ER work hours

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I know I'm going to regret bothering to get into this debate with you, but I will anyway. Yes, you were hard on her. It's jerky to post someone's stats from her MDApps and call her out because of them when she's asking an honest question.


She wasn't asking you; she was asking people who are working as EPs. You're two months into your M1 year. That means you have exactly two months more experience with medical school than she has, and you yourself have no idea how hard or easy most of medical school is going to be! And how do you know that being a physician is so hard? It's not like you've ever been one. What would you say if I told you that being a resident is easier than being a med student? Because in certain ways, it is. Since you like reading my blog, go back a few entries to the one where I talked about why my residency OB rotation was better than my med school OB rotation was, and there's an example. As another example, it's also nice to be paid for what you do rather than borrowing money and watching your debt go higher and higher.


I'm finding it funny that the people who are getting all bent out of shape about a pre-med asking why working overnights is harder than it seems are med students, but the people who are actually working this schedule aren't insulted by it.

Be that as it may, I'm done with derailing this thread. Feel free to PM me if you want to continue the discussion.

I had a response typed out, but then I realized there is no reason to justify my position to you. Believe me that my opinions were formed from the minds of competent physicians (with decades of combined experience) that I've had the good fortune to interact with.

We can agree to disagree here. Good luck to you, I wish you well.

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Our night shifts pay $300 extra. Our 6p-2a shifts pay $75 extra.
 
Some places do offer a night differential. My shop doesn't, but we all share nights. If you're trying to recruit a night guy (or 2 or 3), a differential in pay might be the trick. This, along with every other variable you can imagine, varies by shop.

We are "oversubscribed" on our nights. People want to come on but we are full. The trick is the differential. I make way more money. Over time at my shop people will come off nights myself included but its a win-win situation right now.
 
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Our night shifts pay $300 extra. Our 6p-2a shifts pay $75 extra.

HOw long are your night shifts? 10 hours? 8 hours? we looked this up and there was an article somewhere that said the avg differential was $50/hour.
 
HOw long are your night shifts? 10 hours? 8 hours? we looked this up and there was an article somewhere that said the avg differential was $50/hour.

8 hour shifts
 
How hard is it to get specific schedule requests? Say for example I have a kid who plays football games Friday nights that I want to go see, is it possible to get Friday nights off, if it's made up for elsewhere (e.g. work sat/sun nights instead)?
 
How hard is it to get specific schedule requests? Say for example I have a kid who plays football games Friday nights that I want to go see, is it possible to get Friday nights off, if it's made up for elsewhere (e.g. work sat/sun nights instead)?

Depends on how your group works, but we're all professionals with family and outside activities so we all have days we need off. In my group we can ask 6 days off each month and we're guaranteed to get those off. We can ask for more and see if we get them.
 
My group we get 9 guaranteed requests a month excluding what we call major holidays, Thanksgiving, Xmas eve, Xmas, NYE, NYD.

We are guaranteed 2 of those off as well.
 
For the most part the "medicine" isnt hard. STEMI, NSTEMI, CVA, Sepsis, Hypoxia, COPD. Those things for the most part arent that hard. The social problems, patients refusing to leave, patients refusing to allow themselves to be cared for, the drunks etc. Thats what makes a bad shift for me. The I came here for a 3rd opinion for my chronic "fill in the blank" pain after seeing 2 subspecialists and Im not leaving until I have an answer.
Bless you for dealing with them though.

I was interested in EM, and I wanted to want to go into it, but after rotating through it, the problems you mentioned were just too much for me.
 
First, thanks to everyone who put up their schedules and insights! This is an awesome thread and I have learned a lot from it.

I also have a question about schedules:

Since overnight shifts are often the shifts that nobody wants, is it possible that offering to work nights only would allow someone to have much greater control over the scheduling of their shifts. For instance, say I was working 144 hours (twelve 12-hour shifts), would I have a decent possibility to say that I wanted to work 4 nights, have 2 off, work 4 more, have 2 off, work 4 more, and have the remaining two weeks of the month off?

This would be absolute best case scenario and I realize it is probably not obtainable, but I would really like to know if its possible. If not, how close to this schedule would it be possible to get?

(I'm only asking for opinions, since every hospital and group has different numbers of people to work nights and shift differentials will affect demand, etc.)

I also have some questions specifically about pediatric emergency, but I'm not sure exactly where to ask them...Would the peds forum or this forum be better?

Thanks!
 
As a night only doc I definitely get scheduling preferences that the mixed schedule docs don't get but I'm one of 5 night-only docs in my group (staffing 3 hospitals) so there are some limitations to the preferential scheduling.
 
As a night only doc I definitely get scheduling preferences that the mixed schedule docs don't get but I'm one of 5 night-only docs in my group (staffing 3 hospitals) so there are some limitations to the preferential scheduling.


At my hospital, out of the 32 docs, 2 of us do all nights. We get a 2 shift reduction, increased night time differential, and schedule preference except for holidays (we have to do either xmas or Thanksgiving and the days around it). I was able to get off for ACEP, I was easily able to get off for my boards and the time around it to study and then a day of rest. Our group on average does 140/month but the night docs do 124-128/month. I can bunch them all and have whole bunch of time off or I can have 3 to 4 day weekends.
 
To night docs, do you just stay up on days you don't work?

I.e. do you sleep the same time everyday pretty much? (10am-4pm or something?)
 
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To night docs, do you just stay up on days you don't work?

I.e. do you sleep the same time everyday pretty much? (10am-4pm or something?)

I flip back and forth, but I don't get up early in the morning unless I have no control of the timing of some unmissable event. If I didn't have a family with a normal person schedule I'd probably stay more on a night schedule even when off.
 
To night docs, do you just stay up on days you don't work?

I.e. do you sleep the same time everyday pretty much? (10am-4pm or something?)

My typical schedule goes like this.

I work from 6p-6a and do 12 12 hour nights. Typically its a run of 3 groups of 4 nights which gives me 17-19 days off a month.

Prior to my first night I sleep until 730 or 8 am. I dont nap since ive not been good at napping since i was about 2 years of age.

I usually sleep from 730-230 between my shifts and 730-noon after my last shift.

Your question is in reference to anchor sleep. I have NONE. This is well studied and is important but I dont understand how any human being with a family can pull this off.

Ive been on nights for 23 months now. Its gone well and Ill be on nights for at least another year and potentially longer if things keep going well.
 
...I'm all nights. There is a shift reduction at one of my jobs (appx 20%), and at the other is additional $ (~10%).

All groups are different and its a negotiation, if you are going to pay $10k more per shift, your whole group will do nights, and if you pay $3 more per shift, nobody is. After time, it all works itself out.
 
...I'm all nights. There is a shift reduction at one of my jobs (appx 20%), and at the other is additional $ (~10%).

All groups are different and its a negotiation, if you are going to pay $10k more per shift, your whole group will do nights, and if you pay $3 more per shift, nobody is. After time, it all works itself out.

FWIW the national avg for differential is $50/hr.
 
FWIW the national avg for differential is $50/hr.

I wish I got paid more for nights. We get hourly plus RVU (if higher), and nights generally pull only the hourly. So people working nights usually earn less, and that makes them even less attractive.
 
I wish I got paid more for nights. We get hourly plus RVU (if higher), and nights generally pull only the hourly. So people working nights usually earn less, and that makes them even less attractive.

Why would anyone do that? Seems insane. no differential, no nights for me. Heck even with the differential I dont know how much longer I would do it.
 
Being in school during the days at UG is like a vacation basically, you don't really have to listen and you can cram when tests come while still getting all A's.

lol... sounds like you've been stalking me.

this is true for the most part. it would be pretty tough to make all A's while working that many hours in addition to school though
 
Why would anyone do that? Seems insane. no differential, no nights for me. Heck even with the differential I dont know how much longer I would do it.

Because someone has to work nights, and we all end up doing it fairly equitably.
Besides, you don't have to work as hard at night, and there are less stupid managerial types around to annoy me.
 
Because someone has to work nights, and we all end up doing it fairly equitably.
Besides, you don't have to work as hard at night, and there are less stupid managerial types around to annoy me.

I know everyone has to work at night but IMO working nights without a pay differential makes no sense. This is obviously different per ED, but in my ED at night the night docs see more patients per hour and bill more critical care time.

I agree regarding the managerial types.
 
I still don't understand a "recovery day." Does this occur after 2-3 consecutive shifts or after a late night shift?

It's a true phenomenon. There are ways to go about it that "lessen" it, like having a good plan for the recovery day.

My way of going about it is my recovery day goes like this:

12a-8a = work
9a = home
9-11 = breakfast + tv
11-2 = nap
2-11 = doing whatever
1130 = sleep

The key is not getting TOO much sleep and not planning anything too strenuous. If my wife and I go out - she drives the majority of the time because I may be just a tad too tired on recovery day.

You see, the worst recovery day is when you go home after a night shift and sleep until 6pm. You just destroyed your entire day and you can't sleep at night and you're screwed the next day.
 
Nevermind...Nervous Ned said all I needed to.
 
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a typical month for james, my partner, looked like this

1. 5am-5pm
2.5am-5pm
3.7am-7pm
4.7am-7pm
5.12am - 12pm
6.12am-12pm
7.off
8. off
9. 5am-5pm
10.5am-5pm
11.7am-7pm
12.7am-7pm
13.12am - 12pm
14.12am-12pm
15.off
16.off
17. 5am-5pm
18.5am-5pm
19.7am-7pm
20.7am-7pm
21.12am - 12pm
22.12am-12pm
23.off
24. off
25. 5am-5pm
26.5am-5pm
27.7am-7pm
28.7am-7pm
29.12am - 12pm
30.12am-12pm
31.off
 
He's only an ED surg consult....most patients they get in cant be bothered going to an after hours GP clinic so mainly sniffles or flu. occassionally theres a stabbing, between 12am friday and 12am sunday it's mainly drunks, and then theres the 300 pound men that come in wondering why their chest hurts....so adelaide isn't full of knife weilding killers...our level 1 trauma centre doesn't see alot of dramatic tramua.

most of ^^that was on call and he prefers nights
he starts his ortho rotation 20th jan so better hours and more time off. good pay though before tax he brought in nearly $4,500-$5000 a week
 
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