I hate night shifts

[GrandCircle]

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I can't stand them. Only did a few sporadic ones as a student, and now I'm a 1st year resident getting slammed w/3-4 in a row. I'm learning I'm particularly sensitive to changes in eating, sleeping and pooping habits. I feel chronically tired and grumpy.

Can't do this for the rest of my life...does it get better or do I need to switch specialties

 

[SoCuteMD]

I can't stand them. Only did a few sporadic ones as a student, and now I'm a 1st year resident getting slammed w/3-4 in a row. I'm learning I'm particularly sensitive to changes in eating, sleeping and pooping habits. I feel chronically tired and grumpy.

Can't do this for the rest of my life...does it get better or do I need to switch specialties

I've found ways to make night shifts more pleasant. I adjust my daily schedule as much as possible. If you work 12s, go to bed as soon as you can and sleep for as long as you can. Don't wake up for lunch - use a sleep mask and earplugs to block out the world. Don't participate in the 3 AM coffee run, either. Have some cold water and a healthy snack if you are tired.

If you work 8s, 9s, or 10s you may be able to sleep in two different shifts. The first should be as soon as you get home, from 8-11. Wake up, do a few things, read, and go back to bed for about 4 hours at whatever time you need to in order to wake up and get to your next shift. For me this translates to 8-11 and then again from 6-9. I haven't had the chance to try that sleep plan, but friends I know swear by it!

 

[BADMD]

I can't stand them. Only did a few sporadic ones as a student, and now I'm a 1st year resident getting slammed w/3-4 in a row. I'm learning I'm particularly sensitive to changes in eating, sleeping and pooping habits. I feel chronically tired and grumpy.

Can't do this for the rest of my life...does it get better or do I need to switch specialties

Until you get into management (and even then you will), EM does nights. You may be able to minimize by trading and/or finding a group with some dedicated night owl, but if you absolutely positively cannot do some overnight shifts, you probably can't do EM.

It will likely get better as an attending. I think I'm down to 2-3 per month with no more than 2 in a row.

 

[diphenyl]

See I can't relate because I work nothing but nights. I work 4 or 5 in a row and then have 2-3 off but I maintain the same schedule. Show up at 9 or 10 pm, work until 7 or 8 am, go home, go right to bed, sleep until 5 or 6 pm. eat dinner with my family enjoy some time with them and back to work. I just like the night shift people so much better. No administration around, people are more easy going. Pt's have higher acuity and are more interesting. We kind of have flow patterns that stay pretty consistent. I know from 9 to 2 am I will be pretty busy, then there will be a lull during which I can catch up on charting and eat until about 4 am when it picks up again and then its a march until 6 am when the AM doc shows up.

 

[kungfufishing]

See I can't relate because I work nothing but nights. I work 4 or 5 in a row and then have 2-3 off but I maintain the same schedule. Show up at 9 or 10 pm, work until 7 or 8 am, go home, go right to bed, sleep until 5 or 6 pm. eat dinner with my family enjoy some time with them and back to work. I just like the night shift people so much better. No administration around, people are more easy going. Pt's have higher acuity and are more interesting. We kind of have flow patterns that stay pretty consistent. I know from 9 to 2 am I will be pretty busy, then there will be a lull during which I can catch up on charting and eat until about 4 am when it picks up again and then its a march until 6 am when the AM doc shows up.

I also like the nightshift flow and patient mix. I just don't like the "me vs. thousands of years of diurnal evolution" bit. I find that the more disciplined I am about getting my ass in bed, the better, and the sooner I get outside and do something in the sunlight when I wake up, the better, and if I exercise, better. What an odd sentence that was.

 

[Arcan57]

It gets easier. Not in terms of number of night shifts worked, but in terms of your ability to adapt to them. If you're working strings of nights then it is crucial to sleep in a completely darkened room (resets your circadian rhythm). Invest in blackout curtains if the facemask doesn't work for you.

I've gotten to the point where it's pretty easy to switch to nights. The return trip back to days (especially with our scheduler's tendency to assign DOMAs) still sucks though. But I figure that and an almost complete lack of control over practice environment is why we get paid so well.

 

[GeneralVeers]

It gets easier. Not in terms of number of night shifts worked, but in terms of your ability to adapt to them. If you're working strings of nights then it is crucial to sleep in a completely darkened room (resets your circadian rhythm). Invest in blackout curtains if the facemask doesn't work for you.

I've gotten to the point where it's pretty easy to switch to nights. The return trip back to days (especially with our scheduler's tendency to assign DOMAs) still sucks though. But I figure that and an almost complete lack of control over practice environment is why we get paid so well.

I agree with you. The switchover to nights isn't hard, and usually by my second shift I'm fine. The return to days can be brutal though, and sometimes takes me two days to feel back to normal, without the anger and constant nausea associated with sleep deprivation.

 

[Arcan57]

I agree with you. The switchover to nights isn't hard, and usually by my second shift I'm fine. The return to days can be brutal though, and sometimes takes me two days to feel back to normal, without the anger and constant nausea associated with sleep deprivation.

How many night shifts do you usually do in a row? I find I can recover in 1-2 days after one to three straight nights, but if I do five or more I completely reset my circadian rhythm and it takes about 5 days to switch back. I've actually been lobbying to do more isolated nights, because I can power through them and not have to reset. The way our group schedules has not been conducive to that, however.

 

[SoCuteMD]

How many night shifts do you usually do in a row? I find I can recover in 1-2 days after one to three straight nights, but if I do five or more I completely reset my circadian rhythm and it takes about 5 days to switch back. I've actually been lobbying to do more isolated nights, because I can power through them and not have to reset. The way our group schedules has not been conducive to that, however.

I would much prefer to do all my nights for a month in one stretch (5-6 nights as a resident, which is far fewer than I expected actually). I go home at the end of my last night shift, nap for 3-4 hours, wake up and do laundry, cleaning, reading and grocery shopping. I try to go to bed early that night, and usually wake up pretty easily the next morning. A run in the afternoon on my DOMA seems to help.

 

[CopToEM]

I worked nights a lot in law enforcement.. I didn't mind them, but I never did get used to them. I just rode around listening to Sirius Radio all night and keeping myself occupied. I liked them for all the same reasons quoted above... liked the people better, no administration around, pretty much do your own thing. It does suck to transition and I don't think anyone's body ever really gets used to it.

Imagine working 6am-6pm for two weeks and then 6pm-6am for two weeks. That's when the suck really kicks in! 😱

 

[mamablotto]

I'm envious. I'm naturally a night owl and having to work during the day in a clinic is killing me. The only thing i liked about working at Walmart was the overnight shifts.

make sure you get enough exercise, my boss told me when he was a resident working the overnights, working out before he went to his shift made him feel more clear minded and less tired.

 

[DoctorMedic]

worked mostly nights as a when i was first a medic for almost 2 yrs. first month was tough, but it definitely got better after that. Sucked when we didn't have any patients, luckly we could catch a quick 15 min nap in the truck and those kept me going 😛 You know what they say EMS = Earn Money Sleeping but seriously when we did run all night being kept busy by patients, run reports etc made it go by a lot quicker and it really wasn't as bad as i thought it would be.

 

[VoiceofReason]

how hard is it to find a working arrangement where one can do isolated nights?

like perhaps 2-3 a month but spread out with a week inbetween each. I feel like i would much rather do that than reset my circadian rhythm

 

[GeneralVeers]

We used to do 4 nights in a row, but one of our night guys recently left, so now we have to do 5.

I found a huge difference between 4 and 5 shifts. Usually at 4 nights I could maintain enough anchor sleep that I was able to recover within one day. For some reason 5 nights takes me at least 2 days to return to normal.

 

[emtcsmith]

I work 2000-0800 at my full time paramedic job on a two week rotation:
mon,tues, friday, saturday, sun
....tuesday, wednesday

So unless I'm working a part time day job I sleep til 11ish before my first shift, and between shifts get home around 0930 and sleep til 1600ish. I enjoy nights alot better then days and since its constant its even better. Oh, and I have black out curtins.

 

[EM_Rebuilder]

I love to work nights and have NO problems working the actual nights. My problem is going from nights to days!

I sleep like a baby during the day. Block out your windows if you havent already (I put 1/2 inch foam cut to fit from Lowers/Home Depot. I shut the bathroom door, my room is as dark day or night.

When I get home from a night shift, I take a quick shower and go to bed. I get off at 7ish, I am usually pulling covers over by 8 or a bit after....

I dont know why, but seems like I ALWAYS wake up around noon to pee....no biggie, just pee... dont check the cell phone, dont check the email, etc... and you can go RIGHT back to sleep!

I have the alarm set up for 5, but I usually wake on my own around 4. I get up, find something for dinner, check emails, etc...before going to work at 7....

I just about ALWAYS take good/meal to eat at work around 1-3AM... I find, if I dont, by morning I am freaking STARVING.. then if I go home and eat or stop on the way home, I have a harder time sleeping and feel all bloated. Its funny how on a normal day, you can eat a buffett at night, and all you want to do is go to sleep....


I have the problem switching back...

 

[Pinner Doc]

I can't stand them. Only did a few sporadic ones as a student, and now I'm a 1st year resident getting slammed w/3-4 in a row. I'm learning I'm particularly sensitive to changes in eating, sleeping and pooping habits. I feel chronically tired and grumpy.

Can't do this for the rest of my life...does it get better or do I need to switch specialties

I hated night shifts until I started an ICU rotation... q3 with 30 hour call... over which I now infinitely prefer night shifts!

 

[Faebinder]

I can't stand them. Only did a few sporadic ones as a student, and now I'm a 1st year resident getting slammed w/3-4 in a row. I'm learning I'm particularly sensitive to changes in eating, sleeping and pooping habits. I feel chronically tired and grumpy.

Can't do this for the rest of my life...does it get better or do I need to switch specialties

As someone who is going to sleep medicine and has been studying sleep shifts a lot, my recommendation follows my mentor's advice.

Always wake up at the same time, it doesn't matter when you go to bed, it's when you wake up that determines the next day your ability to sleep and your reset of your sleep hours.

 

[KidDr]

I know it doesn't change the general crappyness that is the night shift, but I have to say that black out shades are amazing. I finally got them about a month ago, and they've totally improved my sleep (and therefore, my life). I used to wake up every couple hours when I would try to sleep during the day. Now I wake up once, at most (usually not at all), during my 8 hour daytime sleep after a night shift, and I wake up feeling totally rested. I don't know why it took me 5 years of post-graduate life to figure this out...but better late than never!

And you don't need to buy actual shades and spend a bunch of money. I just got a few yards of white fabric that doesn't let any light through, cut the fabric to fit inside my windows, and used adhesive-backed velcro to hang them up. Probably cost about $15 total and so worth it. Oh, and I use earplugs too, which helps a ton.

 

[SoCuteMD]

As someone who is going to sleep medicine and has been studying sleep shifts a lot, my recommendation follows my mentor's advice.

Always wake up at the same time, it doesn't matter when you go to bed, it's when you wake up that determines the next day your ability to sleep and your reset of your sleep hours.

Which is a really great thought...except when you have to totally switch your schedule there is no way to "always" wake up at the same time. When I work days, I have to be up no later than 6 AM and I'm not home until 8:30 PM. When I work nights I have to be at work by 7 PM. There's simply no way I can consistently wake up at the same time.

 

[njac]

towels: the student's black out curtains. Or black trash bags.

The hardest was when I lived in a house with skylights. Nothing a Hefty bag couldn't fix.

 

[Jeff698]

Always wake up at the same time, it doesn't matter when you go to bed, it's when you wake up that determines the next day your ability to sleep and your reset of your sleep hours.

Perhaps you could also explain how I can do this with 12 hour shifts?

I have to be at work at either 7am or 7pm.

I'm eagerly awaiting the answer, although I'm a bit sleepy at present from all my night shifts. Oops, off to one now.

Take care,
Jeff

 

[dchristismi]

I was wondering the same. When you are getting home an hour or two after you would "normally" wake up, it's physiologically impossible.

And thus, the achilles heel of EM.

I can do 4 nights fairly well. Five is pushing it, and I don't feel mentally as sharp. Abrupt swaps from nights to days are known as "grumpy days" in my household. Because they are. We have both "true nights" (11p-7a) and "pseudo nights" (9p-5a). The pseudo nights are one of my favorite shifts, mostly because they're psychologically easier than true nights, and it's still dark when I get home and go to bed, sort of like college, but less fun.

 

[CopToEM]

Perhaps you could also explain how I can do this with 12 hour shifts?

I have to be at work at either 7am or 7pm.

I'm eagerly awaiting the answer, although I'm a bit sleepy at present from all my night shifts. Oops, off to one now.

Take care,
Jeff

I agree. I never did figure out how to keep my body straight when I'd get off work at 7PM one night and be back to work at 7AM the next morning. Day after that, back to work at 7PM. Black out curtains can only help so much!

 

[anonymousEM]

It wasn't pretty but we found tin foil worked as a cheap blackout shade too when we were doing night shifts at a community hospital out of town for residency and staying in the hospital apartments.