Circadian rhythm and nights part deux

[Moose52]

Alright, please hold the flames for just a second as I realize, on first glance, this will look like a ridiculous question, but I will do my best to thoroughly clarify it.

In searching past posts in this forum, I've seen it stated multiple times that (potential) downsides to EM are weekends, holidays, and nights, that nights can wreck havoc on your circadian rhythm, that they get harder to recover from...I also saw it posted that attendings can, in some practices, work only 3-4 nights/month.

My question is, what do you consider a night shift? Is it truly overnight (7P-7A or 11P-7A)? Or do you also consider the "second shift" (for lack of a better term) from, say 5P-1A or 3A a night shift as well?

A family friend just started as an EM attending, and he was saying, as the new guy, he has to work pretty much all "nights," meaning 5P-3A. He said that the 11P-8A shifts were in high demand in his group because they paid a lot better.

I ask because I hear a lot, mainly from other specialties, about how one of the main downsides to EM is the night work, but, in my mind, a 5P-3A shift would not be as hard to recover from as an 11P-7A. I think I could handle multiple shifts of 5P-3A (or whatever) a lot better than I could the true third shift. Of course, I'm only 2-3 yrs out of college, and getting home at 3 or 4 in the morning was (usually) the sign of a good weekend back then...

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[southerndoc]

Night work is not a downside in my opinion. I much prefer to work nights. I'm a night person.

 

[ERMudPhud]

I don't mind overnights 11p-7a since we get a pay differential for those. They are especially good if I can group a bunch in a row. Some places aren't busy enought for a 5p-1a type shift. I've worked two places that had a 5p-2a or a 6p-3a shift. The problem with those is that if you get out late by say 30-60 minutes, drive home, eat something, decompress for a while, and then get ready for bed. Before you know it you are going to bed at 5 or 6am anyway. It feels like an overnight without the differential.


I do find as I get older it takes me longer to get back to a daytime schedule after I've done a few nights.

 

[Flopotomist]

Wow.. just an MS2 here, but this thread made my day. I can't IMAGINE that some day in my future I might be lucky enough to find somewhere that I can work 5p-2a. Those are dream hours! Get to bed by 4 am -ish... sleep until noon... go to the gym, hang out... do things while there are no lines at stores.

Sounds awesome!

 

[kungfufishing]

I dont consider that a night shift. Having worked it before, can tell you I much prefer the 6-3 deal IF I am disciplined enough to get in bed by about 0415 or so. If you do that, you are still pretty diurnal and fine.

 

[Febrifuge]

For a while, I did my tech thing on a regular 3p-11p schedule. It was fine, but kind of a pain... yes I could run to the bank in the morning and never had a line at the grocery store, but when bar close is 2AM it's damned inconvenient.

11p-7a is rough the first night, but by day 3 it's completely awesome. Nothing's better than coming to the end of a series of shifts, and hitting the brew-pub at 8:30 for bacon, eggs, and beer with the residents and medics.

To answer the original question, nahh, 2nd shift isn't really nights.

 

[acrunchyfrog]

B (or second) shift isn't considered nights here, but rather "swing."
After about 5 years of consistent nights (7p-7a and 22-06) I much prefer to move my circadian rhythm forward rather than try and turn it back. That usually meant that once I got to the end of my stretch I was staying up until 11 or noon, and then sleeping until right before work. On my first day off I usually just stayed up until 8pm and was back to a diurnal rhythm (more or less) in the morning.

/just my $.02

 

[Moose52]

Thanks for the responses guys.

 

[GeneralVeers]

We do 9 hour shifts:

Day: 7AM to 4PM
Swing: 3PM to 12AM
Night: 11AM to 8AM

When I make the schedule, I generally try to put everyone on a circadian cycle, i.e. grouping days, swings and nights together in succession. I also try to group the nights as closely as possible in order to limit the total number of days people have to be on a night schedule.

BTW, if someone had told me how time-consuming and frustrating making the schedule is, I may have reconsidered the chief thing. I've never seen a group of adults complain about scheduling as much as residents.....

 

[Apollyon]

I've never seen a group of adults complain about scheduling as much as residents.....

Any manager, HR person, or scheduler can tell you that 90% of their problems are the people with whom they have to work.

 

[bartleby]

There are tons of benefits of working "off" shifts (non-days). People have asked my wife "So, does your husband work?" because they see us walking around in town together during the day so often when everybody else is at the office.

Regardless of the shift you're working, remember that you've got a built-in hour limitation (barring mass-casualty catastrophes, emergency illness of another doc) which many other specialties don't have. No week-long blocks of calls. When you do shift work, even if you're exceptionally busy, you're not going to be there for 20 hours at a time.

I also like knowing what to expect at work. I figure that I'm going to be WORKING at work and on my feet while I'm there. If I'm wrong, it means that I'm only at 90% effort, in which case I'm pleasantly surprised.

An additional appeal of nights is that night people tend to be a lot more laid back and cooler to work with than the day people.

Any manager, HR person, or scheduler can tell you that 90% of their problems are the people with whom they have to work.