How to cope with night shifts? What about for bodybuilding?

[KeikoTanaka]

Hey all,

I recently was speaking with a friend who has a friend who is an EM doc. He was saying how his friend's hospital is understaffed and forces him to work many many undulating shifts between day and night. He was worried about his health given how often he has to do this, and says he is very stressed out by it. Also he doesn't find out his schedule until a few weeks before, making it hard to plan things he says.

Obviously this is probably a rarer case, but just curious - how do you go from being a medical student who does everything during the day to suddenly changing to dealing with night shifts?

Also, as a bodybuilder, sleep is obviously super crucial for muscle growth and for hormone regulation. If you displace your sleep to another time, is it still just as beneficial? Or with your circadian rhythm out of whack, are you going to have difficulty keeping off fat and what not?

For you people who go to the gym out there - how do you schedule your gym time in a schedule that is constantly changing? If you do an overnight, do you go to the gym before work? After work before bed? I know it's possible because they actually put a DO EM doc on the cover of Men's Health before and did a whole article about him, but it seemed to have a lot of unanswered questions about day and night shifting - more of just what being a doctor and a power lifter means to him

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[Rekt]

Hey all,

I recently was speaking with a friend who has a friend who is an EM doc. He was saying how his friend's hospital is understaffed and forces him to work many many undulating shifts between day and night. He was worried about his health given how often he has to do this, and says he is very stressed out by it. Also he doesn't find out his schedule until a few weeks before, making it hard to plan things he says.

Obviously this is probably a rarer case, but just curious - how do you go from being a medical student who does everything during the day to suddenly changing to dealing with night shifts?

Also, as a bodybuilder, sleep is obviously super crucial for muscle growth and for hormone regulation. If you displace your sleep to another time, is it still just as beneficial? Or with your circadian rhythm out of whack, are you going to have difficulty keeping off fat and what not?

For you people who go to the gym out there - how do you schedule your gym time in a schedule that is constantly changing? If you do an overnight, do you go to the gym before work? After work before bed? I know it's possible because they actually put a DO EM doc on the cover of Men's Health before and did a whole article about him, but it seemed to have a lot of unanswered questions about day and night shifting - more of just what being a doctor and a power lifter means to him

Sounds like your friend needs to find a new job.

As for your question, I didn't find it difficult. Most places aren't inept like your friends shop when it comes to schedule. You'll usually gradually switch to each, i.e. start with mornings, then mids, then nights, then some days off. Gym is a huge part of my deal and you just go whenever you feel like it. I've always been a morning gymer, so my ideal time is always before shift as it makes you feel 100x better during the shift and you won't be sure how busy you'll be during the shift and you're more likely to skip out if you wait until after. When I'm 50? Probably won't be that easy, but I'll cross that bridge later.

 

[KeikoTanaka]

Sounds like your friend needs to find a new job.

As for your question, I didn't find it difficult. Most places aren't inept like your friends shop when it comes to schedule. You'll usually gradually switch to each, i.e. start with mornings, then mids, then nights, then some days off. Gym is a huge part of my deal and you just go whenever you feel like it. I've always been a morning gymer, so my ideal time is always before shift as it makes you feel 100x better during the shift and you won't be sure how busy you'll be during the shift and you're more likely to skip out if you wait until after. When I'm 50? Probably won't be that easy, but I'll cross that bridge later.

How does seniority work in ED shifts? Like when you're 50 and no longer want to do nights, can you just switch to Per Diem? or are you kinda locked in for benefits and what not? Also, random question, you may not know the answer to but, my partner is in medical school with me, and interested in psych. If lets say im 50 and wanna drop to per diem, I would lose by benefits, but if he was full time working - could I be under his? I'm not sure how all that works haha

 

[Rekt]

How does seniority work in ED shifts? Like when you're 50 and no longer want to do nights, can you just switch to Per Diem? or are you kinda locked in for benefits and what not? Also, random question, you may not know the answer to but, my partner is in medical school with me, and interested in psych. If lets say im 50 and wanna drop to per diem, I would lose by benefits, but if he was full time working - could I be under his? I'm not sure how all that works haha

It'll be heavily group/job/CMG/SDG dependent and how many young new docs want the night shift differential. Usually there is a required number of nights for EM docs and they can decrease as their seniority increases. Some are able to eliminate nights altogether, but usually after many years of loyalty. There's ways to get around it like being core faculty and such. Probably other ways too I'm sure. It'll depend on your colleagues, but generally I feel like most people's goals are to work as little nights as possible as time goes on so there's competition.

As for the other question, probably? Probably depdendent on their plan.

 

[GeneralVeers]

It'll be heavily group/job/CMG/SDG dependent and how many young new docs want the night shift differential. Usually there is a required number of nights for EM docs and they can decrease as their seniority increases. Some are able to eliminate nights altogether, but usually after many years of loyalty. There's ways to get around it like being core faculty and such. Probably other ways too I'm sure. It'll depend on your colleagues, but generally I feel like most people's goals are to work as little nights as possible as time goes on so there's competition.

As for the other question, probably? Probably depdendent on their plan.

Just curious as to how a medical student is responding to this question???

The real answer is: As an EM physician you will have 50% or more of your days off each month, so going to the gym 3-4 times per week is easy. If you can squeeze it in after/before shift then that's just gravy.

 

[Groove]

Hey all,

I recently was speaking with a friend who has a friend who is an EM doc. He was saying how his friend's hospital is understaffed and forces him to work many many undulating shifts between day and night. He was worried about his health given how often he has to do this, and says he is very stressed out by it. Also he doesn't find out his schedule until a few weeks before, making it hard to plan things he says.

Obviously this is probably a rarer case, but just curious - how do you go from being a medical student who does everything during the day to suddenly changing to dealing with night shifts?

Also, as a bodybuilder, sleep is obviously super crucial for muscle growth and for hormone regulation. If you displace your sleep to another time, is it still just as beneficial? Or with your circadian rhythm out of whack, are you going to have difficulty keeping off fat and what not?

For you people who go to the gym out there - how do you schedule your gym time in a schedule that is constantly changing? If you do an overnight, do you go to the gym before work? After work before bed? I know it's possible because they actually put a DO EM doc on the cover of Men's Health before and did a whole article about him, but it seemed to have a lot of unanswered questions about day and night shifting - more of just what being a doctor and a power lifter means to him

I know that night shifts seem horrifying right now but if you end up choosing EM, you'll hopefully get used to it. If the circadian disruption is a complete deal breaker then do something else. That being said, you're going to work plenty of nights in other fields so part of me really doesn't understand the reactions I see on here when people swoon at the thought of being awake and working past 7p.m. I mean, help me understand how obtaining one of the most difficult degrees in the world connotes an easy life of opulence with minimal effort with no self sacrifice? I guess I just never really expected to go into the medical profession and work 6 hours a day for 4 days a week with no call, weekends or nights but hey... that's me. If you wanted to make 300K with a regular M-F 9-5 schedule with low stress, no nights, weekends or holidays then you probably should have been an orthodontist, not a doctor.

I had plenty of time for the gym in residency with a much busier schedule and you can carve out plenty of time as an attending so I wouldn't worry excessively about that. I typically do my big (2h) workouts on my days off because it's just too exhausting before or after work for me. If I do go on my work days, it's for light workouts that last about 45 mins.

 

[deleted109597]

Sounds like your friend needs to find a new job.

As for your question, I didn't find it difficult. Most places aren't inept like your friends shop when it comes to schedule. You'll usually gradually switch to each, i.e. start with mornings, then mids, then nights, then some days off. Gym is a huge part of my deal and you just go whenever you feel like it. I've always been a morning gymer, so my ideal time is always before shift as it makes you feel 100x better during the shift and you won't be sure how busy you'll be during the shift and you're more likely to skip out if you wait until after. When I'm 50? Probably won't be that easy, but I'll cross that bridge later.

I would argue that most places are single coverage, and the shifts are 50/50 day or night. You will gropu them, but there's no gradual step up with that.

 

[Rekt]

Just curious as to how a medical student is responding to this question???

The real answer is: As an EM physician you will have 50% or more of your days off each month, so going to the gym 3-4 times per week is easy. If you can squeeze it in after/before shift then that's just gravy.

6mo of aways. Several years ED experience with multiple groups before med school. Was I wrong?

 

[Jlaw]

im just coming out of residency so my "n" is small but everywhere I interviewed at for attending jobs (mid volume community ED's) had nocturnists on staff. Several were no nights but a few mids til 1 or 3am, the others were 2-3 nights a month. Nights can be difficult, I actually prefer them to day shifts (no admin, less BS, more camaraderie, and decreasing volume from start to end) but find the transition back to days difficult. As a resident I do 6 nights a month, so I anticipate 2-3 being significantly easier.

They have gotten easier through residency, I can stay up and functional for 30 hours fairly easily. I try to mitigate the switches back and forth by getting good sleep (sound machine, blackout curtains, sleep mask, cold room, melatonin/benadryl), and making it a habit to workout (lift and or run) before my night shifts. I actually find it easier to workout when I'm on nights because I can go to bed around 9am and wake up around 4:30pm fairly easily, I can't do 9pm to 4:30am when I am on days for some reason.

I don't think you will find many attendings doing more than 3 or 4 nights a month, your friend's situation is not typical and most people wouldn't tolerate it unless they were getting compensated very well.

 

[bky3c]

I'm not a gym person, but I ran a marathon in medical school and another during residency, and throughout all of my training and most of my attending years thus far, until about a year ago, I ran about an hour a day, 5 days a week. Plus obviously more during marathon training -- some days 3 hours or so. I just scheduled my runs whenever they fit in. Longer runs on days off, 1 hour runs in the morning before a day shift, afternoon if it's an overnight shift. Rest days on particularly awful work days. There were times when I got off work at 3am and waited for the sun to come up so I could run, then shower and go to bed. There were mornings when I had to be at work at 5am, so I ran before that (safer area, no need to wait for sunrise).

My thinking about exercise vs. sleep has evolved over the years. I don't do that crazy early morning stuff anymore, mostly because I know now how important sleep is... and also probably because I'm not 26 anymore. I don't run anymore, but I do a lot of hiking instead. I don't do much, if anything, on days when I have to work a 12-hour shift. That requires a reduction in sleep for me, which I'm just not willing to do anymore, especially after reading Matthew Walker's "Why We Sleep." I've also learned that I can't outrun a bad diet, so I've drastically improved my diet, and to my surprise, my fitness/weight really didn't change when I stopped running.

As for sleep quality, what I've read says that nighttime sleeping is best, but as others have mentioned, you shouldn't have a huge number of overnight shifts, so you just do the best you can on those days. I haven't worked a night shift in over 2 years, but that will be changing soon. My next plan is FIRE in a few years, and then I'll be done with nights forever. It seems like there are some docs who thrive on night shifts, even as they age, but for the rest of us, we really need a plan in place so that we're not working nights at age 60.

 

[Birdstrike]

Hey all,

I recently was speaking with a friend who has a friend who is an EM doc. He was saying how his friend's hospital is understaffed and forces him to work many many undulating shifts between day and night. He was worried about his health given how often he has to do this, and says he is very stressed out by it. Also he doesn't find out his schedule until a few weeks before, making it hard to plan things he says.

Obviously this is probably a rarer case, but just curious - how do you go from being a medical student who does everything during the day to suddenly changing to dealing with night shifts?

Also, as a bodybuilder, sleep is obviously super crucial for muscle growth and for hormone regulation. If you displace your sleep to another time, is it still just as beneficial? Or with your circadian rhythm out of whack, are you going to have difficulty keeping off fat and what not?

For you people who go to the gym out there - how do you schedule your gym time in a schedule that is constantly changing? If you do an overnight, do you go to the gym before work? After work before bed? I know it's possible because they actually put a DO EM doc on the cover of Men's Health before and did a whole article about him, but it seemed to have a lot of unanswered questions about day and night shifting - more of just what being a doctor and a power lifter means to him

I can't speak to bodybuilding, but I did train for and run several marathons as well as countless half marathons and 5Ks while working a crazy, rotating shift EM schedule. I imagine that sleep and recovery are just as important in endurance running as it is in body building.

The answer is, it's just plain hard, but you do it. Like anything else in life, you juggle it around based on your schedule. If that means you slept 8 hours the night before a day shift and you feel rested before your workout, then great. If it means you worked all night, you came home slept from 8 am to 12:00 noon, then worked out for 1-2 hours, then went back to sleep from 4 pm to 8 pm, then that's what you do. You're not going to do a 20 mile training run (or your hardest weight workout) that day, whether your schedule calls for it or not. You do a short run on your worst (post nights) day and do your long run or longest workout on a day off.

Bottom line: The circadian shift switches definitely make training harder, like they make everything else in life harder, but what's most important to you, you get done, whether you feel rested or whether your circadian rhythms have you feeling tortured. You do what you need to do, and rest when you can. Hopefully you're at a job and place in your life where you can work few enough hours to build in lot's of recovery time. If not, then you end up like your friend or like I did after several years in EM.

Now, after doing a fellowship, I do Interventional Pain medicine. Although I do work slightly more hours and therefore have slightly less time for working out, the consistency of the schedule makes planning workouts much easier, as does not having to deal with the physical and psychological turbulence caused by the constant circadian rhythm chaos.