I haven't posted in here since my med school days but was wondering what everyone's opinion was of starting as a nocturnist straight out of residency. I'm in my final year of a large community hospital IM program where we are trained well in hospital medicine. There is a specific rotation where for a few months we are doing all the admissions straight from the ER (up to 30+ some nights), determining input vs ops, putting in consults for specialists, overseeing all the orders and notes for junior residents, making sure all quality measures (PQRS/HCAPS/ect) are met, and running all codes/rapids. I feel prepared to do nocturnist and it wouldn't effect my family life as my wife is a night shift RN but some of my colleagues, as well as older threads here i've been reading on, advise against nocturnist work initially. I was wondering what reservations experienced hosptialists/nocturnist have against starting as a nocturnist.
The position i'm debating on accepting is also a large community hospital with a closed ICU (intensivist in house at all times), no procedures or codes, rapids only on the groups patients. 7pm - 7 am shift, 182 shifts a year. There are 2 other nocturnists on at night who take turns holding the cross-coverage pager. They say 8-12 admits a night per physician with 12 being the "cap". Some of the hospitalists i've spoken to say the 10-12 admit/physician mark is only reached maybe 25% of the time. Cross-coverage worries me as it can get up to 150 patients for the group (usually 80-120) but since it's a 12 hr shift, each nocturnist only has to hold onto the pager for 4 hrs. Compensation of 260K a year not including bonuses. They did have two nocturnists recently leave but one was for family reasons (hard to be a nocturnist with a family and kids) and the other nocturnist was looking more for a job you can nap 3-4hrs each shift. The day shift of the group has very low turn over and high physician satisfaction from what I could gather. I've done other interviews but this is the first contract offer I've received and i'm wondering if I should just sign...
The position i'm debating on accepting is also a large community hospital with a closed ICU (intensivist in house at all times), no procedures or codes, rapids only on the groups patients. 7pm - 7 am shift, 182 shifts a year. There are 2 other nocturnists on at night who take turns holding the cross-coverage pager. They say 8-12 admits a night per physician with 12 being the "cap". Some of the hospitalists i've spoken to say the 10-12 admit/physician mark is only reached maybe 25% of the time. Cross-coverage worries me as it can get up to 150 patients for the group (usually 80-120) but since it's a 12 hr shift, each nocturnist only has to hold onto the pager for 4 hrs. Compensation of 260K a year not including bonuses. They did have two nocturnists recently leave but one was for family reasons (hard to be a nocturnist with a family and kids) and the other nocturnist was looking more for a job you can nap 3-4hrs each shift. The day shift of the group has very low turn over and high physician satisfaction from what I could gather. I've done other interviews but this is the first contract offer I've received and i'm wondering if I should just sign...
