I hate nights.

[Nivens]

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It's the end of my intern year (a medicine categorical year), and looking back on it it amazes me how different I feel in the hospital during the day versus at night. Things I find interesting between 7 and 6 lose all of their allure after dark, and all I want to do is go home and have dinner with my wife. Sure, it could be that I'm an intern, and that this is medicine, not anesthesia, and I very well could find being a firefighter overnight as an anesthesia resident to be much more preferable to waiting around as the responding clinician in the CCU for admits or urgent 0300 potassium repletion. But it could also be that there simply isn't anything interesting enough in medicine for me to want to be away from my family in the evenings or on the weekends, and maybe I should plan my career accordingly. I would think this is normal, but none of my coresidents seem to mind as much as I do. I'm curious how other people feel about nights, both early and later in their career, and how many nights and weekends anesthesiologists in PP typically work in a given month (understanding that this is of course, variable).

 

[Planktonmd]

It's the end of my intern year (a medicine categorical year), and looking back on it it amazes me how different I feel in the hospital during the day versus at night. Things I find interesting between 7 and 6 lose all of their allure after dark, and all I want to do is go home and have dinner with my wife. Sure, it could be that I'm an intern, and that this is medicine, not anesthesia, and I very well could find being a firefighter overnight as an anesthesia resident to be much more preferable to waiting around as the responding clinician in the CCU for admits or urgent 0300 potassium repletion. But it could also be that there simply isn't anything interesting enough in medicine for me to want to be away from my family in the evenings or on the weekends, and maybe I should plan my career accordingly. I would think this is normal, but none of my coresidents seem to mind as much as I do. I'm curious how other people feel about nights, both early and later in their career, and how many nights and weekends anesthesiologists in PP typically work in a given month (understanding that this is of course, variable).

Can you switch to dermatology?

 

[Doctor4Life1769]

It's the end of my intern year (a medicine categorical year), and looking back on it it amazes me how different I feel in the hospital during the day versus at night. Things I find interesting between 7 and 6 lose all of their allure after dark, and all I want to do is go home and have dinner with my wife. Sure, it could be that I'm an intern, and that this is medicine, not anesthesia, and I very well could find being a firefighter overnight as an anesthesia resident to be much more preferable to waiting around as the responding clinician in the CCU for admits or urgent 0300 potassium repletion. But it could also be that there simply isn't anything interesting enough in medicine for me to want to be away from my family in the evenings or on the weekends, and maybe I should plan my career accordingly. I would think this is normal, but none of my coresidents seem to mind as much as I do. I'm curious how other people feel about nights, both early and later in their career, and how many nights and weekends anesthesiologists in PP typically work in a given month (understanding that this is of course, variable).

You'll be waiting around for the surgeons too.
It's a lot less stressful doing medicine nights than anesthesia nights can be.
If you don't want to work nights, I also recommend switching to derm or PM&R.

 

[partydoc]

or a pain fellowship

 

[QofQuimica]

It's good that you're thinking about these things now. I currently work all nights, but I don't have a family, so I usually just stay on the night schedule even on the nights I'm off. That being said, one of the reasons why I'll be semi-retiring and going into fellowship next year is because this vampire lifestyle isn't nearly as fun in your 40s as it is in your 20s or 30s. And I can afford to take the paycut.

 

[ranvier]

Depending on your eventual job, it can feel very different. We are eat what you kill and while I don't like being away from home once a week, if I am up late I am earning money. In today's climate, who knows how long this can last.

Make hay while the sun is shining.

 

[deleted171991]

It's the end of my intern year (a medicine categorical year), and looking back on it it amazes me how different I feel in the hospital during the day versus at night. Things I find interesting between 7 and 6 lose all of their allure after dark, and all I want to do is go home and have dinner with my wife. Sure, it could be that I'm an intern, and that this is medicine, not anesthesia, and I very well could find being a firefighter overnight as an anesthesia resident to be much more preferable to waiting around as the responding clinician in the CCU for admits or urgent 0300 potassium repletion. But it could also be that there simply isn't anything interesting enough in medicine for me to want to be away from my family in the evenings or on the weekends, and maybe I should plan my career accordingly. I would think this is normal, but none of my coresidents seem to mind as much as I do. I'm curious how other people feel about nights, both early and later in their career, and how many nights and weekends anesthesiologists in PP typically work in a given month (understanding that this is of course, variable).

That's kind of normal. It also shows that your internship program is/was not really challenging you. Had you had interesting educational opportunities even after dark, you wouldn't have minded being in the hospital.

I used to be once as dispassionate as you about calls (I still am, but about anesthesia calls). In critical care, there are a number of sick patients one can fine-tune during the night, if one is so inclined. Also, I personally love the firefighter aspect, and for me that means consults. That's what I loved the most even as an intern, and that's why floor coverage during the night was waaaay more interesting than ICU. Probably some degree of easily-bored ADHD.

I just want you to realize that you are kind of in the wrong specialty, if you don't like calls at all. Unless you become an academic, or you take a mommy-track/ASC job, or you go into pain or palliative, you will be on call at least once a week. But this applies to most specialties, not only to anesthesia. There is more and more expectation of 24x7 coverage and a trend towards a factory type of workplace environment, where weekends and nights are becoming just a regular weekday. It's called "OR utilization". The only thing stopping it for now is nursing "after-hours" pay, but I bet that will go away in a decade or so, once the nursing shortage is solved. But there is a trend and push towards a 8/12-hour shift and continuous work setting, and sooner or later it will happen.

I am sure there will always be jobs with no or less call. You just have to realize that they will be paying up to 40% less, disproportionately. Nobody likes calls, that's why they people are incentivized to take them.

 

[deleted126335]

early in my career I found nights unpleasant, but the cost of doing business. I frequently picked up extra night call from the old guys in the group. Now I am one of the old guys who gives away some of his night call. I now really hate night call. Even when things are quiet, I can no longer sleep well in the hospital. Thinking about a no call position, but the drop in status and income is pretty dramatic in our group.

 

[criticalelement]

i hate days and nights as long as i am not getting paid per minute.

 

[pgg]

I'm only 41 but it takes me a day or so to recover from being up all night. It used to be easy, and as a resident call cases were sort of fun because they weren't optimized elective patients.

Now what I think of when I get called for a 1 AM case is that the blood bank and ICU have the skeleton crew B teams working.

I won't be taking much (if any) call 15-20 years from now, at any rate.

 

[deleted643396]

I hate nights. I don't feel well the next day and really don't sleep well in hospitals. The worst feeling in the world is walking into the hospital on a call day and knowing you won't see sunlight or breathe fresh air for at least another 24 hours.

If you are doing anesthesia residency at a busy place, you won't sleep much. I slept when I was a CA-1, but by the time I was a CA-2, I was pretty independent with a lot of things at night. The majority of the things I did at night were non-learning things like appys, labor epidurals, c-sections, or epidurals for rib fractures. It's good to be able to do these things "in your sleep," but it definitely gets old. Occasionally you get a big case like a liver transplant, aortic dissection, or bad trauma, but it is hard to appreciate the learning opportunities in those cases when you've been working for 20 straight hours.

 

[ranvier]

I hate nights. I don't feel well the next day and really don't sleep well in hospitals. The worst feeling in the world is walking into the hospital on a call day and knowing you won't see sunlight or breathe fresh air for at least another 24 hours.

If you are doing anesthesia residency at a busy place, you won't sleep much. I slept when I was a CA-1, but by the time I was a CA-2, I was pretty independent with a lot of things at night. The majority of the things I did at night were non-learning things like appys, labor epidurals, c-sections, or epidurals for rib fractures. It's good to be able to do these things "in your sleep," but it definitely gets old. Occasionally you get a big case like a liver transplant, aortic dissection, or bad trauma, but it is hard to appreciate the learning opportunities in those cases when you've been working for 20 straight hours.

This is the crux of the arguments for and against workhorse training programs.

 

[kidthor]

Nights seriously mess me up too... The upside is being able to get a few things done the next day, but then I'm absolutely destroyed.

Our call rooms are freezing cold and spartan, at best...

 

[IlDestriero]

I picked a relatively low call job for a reason. The usual pathway in academics, for the slow fade out, is to cut back to 80% clinical time and keep 100% of the call burden to preserve income. Then eventually stop taking overnight call when they hit the magic 60.
I think I'm actually more likely to go the other way. I'd rather dump 1st call, take my chances with 2nd call and keep working 100% clinical time to preserve income.
I think the same as PGG. It's always the B-team skeleton crew at night, taking 20% longer for everything, incorrectly asking for signatures for the emergency release blood, etc.

--
Il Destriero

 

[WholeLottaGame7]

I actually liked night call as a resident a lot more than as an intern. For one, you weren't covering 30-40 patients, most of whom you knew nothing about. Much better to only worry about 1-3 rooms at a given time. Typically had more independence, especially as a CA-3. Of course, we also did a week of nights at a time. Actually think I prefer that to the qWhatever overnight call.

 

[BobBarker]

Anesthesia call is better than intern call. Intern call was very lonely and at the time I had no upper level or attendings in the hospital to talk to. Running codes, putting in lines, etc at a big hospital. I intubated a 300lber alone on July 4th of intern year.

 

[deleted171991]

Anesthesia call is better than intern call. Intern call was very lonely and at the time I had no upper level or attendings in the hospital to talk to. Running codes, putting in lines, etc at a big hospital. I intubated a 300lber alone on July 4th of intern year.

That's like 2 weeks into your internship. You must be Superman (or Batman).

 

[Doctor4Life1769]

Anesthesia call is better than intern call. Intern call was very lonely and at the time I had no upper level or attendings in the hospital to talk to. Running codes, putting in lines, etc at a big hospital. I intubated a 300lber alone on July 4th of intern year.

No upper level or attending inhouse?
Usually there's hospitalists devoted to residents at night, and even more likely, upper level residents. Maybe your program was different though.

 

[urge]

It's the end of my intern year (a medicine categorical year), and looking back on it it amazes me how different I feel in the hospital during the day versus at night. Things I find interesting between 7 and 6 lose all of their allure after dark, and all I want to do is go home and have dinner with my wife. Sure, it could be that I'm an intern, and that this is medicine, not anesthesia, and I very well could find being a firefighter overnight as an anesthesia resident to be much more preferable to waiting around as the responding clinician in the CCU for admits or urgent 0300 potassium repletion. But it could also be that there simply isn't anything interesting enough in medicine for me to want to be away from my family in the evenings or on the weekends, and maybe I should plan my career accordingly. I would think this is normal, but none of my coresidents seem to mind as much as I do. I'm curious how other people feel about nights, both early and later in their career, and how many nights and weekends anesthesiologists in PP typically work in a given month (understanding that this is of course, variable).

Nights are usually good. They pay you to sleep, and some times work.

You might want to change career.

 

[deleted171991]

Nights are usually good. They pay you to sleep, and some times work.

You might want to change career.

It depends. As an intern (and also as an attending) in some places, they definitely don't pay you to sleep.

 

[BobBarker]

It was different than any other that I am aware of. It was my 4th day of internship. It was a crazy way to run an internship and they don't do it that way any more. I think I was the last year before they moved the total continuous hours for interns down from 30 to 16. Anesthesia call was fun in comparison. Friends to talk to and more experienced people everywhere to help.

 

[Random Anesthesiologist]

Anesthesia call is better than intern call. Intern call was very lonely and at the time I had no upper level or attendings in the hospital to talk to. Running codes, putting in lines, etc at a big hospital. I intubated a 300lber alone on July 4th of intern year.

I am also in the minority about not being too bothered by night call. I also enjoyed my internship (surgical). Call is a rite of passage. You can find jobs with less of it if you want.

 

[sigrhoillusion]

Nights really depend on your workplace especially the staffing. Same goes for weekends.

Seems like sometimes they try to do more during these times than they do during the day and "regular" work hours. More work + less staff = frustration. Especially if you're not getting paid per case. Problem comes that the surgeons on call all want to do "one small little" semi-urgent case which would be fine, but there might be 10-15 surgical service teams and only one anesthesia team, so you can only run so many rooms. Then when the actual urgent/emergent case comes in, you're stuck babysitting the new surgeon who can't get OR time during the week...

I mentioned this in another thread as well, that while I appreciate teaching residents and fellows in academic places, but these are NOT the times to do it. These cases should be done quickly and efficiently as not to delay or impede other more serious things.