Night float position

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xtina0

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Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
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xtina0 said:
Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
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I take a lot of overnight call. Thr worst part js orienting from day shift to night shift, so doing a row of nights is better imo
 
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xtina0 said:
Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
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1) I would not take a position like this as a relatively new grad. Best served to be someone with at least a reasonable amount of experience because you will be on your own all the time with nobody to ask for advice/help.

2) Make sure home life is amenable to this. For example can you actually get 7+ hours uninterrupted sleep during the day? You don't want to constantly have home life intruding into dedicated sleeping hours which will quickly make you go crazy.

As long as neither of those is an issue could be just fine.
 
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I'm doing night Obs currently. Hospital has an audited 85% epidural rate and (seems like) a greater than 75% induction rate. You need to figure out the numbers at your hospital, because when IOLs start requesting EDBs from 03:00 onwards; that's the end of any rest you're having.

How many concurrent labourers on the delivery suite can they handle? Are you the only one there? What's the expectations re: epidural request/attendance? What's their Emergency LSCS rates? Does the hospital have NICU/adult ICU/refer on to larger centers - i.e. are you getting the "easy" or the "hard" patients? How frequently does the first-on/second-on get called in to help? The answers can make a big difference overnight when you're on your own.

Personally, I don't mind it. It's busy for most of the night, but I usually get an uninterrupted 1-2 hours sleep at some point over the 12 hours. That means I don't have to sleep for 7 hours straight when I'm home and I can be involved with family.
 
I think that kind of position ages you prematurely. It's about marathon, not a sprint.
 
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woopedazz said:
I'm doing night Obs currently. Hospital has an audited 85% epidural rate and (seems like) a greater than 75% induction rate. You need to figure out the numbers at your hospital, because when IOLs start requesting EDBs from 03:00 onwards; that's the end of any rest you're having.

How many concurrent labourers on the delivery suite can they handle? Are you the only one there? What's the expectations re: epidural request/attendance? What's their Emergency LSCS rates? Does the hospital have NICU/adult ICU/refer on to larger centers - i.e. are you getting the "easy" or the "hard" patients? How frequently does the first-on/second-on get called in to help? The answers can make a big difference overnight when you're on your own.

Personally, I don't mind it. It's busy for most of the night, but I usually get an uninterrupted 1-2 hours sleep at some point over the 12 hours. That means I don't have to sleep for 7 hours straight when I'm home and I can be involved with family.
Click to expand...

I dunno why those people can't start inductions at a reasonable time.
 
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woopedazz said:
I'm doing night Obs currently. Hospital has an audited 85% epidural rate and (seems like) a greater than 75% induction rate. You need to figure out the numbers at your hospital, because when IOLs start requesting EDBs from 03:00 onwards; that's the end of any rest you're having.

How many concurrent labourers on the delivery suite can they handle? Are you the only one there? What's the expectations re: epidural request/attendance? What's their Emergency LSCS rates? Does the hospital have NICU/adult ICU/refer on to larger centers - i.e. are you getting the "easy" or the "hard" patients? How frequently does the first-on/second-on get called in to help? The answers can make a big difference overnight when you're on your own.

Personally, I don't mind it. It's busy for most of the night, but I usually get an uninterrupted 1-2 hours sleep at some point over the 12 hours. That means I don't have to sleep for 7 hours straight when I'm home and I can be involved with family.
Click to expand...


What do the abbreviations EDBs and LSCS stand for?
 
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xtina0 said:
Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
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I would want some vacation time on top of thato_O
 
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It also depends on how nice the call room is.
 
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This job is brutal. Depending on how you are hardwired, you might be able to tolerate it well. It should be 99th percentile salary and benefits for your local market. Don't buy a house for awhile.
 
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GassYous said:
What's wrong with starting inductions early in the morning so they can do their office hours and deliver in the afternoon
Click to expand...

Nothing at all. Except when the in-house OB doc brings in their private patient so they can deliver when they are in house anyway. 5am phone call for the unscheduled C-section so I can get it done before my shift ends @7am? Anyone? Anyone?

Or maybe the OB has a full office the next day and doesn't want this hanging over their head.
 
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I tried to think of how I would feel working continuous nights at a heavy OB center solo... seemed similar to torture by twitch monitor. There’s no $$ amount that could convince me to do that
 
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As someone who did a lot of nocturnalist work. I will tell you it will be fine for 6 months to a year. At some point social isolation will hit. Your schedule is different than everyone else’s. You will be unable to keep a normal social life.

I’d recommend to do this for only a set amount of time. I hope they pay your handsomely, save up the money and at some point move on.
 
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Yes thanks for all the input. You all brought up some good points... it seemed appealing to me (nights and OB are what I enjoy), I didn’t realize it would not be appealing to most- not a sought after position.

Now realizing this , perhaps the pay is not as rewarding and they were offering no supplemental vacation weeks which does seem pretty harsh.
 
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xtina0 said:
Yes thanks for all the input. You all brought up some good points... it seemed appealing to me (nights and OB are what I enjoy), I didn’t realize it would not be appealing to most- not a sought after position.

Now realizing this , perhaps the pay is not as rewarding and they were offering no supplemental vacation weeks which does seem pretty harsh.
Click to expand...

what’s the pay
 
xtina0 said:
Yes thanks for all the input. You all brought up some good points... it seemed appealing to me (nights and OB are what I enjoy), I didn’t realize it would not be appealing to most- not a sought after position.

Now realizing this , perhaps the pay is not as rewarding and they were offering no supplemental vacation weeks which does seem pretty harsh.
Click to expand...

I would expect >$250/h for this job.
 
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dr doze said:
Nothing at all. Except when the in-house OB doc brings in their private patient so they can deliver when they are in house anyway. 5am phone call for the unscheduled C-section so I can get it done before my shift ends @7am? Anyone? Anyone?

Or maybe the OB has a full office the next day and doesn't want this hanging over their head.
Click to expand...
Hence I F in hate mother f in OB.
Please forgive my language. Damn Covid makes you a little jaded.
I got threatened with a lawsuit today. If I stopped coding a patient. Whatever.
And she coded again about 60 minutes later.
**** Covid. The fact that we code these patients repeatedly and they always die, expose the nurses and techs to spewing viruses makes me hate this litigious country a little bit more and more.

I am in TX. Sue the f away. Good luck.
 
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chocomorsel said:
Hence I F in hate mother f in OB.
Please forgive my language. Damn Covid makes you a little jaded.
I got threatened with a lawsuit today. If I stopped coding a patient. Whatever.
And she coded again about 60 minutes later.
**** Covid. The fact that we code these patients repeatedly and they always die, expose the nurses and techs to spewing viruses makes me hate this litigious country a little bit more and more.

I am in TX. Sue the f away. Good luck.
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By whom?
We don’t do “soft” or “slow” code anymore?
 
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IMGASMD said:
By whom?
We don’t do “soft” or “slow” code anymore?
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Nope. I do time mine if I can.
These families are clueless about what we see and deal with in the front lines. We code them repeatedly.
I try not to by talking to families but never really get far on stopping the code midway.
I have seen other docs go at it again and again for prolonged periods. I am at a site that is finnaly seeing Covid and the docs are arrogant, narcissistic, greedy and very inexperienced with Covid.
But in a Red state the families see and believe what happened to Trump and don’t understand what money and class can buy. And that everyone reacts differently to this illness. And lots of comorbidities lead to poor outcomes. And go about their business eating out and partying it up as hospitals reach capacity.
 
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@chocomorsel , don't be silly there is no covid in texas!!

In all seriousness, you're still doing locums for ICU? Honestly the amount of COVID I've seen in Texas is so negligible compared to what we saw in NY back in April, I could see why it's so easy to deny it.

Keep safe! Hope you don't get sued over this.
 
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There are a lot of hospitals that are going to be trying this out. It totally depends on the volume of childbirth and csections,. If the volume of All deliveries is less than 1000 per year u may be able to sustain it longer. My 2 cents

What's wrong with starting inductions early in the morning so they can do their office hours and deliver in the afternoon
Insurance companies pay the hospital only for 2 days , so the clock starts ticking from midnight . Also OB nurses get paid premium for sitting on their asses? At night?. The lawyers and litigation make the hospital employ them to monitor fetal heart rate. Systemic problems with consequences for anesthesiologist life style
 
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dchz said:
Honestly the amount of COVID I've seen in Texas is so negligible compared to what we saw in NY back in April, I could see why it's so easy to deny it.
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Amount of SEVERE COVID, probably. It’s just not as bad as it was back when it first came onto the scene in NY. Probably because we are so much better at supportive care (namely, not intubating at the first sign of distress).
 
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Back to the OP - if you are good with those hours, that can be a great gig. Doing the math, it comes out to 42 hours a week roughly. With 25+ weeks vacation. If it pays well, and you don’t have family attachments, go for it.

Only issue - any wiggle room if you want to get away for a major event? Ex: weddings, reunions, conferences?

If I’m offering this position, no chance I’m giving extra leave on top of that. You already get 25 weeks!
 
Adductor canal said:
If the volume of All deliveries is less than 1000 per year u may be able to sustain it longer.
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Its sustainable where i am with over 5500. Its very doable. Still get 1-2 hours sleep every night.
 
xtina0 said:
Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
Click to expand...
What’s considered an excellent salary for this.
I am genuinely curious because it’s so rare.
How did you find it?
 
Adductor canal said:
There are a lot of hospitals that are going to be trying this out. It totally depends on the volume of childbirth and csections,. If the volume of All deliveries is less than 1000 per year u may be able to sustain it longer. My 2 cents

What's wrong with starting inductions early in the morning so they can do their office hours and deliver in the afternoon
Click to expand...

Depends on timing and local expectations and staffing. One practice I worked at this type of set up. The problem was the OB and L&D nurses were "picky" about when they felt patients should have their epidural. During the afternoon as rooms were starting to close and we were trying to send people home, we would send someone over to OB to try to get an impending epidural in. Often we were told "she is not ready yet". One hour later suddenly, "it's time". When we would say "about an hour before someone is available"----> Their response would be this is a crime against humanity. Led to a lot of conflict.
 
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dr doze said:
Depends on timing and local expectations and staffing. One practice I worked at this type of set up. The problem was the OB and L&D nurses were "picky" about when they felt patients should have their epidural. During the afternoon as rooms were starting to close and we were trying to send people home, we would send someone over to OB to try to get an impending epidural in. Often we were told "she is not ready yet". One hour later suddenly, "it's time". When we would say "about an hour before someone is available"----> Their response would be this is a crime against humanity. Led to a lot of conflict.
Click to expand...

Yeah this speaks to one of my major criticisms of what seems to be the relation between the anesthesia department and the OB department at every place I’ve worked. Im curious if anyone has studied the quality of obstetric care, pain relief, and safety during daytime versus nighttime hours. One would think that the obstetricians would do everything they can to maximize daytime deliveries when scheduling patients for inductions so that more anesthesia staff are around when **** hits the fan and they emergently call on our help. Alas it never works out this way...
 
In my past life I was a shift manager at a factory. It took a couple of days for my body to get used to the night shift and then a couple of day to turn my body back around. During the transition I’d feel like crap and that was back in my 20s. No way I’d do that now.
 
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chocomorsel said:
What’s considered an excellent salary for this.
I am genuinely curious because it’s so rare.
How did you find it?
Click to expand...

I think it depends on the market but I wouldn’t personally accept less than 475k. While it works out to 41 hours when averaged out, if it doesn’t include PTO I’d want at least 225/hr for working those crap hours
 
xtina0 said:
Does anyone have any experience with overnight night float Anesthesia position. I’m looking at a new job which would offer seven days on , seven days off. It would be from 7 PM to 7 AM covering either OB or general surgery. Hospital has a moderate volume , and it sounds like I would be able to rest a few hours overnight. Benefits and salary are excellent so that’s less of a concern. I was just wondering if anyone had any thoughts into the feasibility of sustaining this ...any pros or cons that you can provide.
Click to expand...
Was this job posted by Satan? F_uuuuuuuuuck that.
 
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dr doze said:
5am phone call for the unscheduled C-section so I can get it done before my shift ends @7am? Anyone? Anyone?
Click to expand...

Man I've had to do this an innumerable amount of times. One last kick in the nuts after the end of a 24 hour shift.
 
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This post is making me so grateful that I have the option someday to phase out of OB at my group if/when I choose to (they pay enough that people are willing to take them in trades).
 
caveat87 said:
I think it depends on the market but I wouldn’t personally accept less than 475k. While it works out to 41 hours when averaged out, if it doesn’t include PTO I’d want at least 225/hr for working those crap hours
Click to expand...

225*12*7*26=491K
??

I don’t think you will get that.....
 
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Devil is in the details. If I am up working all night consistently on these shifts, $250/h or no thanks.

There is a premium that must be paid for night time/OB work.

They are offering this position presumably because the other anesthesiologists don't want this work...
 
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caveat87 said:
I think it depends on the market but I wouldn’t personally accept less than 475k. While it works out to 41 hours when averaged out, if it doesn’t include PTO I’d want at least 225/hr for working those crap hours
Click to expand...
$225 an hour is way too low for me. I would need more than that for those hours.
 
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dr doze said:
Depends on timing and local expectations and staffing. One practice I worked at this type of set up. The problem was the OB and L&D nurses were "picky" about when they felt patients should have their epidural. During the afternoon as rooms were starting to close and we were trying to send people home, we would send someone over to OB to try to get an impending epidural in. Often we were told "she is not ready yet". One hour later suddenly, "it's time". When we would say "about an hour before someone is available"----> Their response would be this is a crime against humanity. Led to a lot of conflict.
Click to expand...
One of the main reasons I absolutely hate OB. I have had that discussion on here over and over.
 
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chocomorsel said:
One of the main reasons I absolutely hate OB. I have had that discussion on here over and over.
Click to expand...

Lots of people are happy to spend an infinite amount of our time and resources so that we can accommodate their personal preferences. Preferences that have zero-minimal evidence showing that they affect patient care in any meaningful way.
 
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GassYous said:
What's wrong with starting inductions early in the morning so they can do their office hours and deliver in the afternoon
Click to expand...
Primip, less than 2 cms 7 AM induction = 2 AM c-section....happens all the time...
 
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