my small democratic group where our hourly typically ranges from $200-275 an overnight shift pays 50% more than a day shift and 25% more than an evening shift. So if the evening pays $250 that month, then the day shift pays something like $215 per hour and the overnight pays something like $310 per hour. That's 4-5 times your $20-30 figure. As it is there are number of people working more nights than they'd like in my group. Try letting "the market" solve the night shift issue and you'd be surprised how much more it takes to get people to voluntarily work more nights.

I'm headed into my 3 overnights for the month starting tonight and I kind of dread them. The higher pay definitely matters to me. If the differential were much lower I'd drop them completely.

My residency is run by a democratic group of around 30 docs. They give "no" night differential whatsoever, none, zip, nada, zilch. They staff their nights just fine as far as I know. Around here in the community gigs there is very little if any night differential, some places will let you do one less shift, or some places will prioritize your schedule, etc.

I'm currently on the job search, and I have yet to hear any place with the kind of set up you describe. Sounds like paradise. How are you guys able to afford such an insane amount of money for night differential?
 
ER is the specialty likely to be up all night guaranteed. At my hospital, a busy place, here are the other specialties up at night in order:

1. OB (up a lot during the Call shift)
2. Anesthesia (a few hours of down time but can quite busy)
3.. Hospitalist- Usually admits patients from ER after hours. Covers ICU
3. General Surgery ( hit or miss depending on Trauma and Appys)
4. Gi- Frequent calls and GI bleeds
5. Ortho- Open fractures
6. Cardiology- Acute MIs needing Cath lab

Neurosurgery only with trauma. ENT is pretty easy with rare night work
 
How many over night shifts per month on average?

ER is the worst specialty in Medicine for having to work nights. A close second is OB followed by the Admitting IM/Hospitalist and Anesthesia. That said, you can find jobs in any specialty allowing you to work days only provided you are willing to take a pay cut.
ER would be the toughest specialty for a day only job but they exist.

Here are the specialties which rarely work at night:

1. Derm- Never
2. Plastics- Rare
3. Radiology- rare in a non trauma setting
4. Oncology- rare
5. Pulmonary- rare
6. ENT- rare
7. Allergy- Never
8. Urology- Rare (usually RN cant get the foley)
9. Optho- Rare in a non trauma setting
10. Pain Medicine and PMR- rare
 
I am a EM resident, we do 4-5 nights per 28 days - typically at a stretch.
 
i'm having a terrible time coming off of nights... migraines, sleeping at wrong times. this is a new problem the last few months, wasn't a problem when i worked nights 1 time a month. if i can't arrange that to be the case again, i may do the nocturnist thing for a bit to be able to work 2 big blocks... see if that helps. i'd then basically be week on/week off.

Thanks for sharing your experience.

ER is the worst specialty in Medicine for having to work nights. A close second is OB followed by the Admitting IM/Hospitalist and Anesthesia. That said, you can find jobs in any specialty allowing you to work days only provided you are willing to take a pay cut.
ER would be the toughest specialty for a day only job but they exist.

Here are the specialties which rarely work at night:

1. Derm- Never
2. Plastics- Rare
3. Radiology- rare in a non trauma setting
4. Oncology- rare
5. Pulmonary- rare
6. ENT- rare
7. Allergy- Never
8. Urology- Rare (usually RN cant get the foley)
9. Optho- Rare in a non trauma setting
10. Pain Medicine and PMR- rare

Thanks for the info.

This thread has been very helpful. Thanks for sharing all the individual schedules. It's helped me understand what doing EM would entail. It seems the circadian challenge is unique to EM, not nights per se, but the shifting.
 
This thread has been very helpful. Thanks for sharing all the individual schedules. It's helped me understand what doing EM would entail. It seems the circadian challenge is unique to EM, not nights per se, but the shifting.

Depends. Nocturnists are becoming an established thing for hospitalists and (to a much less extent) surgeons and OB/GYN. Due to the high fixed costs of labor, it's in the hospitals' best interests to have things running 24/7 which typically can't be done using the traditional call schedule.
 
Not to rain on the EM parade (I've got a great float rolling down the street in the parade too), but EM is actually one of the only specialties where you will be up all night in the hospital. In academics and residency you get the mistaken impression that everyone else will be in the hospital overnight too. Outside of critical care and hospitalists in my community hospital, most specialties can count on sleeping through the majority of the night even when they are on call. If they do get their sleep interrupted its usually to return a page and go back to sleep.


It's not the only specialty if hospitalists, intensivits, and OBGYN do it. Most specialties can if they are not cards or surgery. Also when EM is off they are off and they don't have to do a day of clinic the morning of waking up.
 
Zero nights here. 4th year out of residency. 14-15 9 hour shifts in a mix between our adult and peds ED. Single site 120k+ volume
 
You can probably get away with not working nights if you really don't want to, it seems. Rotation I just got off of was a small-ish rural hospital, ~12 docs, with nights being almost entirely split between two of them, both of whom seemed to be near the tail end of their careers. Certainly a cushy gig for the others, but I don't know how common the arrangement is.

Personally, I'm a night owl, and I'm very happy with night work. I guess it's not quite right to cast EM as a 'lifestyle' specialty, but while the hours are predictably crappy, at least they're predictable. So if you accept nights/weekends/holidays as part of the deal, it works out just fine.
 
You can probably get away with not working nights if you really don't want to, it seems. Rotation I just got off of was a small-ish rural hospital, ~12 docs, with nights being almost entirely split between two of them, both of whom seemed to be near the tail end of their careers. Certainly a cushy gig for the others, but I don't know how common the arrangement is.

Personally, I'm a night owl, and I'm very happy with night work. I guess it's not quite right to cast EM as a 'lifestyle' specialty, but while the hours are predictably crappy, at least they're predictable. So if you accept nights/weekends/holidays as part of the deal, it works out just fine.

Seems like no nights is possible if you don't mind searching and maybe a pay cut.
 
Granted just in residency here but we do a stretch of 6 nights (intern, usually 4-5 for senior residents) 10hr shifts. We do the circadian scheduling so you work swing shifts from 5p-3a for a couple days before your nights and I was surprised how much that helped. Chiefs almost always give us 2 days off after nights to get back on day schedule as well.
 
My residency is run by a democratic group of around 30 docs. They give "no" night differential whatsoever, none, zip, nada, zilch. They staff their nights just fine as far as I know. Around here in the community gigs there is very little if any night differential, some places will let you do one less shift, or some places will prioritize your schedule, etc.

I'm currently on the job search, and I have yet to hear any place with the kind of set up you describe. Sounds like paradise. How are you guys able to afford such an insane amount of money for night differential?

Uh....we take it from our own day shifts. It's one pot of money and we can divide it up any way we please. Since most of us don't like nights, we pay less for the day shift and more for the night. If your group can find people willing to work nights without a differential, good for you. You can work all days and make the same amount of money. However, what I usually see is that the nights are just divided up equally, which I think is an inferior option compared to our "market-based" system. This way, the young, poor guys work the majority of nights voluntarily.
 
I guess it makes sense for your group, but from the outside that looks insane. $1000 is that kind of shift bonus (assuming 10 hr shifts) that get handed out for unfilled holidays or last minute cancellations. If I tried to trade a night shift for somebody's day shift + $1000 I'd be told to f%^$ off. If there are still people working more nights than they want, I'd suggest that the dedicated nocturnists in your group are screwing over the rest of you. Unless you're working no nights, I don't understand how that pay structure is tolerated (or tolerable).

I'm not sure I follow your logic. How is anyone screwing anyone else over? If anyone in the group would like to work more nights, they can do so and make that same differential. As it is, people who do not want to work nights, still have to work one every couple of months. It's not a bad enough problem that we need to adjust the differential at this point, but I assure you if the differential went down significantly I'd drop the 3 a month I'm working.

Personally, I think it's insane to have a shift bonus for unfilled holidays (we have no unfilled holidays since everyone must work their share) and last minute cancellations are rare and covered by the other members of this close-knit family out of the goodness of their heart. For example, one doc in the group left in the middle of a shift to join her task force going to Colorado to help out with the floods. There was no trouble covering the 4 shifts she's missed this week (so far.) That's the way a functional partnership works.

Someone might not be willing to trade a day shift + $1000 for a night shift, but I bet they'd be willing to trade a day shift + $100. The market rate is going to be different in every group. In my group, this is what it is.
 
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Uh....we take it from our own day shifts. It's one pot of money and we can divide it up any way we please.

This is what my group does. Overall I don't have a big differential for my night contract, but I'd have to work 21 more hours a month of day shifts to make the same as I do on my night contract.
 
I'm not sure I follow your logic. How is anyone screwing anyone else over? If anyone in the group would like to work more nights, they can do so and make that same differential. As it is, people who do not want to work nights, still have to work one every couple of months. It's not a bad enough problem that we need to adjust the differential at this point, but I assure you if the differential went down significantly I'd drop the 3 a month I'm working.

Who's going to take them? I assume that your nocturnists are probably maxed out on shifts, so you'd be trying to give them up to someone else who is probably looking to do the same thing. If most people are working a mix of shifts and the pay about evens out then goodie, but if you have the majority of your group doing only days then the differential seems confiscatory. I'm basing this off of currently working 4 nights with no differential.

I agree with you on holiday pay (we haven't had to do it in any of the shops I've worked but I've definitely seen it happen) but when you're already short staffed (and have been so for 6 months) and someone breaks their contract without notice those 12 holes don't tend to fill themselves.
 
Who's going to take them? I assume that your nocturnists are probably maxed out on shifts, so you'd be trying to give them up to someone else who is probably looking to do the same thing. If most people are working a mix of shifts and the pay about evens out then goodie, but if you have the majority of your group doing only days then the differential seems confiscatory. I'm basing this off of currently working 4 nights with no differential.

I agree with you on holiday pay (we haven't had to do it in any of the shops I've worked but I've definitely seen it happen) but when you're already short staffed (and have been so for 6 months) and someone breaks their contract without notice those 12 holes don't tend to fill themselves.

If I dropped them they'd be divided evenly among the group. (I'd get 3 more days and 3 of them would work another night a month.) That's how the extra night shifts are dealt with currently. If people go down in shifts, they're either covered by moonlighters or divided up evenly until we can hire again.
 
Can the nocturrist comment on how you sleep ? if you are not working 15 days a month, do you stay awake overnight Still or do you constantly shift back and forth ? •
 
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