EM night and weekend shift

[AOX4]

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as a resident how many of your shift are nights or weekends? how about as an attending? ive heard other residents tell me that you can expect 2/3 of your shifts to be nights or weekends.

 

[ccfccp]

At least in residency, you can expect to average aout half nights and half days (with 7-7 12 hour shifts... or equally split shifts if your prgram has shorter shifts.) Weekends are usually also equally split equally (as long as you don't piss off your chiefs 🙂 )At least that's how it works in our shop.

 

[Arcan57]

Weekends = 2/7 days
Nights = 2.5/remaining 5 days

4.5/7 days are nights or weekends. The only thing that gets that equation changed is if you have one or more docs in your group that just work nights.

 

[Hercules]

Part of that depends on how you define nights. Do you mean the overnight shift, the swing or the afternoon. At my place we have a 7a-4p, 11a-9p, 4p-2a, and a 9p-7a. Lower volume days have a 7a-7p, 12p-12a, and a 7p-7a. We are set up to do 15 shifts split equally among those options with 2 weekends on and 2 weekends off. Hope that helps

 

[SoCuteMD]

Depends if you have 12 hour or 9 hour shifts.

For 12s - about 1/3 of your shifts will be weekend and about half will be night. Obviously, there's some overlap, so the 2/3 figure is probably right.

For 9s - about 2/3 of your shift will be evening and overnight. Depends what you think about evening shifts (ours are 4p-2a), but I tend to lump them into the "killing my social life" category. In the end, about 1/3 of your shifts will be weekend and 2/3 of your shifts will be evening/overnight. I'd say that means 1/4 of your shifts will be non-night/evening, non-weekend shifts.

 

[sideways]

Why on earth isn't EM structured such that you always work the same shift? I'm not talking about in residency, but out in practice. I mean, working from 7a-4p one day then 9p-7a another just seems asinine.

You mean to tell me they can't structure a pay differential scheme that results in equal competition for all shifts and puts an end to this *****ic, unhealthy, and (presumably) unnecessary assault on one's circadian rhythm?

 

[AOX4]

Why on earth isn't EM structured such that you always work the same shift? I'm not talking about in residency, but out in practice. I mean, working from 7a-4p one day then 9p-7a another just seems asinine.

You mean to tell me they can't structure a pay differential scheme that results in equal competition for all shifts and puts an end to this *****ic, unhealthy, and (presumably) unnecessary assault on one's circadian rhythm?

i love EM but i feel like the nights and weekends will get old..i'm considering neuro..salaries have increased in the last few years and not as much night/weekends (from what i've seen).

http://www.merritthawkins.com/compensation-surveys.aspx

Neurology
2009/10 $180,000 $281,000 $460,000
2008/09 $180,000 $258,000 $375,000
2007/08 $150,000 $230,000 $325,000
2006/07 $170,000 $234,000 $275,000

 

[SoCuteMD]

Why on earth isn't EM structured such that you always work the same shift? I'm not talking about in residency, but out in practice. I mean, working from 7a-4p one day then 9p-7a another just seems asinine.

You mean to tell me they can't structure a pay differential scheme that results in equal competition for all shifts and puts an end to this *****ic, unhealthy, and (presumably) unnecessary assault on one's circadian rhythm?

There certainly are places that are salaried (mostly academic, I think). However, why should every shift be compensated equally? The 7a-4p shift often has a HUGE lull until around 11 AM. Any shift that starts around or after noon and ends around midnight is one of the busiest shifts of the day - peak volume throughout. The night shift is tough because you have to switch your schedule, it's busy, and it's the time at which you are most likely to be single coverage.

Do you mean that one provider would, for example, always work the Sunday-Wednesday 7a-4p shift? And another provider would cover the Sunday-Wednesday overnight shift? There are certainly people who do this within their groups, mostly for overnights. Almost any EP who offered to work 3-4 overnights a week but asked for the same overnights would not have trouble finding a job that met those specifications. The problem is that there aren't a lot of people who want to work lots of overnights.

I, personally, enjoy the flexibility of a changing schedule. If I work the day shift one day and the evening/night shift the next I enjoy the chance to sleep in and still get something done before I have to go to work.

 

[J ROD]

Guess EM may be for me then since I like the pace and work...and the drug seekers are like a game to me to see who wins! Can you guess right? 😀

Also, I prefer to work nights and weekends...although I would prefer to get off more around 2AM than 7AM....but nothing is perfect.

 

[sideways]

There certainly are places that are salaried (mostly academic, I think). However, why should every shift be compensated equally? The 7a-4p shift often has a HUGE lull until around 11 AM. Any shift that starts around or after noon and ends around midnight is one of the busiest shifts of the day - peak volume throughout. The night shift is tough because you have to switch your schedule, it's busy, and it's the time at which you are most likely to be single coverage.

Do you mean that one provider would, for example, always work the Sunday-Wednesday 7a-4p shift? And another provider would cover the Sunday-Wednesday overnight shift? There are certainly people who do this within their groups, mostly for overnights. Almost any EP who offered to work 3-4 overnights a week but asked for the same overnights would not have trouble finding a job that met those specifications. The problem is that there aren't a lot of people who want to work lots of overnights.

I, personally, enjoy the flexibility of a changing schedule. If I work the day shift one day and the evening/night shift the next I enjoy the chance to sleep in and still get something done before I have to go to work.

Don't get caught up in the pay structure - however it would work it would work. It just seems bizarre to me that everyone has to shift their schedules constantly. If nights are unpopular, pay them more. If days are competitive, shift some of their pay to the night people and adjust the competition accordingly.

I just think there should be CHOICE in the matter. The entire specialty shouldn't revolve around changing shifts. Let the compensation sort out who decides to work X vs Y shift, not some sort of externally imposed obligation to work these varied shifts.

 

[SoCuteMD]

Don't get caught up in the pay structure - however it would work it would work. It just seems bizarre to me that everyone has to shift their schedules constantly. If nights are unpopular, pay them more. If days are competitive, shift some of their pay to the night people and adjust the competition accordingly.

I just think there should be CHOICE in the matter. The entire specialty shouldn't revolve around changing shifts. Let the compensation sort out who decides to work X vs Y shift, not some sort of externally imposed obligation to work these varied shifts.

As I mentioned before, I think if you want to commit to a certain shift and work it regularly, you may find a group open to that arrangement. I've seen this work with evening, night, and weekend shifts, but haven't heard of anyone trying to do it with day shifts. On a side note - if you put me on all day shifts, I'd burn out in short order - some of the sickest, most time-intensive patients come in between 10 AM and 3 PM.

It seems like you dislike the schedule of EM. I can tell you that most of the people I know who went into EM enjoy the variety and changing shifts. If I want a random Thursday off, even as a resident, I can ask for it and probably get it. The attendings at our community site are able to arrange their schedules so that they might have 10 consecutive days off in a month - some will use this time for travel without even having to take vacation. The irregular schedules are something about EM that is pretty unlikely to change, given how much the people attracted to this specialty embrace it.

 

[sideways]

As I mentioned before, I think if you want to commit to a certain shift and work it regularly, you may find a group open to that arrangement. I've seen this work with evening, night, and weekend shifts, but haven't heard of anyone trying to do it with day shifts. On a side note - if you put me on all day shifts, I'd burn out in short order - some of the sickest, most time-intensive patients come in between 10 AM and 3 PM.

It seems like you dislike the schedule of EM. I can tell you that most of the people I know who went into EM enjoy the variety and changing shifts. If I want a random Thursday off, even as a resident, I can ask for it and probably get it. The attendings at our community site are able to arrange their schedules so that they might have 10 consecutive days off in a month - some will use this time for travel without even having to take vacation. The irregular schedules are something about EM that is pretty unlikely to change, given how much the people attracted to this specialty embrace it.

Well I've yet to experience it, so I have no idea how I'd feel. It's just something I've thought about.

 

[alwaysaangel]

I can tell you that most of the people I know who went into EM enjoy the variety and changing shifts. If I want a random Thursday off, even as a resident, I can ask for it and probably get it. The attendings at our community site are able to arrange their schedules so that they might have 10 consecutive days off in a month - some will use this time for travel without even having to take vacation. The irregular schedules are something about EM that is pretty unlikely to change, given how much the people attracted to this specialty embrace it.

Exactly! I love the variety of the shift and the freedom of scheduling. One of my favorite things about the specialty. A little benadryl or melatonin and switching days to nights is fine 🙂 But I can also still live on 4-5 hrs/sleep. May get harder as I get older.

 

[Tiger26]

Well I've yet to experience it, so I have no idea how I'd feel. It's just something I've thought about.

The question you have to ask yourself is whether you like the medicine in the ED enough to do it as a career. Most surgical residents (although not all) don't love getting up a O-dark thirty in the AM but they do it because they love operating.

For me, getting to work nights/weekends is actually kind of an ancillary benefit to the pathology I see and things I get to do in the ED. More often than not I can sleep in as late as I want. As the type of guy who likes to sleep until noon, getting to do it during residency is triple-awesome.

Plus, fun stuff happens at night . . .

 

[FLTDOC1]

another great piece by Ed Leap on this subject..

http://edwinleap.com/blog/?p=696

 

[diphenyl]

We have a pretty nice group set up here. We have 3-4 dedicated night docs which do a pretty goof job of covering the schedule. The rest of the docs only work about 1 night shift a month.
Most full time attendings here work 10-15 days per month. Each shift is 10 hrs. We have a pod system. during the day/ evening you have an hour overlap with the next doc so it usually isn't a problem getting out on time.
Times for ships are staggered so the above is possible.

6 am, 7, 8 noon, 3 pm, 4, 5, 9 pm, 10 pm. Also have two midlevels on at 10 am and 8 pm.

 

[doctorFred]

another great piece by Ed Leap on this subject..

http://edwinleap.com/blog/?p=696

I have back pain and I'm out of Lortab!

 

[deleted109597]

So obviously, it can be done in a way that people work only nights and only days. Nurses have been doing it for years. People in other fields do it (cops, taxi drivers, 24 hour gas station attendants) Hospitalists generally do one or the other. I suppose another way (that would make scheduling even harder) would be to have a month of days, then a month of nights. However, to say that it can't be done is fairly ridiculous. We as physicians have just kept on with the "this is how it is done" mentality without reason.

My moonlighting gig pays more for nights than for days. You also don't work as hard (usually). Guess which one I do?

 

[Apollyon]

I suppose another way (that would make scheduling even harder) would be to have a month of days, then a month of nights. However, to say that it can't be done is fairly ridiculous.

The South Carolina State Police do a month of days, then a month of nights, rotating regularly.

 

[xaelia]

Sure, you can say 55-65% of your shifts will be evenings, nights and/or weekends....

But when you only work 14 shifts a month....

Neurology, assuming normal office hours plus call, turns into a lot more hours, regardless of the money. Being on-call on top of your normal office hours blows.

 

[docB]

Why on earth isn't EM structured such that you always work the same shift? I'm not talking about in residency, but out in practice. I mean, working from 7a-4p one day then 9p-7a another just seems asinine.

You mean to tell me they can't structure a pay differential scheme that results in equal competition for all shifts and puts an end to this *****ic, unhealthy, and (presumably) unnecessary assault on one's circadian rhythm?

Don't get caught up in the pay structure - however it would work it would work. It just seems bizarre to me that everyone has to shift their schedules constantly. If nights are unpopular, pay them more. If days are competitive, shift some of their pay to the night people and adjust the competition accordingly.

I just think there should be CHOICE in the matter. The entire specialty shouldn't revolve around changing shifts. Let the compensation sort out who decides to work X vs Y shift, not some sort of externally imposed obligation to work these varied shifts.

There's no "externally imposed obligation." Every group decides how they want to do their scheduling. There is no rule or regulation that precludes any EM group from establishing regular shifts as you suggest. The vast majority of groups though don't do it that way for a lot of reasons:
-It's often more practical to "share the pain" equally than to up the compensation of the night guys.
-When the pain isn't shared (ie. the senior partners take all the weekday shifts) resentment builds.
-Static shifts make taking days off or vacation much more difficult.
-Many docs like to have some variety in their shifts for different reasons.

But there's nothing forcing groups to do it any particular way.