Breaks during EM shift?

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Yadster101

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Hi all,

I am a Muslim student interested in EM and I had a question about taking breaks to pray. As a Muslim I pray 5X a day which takes about ~5 minutes each time. In a hospital it's normally as simple as just running to the hospital chapel, nearest empty room, etc. and then coming back after 5 mins. Although the prayers shift around as the day light hours change, a typical prayer schedule would look like this: Pray anytime between 5:30am-6:45am, 11:30am-2:00pm, 2:10pm - 4:10pm, 4:30pm-5:30pm, 5:45pm-12am. As you can see the prayer time windows are pretty wide except for the prayer that occurs after sunset (second to last) since that's normally prayed within a 1 hour window of time. I realize that at times I will be so busy that it may not be possible, but how often would you say I should expect to be able to pray on time? Could I get a 5 min break within these time frames 80-90% of the time?

Also I realize how things may become more complicated in the future as we no longer have a Muslim president. I'd rather not take that into consideration.

Edit: The Muslim president thing was a joke. Sorry to confuze.

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Dude.

EM is where you suck it up and make sacrifices for your patients and the department, not the other way around.

We have one MLP that just likes to *check out* for 15 mins for lunch at his fixed time. He's not a popular guy for that.
 
i know a jewish doc who says that the jewish god gives them a pass on some of the stricter rules for performing life saving activities like doctoring. would your god accept a similar arrangement? perhaps 30 seconds of quiet mindfulness in place of the whole ordeal?
 
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I'm also assuming this is not in the US?
 
I'm also assuming this is not in the US?


Why? One of the EM physicians at my hospital (small community hospital, not an EM residency) that I've accidentally walked into a dictation room mid-prayer. However day shift at a community hospital is going to be a big difference when compared to day shift at an academic hospital (be it university or county).
 
i know a jewish doc who says that the jewish god gives them a pass on some of the stricter rules for performing life saving activities like doctoring. would your god accept a similar arrangement? perhaps 30 seconds of quiet mindfulness in place of the whole ordeal?
There is literally nothing in the Jewish tradition that prohibits any life saving maneuver.
 
Why? One of the EM physicians at my hospital (small community hospital, not an EM residency) that I've accidentally walked into a dictation room mid-prayer. However day shift at a community hospital is going to be a big difference when compared to day shift at an academic hospital (be it university or county).

Because he put in a political twist at the end and said we "no longer having a Muslim president", which makes me think that either the poster wasn't from the US, or may be trolling (or just doesn't have a clue about the current president's religious affiliation).
 
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Also I realize how things may become more complicated in the future as we no longer have a Muslim president. I'd rather not take that into consideration.

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Because he put in a political twist at the end and said we "no longer having a Muslim president", which makes me think that either the poster wasn't from the US, or may be trolling (or just doesn't have a clue about the current president's religious affiliation).

Ahh, I missed that part to be honest.
 
Lol that last part was just a joke guys. I was just trying to show that religious people can kid around. So is this something I can reasonably expect in EM? I know a couple of Muslim EM physicians and I plan on speaking with them in the future but I wanted to also get input from this forum.
 
This shouldn't be a problem. 5 minutes once or twice a shift is doable as long as it can be flexed around a bit and it sounds like it can. I mean, I've had shifts where I didn't eat, drink, or pee, but you don't want to be working somewhere that every shift is like that.

You might also consider being a nocturnist. Then your shift starts after the last prayer and ends before the first.

Now if you're hard-core Jewish and not willing to walk more than a certain number of steps on Saturday, that's going to be a problem. If you're Mormon and not willing to work on Sundays, that's going to be a problem. If you're Jehovah's Witness and not willing to give blood to others, that's going to be a problem. But 5 minutes to pray? Nah, we can work with that, especially if you can find an office in the ED itself to do it in.
 
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Lol that last part was just a joke guys. I was just trying to show that religious people can kid around. So is this something I can reasonably expect in EM? I know a couple of Muslim EM physicians and I plan on speaking with them in the future but I wanted to also get input from this forum.
As far as residency is concerned, it will highly depend on where you go. aprogdirector would probably be able to answer this better than I.

For an n=1: If you were at my program, you would always be expected to put patient care ahead of prayers, but a small accommodation would likely be made whenever possible. Based on the patient load you see during your first two years, I'd guess you'd be able to pull it off maybe 50-70% of the time. More like 60-80% as a senior.

That said, if you were ever in prayer and one of your patients needed attention ASAP, you would be expected to be somewhere where you could hear an overhead page for you and get up and go, regardless of whether you were finished with your prayers.
 
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Lol that last part was just a joke guys. I was just trying to show that religious people can kid around. So is this something I can reasonably expect in EM? I know a couple of Muslim EM physicians and I plan on speaking with them in the future but I wanted to also get input from this forum.

Yes, you should be able to find 5 minutes during almost every shift to pray. The exception would be when you get a perfect storm such as a STEMI patient coming in at 430pm, a bad trauma arriving at 450pm, and a cardiac arrest arriving at 510pm. Fortunately, that will be rare. Unfortunately, the 430-530pm window is the busiest time of day in an ED, so it's the time when this is most likely to happen.

White Coat's suggestion of being a nocturnist should be given a lot of consideration. It would totally solve your conundrum, and it would have a lot of beneficial side effects.
 
Yes, you should be able to find 5 minutes during almost every shift to pray. The exception would be when you get a perfect storm such as a STEMI patient coming in at 430pm, a bad trauma arriving at 450pm, and a cardiac arrest arriving at 510pm. Fortunately, that will be rare. Unfortunately, the 430-530pm window is the busiest time of day in an ED, so it's the time when this is most likely to happen.

White Coat's suggestion of being a nocturnist should be given a lot of consideration. It would totally solve your conundrum, and it would have a lot of beneficial side effects.
Funny thing is that I spent a year off before med school working as a night shift (11pm - 7am, 3 days a week) pct to avoid this problem. It worked but I was also taking classes twice a wk from 1pm till about 6pm and I volunteered right after work from 8am till 1pm on Wednesdays. My sleep schedule was horrible and I legit felt like I was in a zombie state towards the end. I'm assuming that nocturnist em would be better since I wouldn't have to juggle work with morning activities like class/volunteering...?
 
I'm assuming that nocturnist em would be better since I wouldn't have to juggle work with morning activities like class/volunteering...?

Ha ha. That's funny. Why do you think it pays more to be a nocturnist? Working at night is fine. It's how it affects the rest of your life.
 
Funny thing is that I spent a year off before med school working as a night shift (11pm - 7am, 3 days a week) pct to avoid this problem. It worked but I was also taking classes twice a wk from 1pm till about 6pm and I volunteered right after work from 8am till 1pm on Wednesdays. My sleep schedule was horrible and I legit felt like I was in a zombie state towards the end. I'm assuming that nocturnist em would be better since I wouldn't have to juggle work with morning activities like class/volunteering...?

Make no mistake, being a nocturnist has plenty of lousy aspects to go along with the pluses. It's pretty much only for people with specific inflexible needs that the positives outweigh the negatives. And if the only way you can see a career in EM working for you is contingent upon being a nocturnist, then you may want to consider other fields.

And while I'm being forthcoming, I'll go ahead and admit that there will be people who will grumble when you step off of the floor for 5 minutes during shift. Nursing mothers who need to pump on shift still get this in spite of working with largely progressively-minded folks. But from the purely factual question of "is this possible?" the answer is "yes."
 
Ha ha. That's funny. Why do you think it pays more to be a nocturnist? Working at night is fine. It's how it affects the rest of your life.

Lol well I'm still interested in em but I guess I'm gonna have to sleep on the nocturnist idea. What are the typical hours for a nocturnist? Could I work 3 12s from 6pm to 6am? I would think that that would be better than my life as a pct cuz as a pct my schedule looked like this:
  • 7am get out of work
  • 8am-12pm sleep for 4 hrs
  • 1pm-6pm class
  • 7pm-9:45 eat and try to sleep for 1-2 hrs
  • 11pm- 7 am back to work
Obviously being an em doc is much harder than being a tech, but if I work from 6pm-6am with no other obligations, couldn't I easily come home and sleep from 7am till 3pm?

I'm genuinely asking these questions. I know my assumptions could be totally wrong which is why I really appreciate the feedback you guys give.
 
Bro your patients need to hear from you more than your god does. How much do you have to say lmao
 
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You guys really should be more encouraging toward Jewish and Muslim emergency doctors. There is a very serious benefit to the entire group at the end of every year. Same for docs without kids around the end of March.
 
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Yes it is helpful to have a diverse group of religions (and/or atheists!), along with single / familied and a diverse love of professional/college sporting events.

If you have a shop of 14 devout Southern Baptists with kids in elementary school who all love SEC football-- scheduling might be an issue ;)

As far as the OP, I think a 5 minute break, as long as the OP is flexible and doesn't mind a 90% success fate, is completely doable. Being a nocturnist would solve the problem. Working in a big place where there are ALWAYS 3-4 providers would also make things a bit easier to step out for 5. We're a smaller place, but there are always two docs from noon-10p, and also at least one PA from 8a-2a. We have a little call room with a bed, shower, etc all attached to the ED. If you wanted to step in there are pray for a couple minutes (understanding there is a phone in there and an RN might call screaming for help...) I think that would be fine. Granted every once in a while you'd be running simultaneous resuscitations and it wouldn't be feasible.

To me the group would respond based on the provider's overall attitude and work ethic. If this is a guy who's always on time, busts his ass, stays late, helps, moves the meat, has a great attitude... no one will mind a prayer break. However, if they are generally an "unliked" provider, I guarantee some people will make an issue of these small breaks.
 
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Yes it is helpful to have a diverse group of religions (and/or atheists!), along with single / familied and a diverse love of professional/college sporting events.

If you have a shop of 14 devout Southern Baptists with kids in elementary school who all love SEC football-- scheduling might be an issue ;)

As far as the OP, I think a 5 minute break, as long as the OP is flexible and doesn't mind a 90% success fate, is completely doable. Being a nocturnist would solve the problem. Working in a big place where there are ALWAYS 3-4 providers would also make things a bit easier to step out for 5. We're a smaller place, but there are always two docs from noon-10p, and also at least one PA from 8a-2a. We have a little call room with a bed, shower, etc all attached to the ED. If you wanted to step in there are pray for a couple minutes (understanding there is a phone in there and an RN might call screaming for help...) I think that would be fine. Granted every once in a while you'd be running simultaneous resuscitations and it wouldn't be feasible.

To me the group would respond based on the provider's overall attitude and work ethic. If this is a guy who's always on time, busts his ass, stays late, helps, moves the meat, has a great attitude... no one will mind a prayer break. However, if they are generally an "unliked" provider, I guarantee some people will make an issue of these small breaks.

All it takes is one patient to go bad. When the lawyer says "So doctor, can you explain your absence from the emergency department when Mrs. Smith, a lovely mother of four beautiful children and a well respected member of the community, started desaturating and had an anoxic brain injury from a cardiac arrest? We have testimony from the other providers at the time that you were unavailable for 5 minutes" what will you say?
 
All it takes is one patient to go bad. When the lawyer says "So doctor, can you explain your absence from the emergency department when Mrs. Smith, a lovely mother of four beautiful children and a well respected member of the community, started desaturating and had an anoxic brain injury from a cardiac arrest? We have testimony from the other providers at the time that you were unavailable for 5 minutes" what will you say?

Nobody is suggesting that the OP be completely unavailable during these 5 minute breaks. In fact, the post you quoted specifically says the OP should be available via phone if needed.

The OP's question was - is it reasonable to expect that I can find 5 minutes to take a break during 80-90% of my shifts? Yes, that is entirely reasonable. In fact, if you can't find 5 minutes to collect your thoughts during 80% of your shifts, then you're doing it wrong.
 
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All it takes is one patient to go bad. When the lawyer says "So doctor, can you explain your absence from the emergency department when Mrs. Smith, a lovely mother of four beautiful children and a well respected member of the community, started desaturating and had an anoxic brain injury from a cardiac arrest? We have testimony from the other providers at the time that you were unavailable for 5 minutes" what will you say?

Sorry but are you suggesting EM physicians can't run to the cafeteria, have a BM, or do any other activity that removes them from the department for 5 minutes? Or were you just suggesting that during prayer the nurse lack the ability to simply walk in or call him and tell him there's a crashing patient? Neither sounds plausible.
 
I've been a practicing Muslim and EM attending for the last 7yrs. I trained at a very busy urban trauma center and now I work at a busy community Level 1 Trauma center with about 80-90k pts/yr. Until recently, it was solo nights. Here's my advice:

1) You always have to be available. It doesn't matter if it's for a STEMI/drop off gunshot wound or if a nurse that wants to know if it's OK to give tylenol; portable phones are key. You need to be in the department dealing with stuff within 2 min tops. This is not much different from getting an overhead page when you are in the bathroom, to be honest. That being said, when I decide to go and pray, rarely do I actually get interrupted, and even rarer for it to be something truly emergent. Divine intervention? I like to think so, but it's mostly because I try to pray when it's just not THAT busy.

2) Be flexible regarding which shifts you work. Doing nights in wintertime and early days in summer time helps logistically as there is less overlap with prayer times. I'm a fulltime nocturnist, but have considered doing seasonal days/nights. It helps that most of my partners don't like the 6am and 10pm shifts.

3) Waterproof socks. That's an insider tip for Muslims.

4) Be a team player. Try to come in early/stay late. Be generous when accepting handoffs and rarely signout your own patients. I generally don't take food breaks unless it's dead (When I did work days, I used to do religious fasting usually). It sucks to say this, but I have had colleagues who I really felt didn't want me in the department b/c of my otherness and me taking breaks would not have been looked upon favorably. Don't give people an excuse to look down on you. Fortunately, when people get to know you, this seems to fade away. That said, overwhelmingly, my colleagues have always been supportive. Given the nature of the work, I've found that most EM providers are accepting/tolerant of other people.

5) +1 for WCI. I have worked every Christmas Eve/Christmas and Easter for my colleagues for the last seven yrs. I don't mind it (it's generally a really quiet shift and then really busy at the end) and they really appreciate it. (Side note: I have tried to get people to trade Christmas for Thanksgiving, but NOBODY wants to give up Thanksgiving...). I also work the Christmas party and most New Years Eves. In residency, I was sometimes a designated driver (ie I don't drink).

6) Usually when I want to pray on a shift, I can make it happen without disruption. That being said, if I'm not paying attention, sometimes it gets busy at the wrong time and I can't get it to work out. Patient care comes first, and I think you just have to be OK with that.

7) There are a bunch of Muslims in EM. Its not the most compatible with intermittent prayer times, but you can make it work.
 
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I find it hard to take any breaks at all during EM shifts, never mind three 5 minute breaks, and have had plenty of shifts where I went without any food or water because it was so busy.
 
There is literally nothing in the Jewish tradition that prohibits any life saving maneuver.


yeah i meant you are allowed to break the rules to save a life, i.e. using electronics on sabbath etc. that being said, if you are an observant jew in my n=2 experience EM is great. you can def work ZERO saturdays or HH days if you are willing to do more nights, sundays, non-jew holidays, etc. maybe you work saturday on a once-a-career double backup call catastrophe but otherwise nah
 
Nobody is suggesting that the OP be completely unavailable during these 5 minute breaks. In fact, the post you quoted specifically says the OP should be available via phone if needed.

The OP's question was - is it reasonable to expect that I can find 5 minutes to take a break during 80-90% of my shifts? Yes, that is entirely reasonable. In fact, if you can't find 5 minutes to collect your thoughts during 80% of your shifts, then you're doing it wrong.
Agree.
 
I find it hard to take any breaks at all during EM shifts, never mind three 5 minute breaks, and have had plenty of shifts where I went without any food or water because it was so busy.
You have time for food and water, you just haven't figured out when those times are yet.
 
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All it takes is one patient to go bad. When the lawyer says "So doctor, can you explain your absence from the emergency department when Mrs. Smith, a lovely mother of four beautiful children and a well respected member of the community, started desaturating and had an anoxic brain injury from a cardiac arrest? We have testimony from the other providers at the time that you were unavailable for 5 minutes" what will you say?

Read my post more carefully. In my specific shop, we have an ED Doc "call room" which is INSIDE the ER. Its basically next to the clean and dirty utility rooms, about 10ft from two patient care rooms. It has a phone inside. It has a single door that a nurse can knock on. People go in there to take a crap, change their clothes, pump breast milk, or (if you are very lucky) catch a cat nap on an overnight. Completely reasonable space to take a 5 minute prayer break. If a nurse needed you, he could be on top of you in 15 seconds from anywhere in our ED.

And of course I've had shifts where I haven't peed in 10 hours and have gotten a K-cup out but haven't taken the 45s to "brew" it for 4 hours and haven't eaten all day, and I stay two hours late to chart. So be it. Some days the prayers would be brief ;) Generally you could absolutely take 5 minutes to prayer and stay 5 extra minutes late to chart after your shift without impacting flow.
 
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