Nocturnist

[cr46100]

Fresh graduate considering a nocturnist position in Los Angeles: 7 on/7 off schedule 12 hrs, 8-12 admissions, floor calls, rapid response calls, intensivist support overnight. What is the typical salary for nocturnists in LA and is the job description above typical for nocturnists?

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[vanillaface1]

Im not sure about salary, but I would hope its quite high if the cross cover is >40 pts while still having to do 8-12 admits. We have a moonlighting resident/attending/PA (whoever wants it) to cross cover at night (110-130pts) and they get blown up with pages, 1 page every 2-3 mins, and can have 0-5 rapids per night. it looks exhausting. I can't imagine doing that and trying to admit at the same time.

 

[Osteoth]

Buddy has a job like this base around $300k all in around $350 everyone needs a good nocturnist

 

[cr46100]

They're offering a base 300K, W2 contract. The contract is for 2 years. Does this mean I can't request a raise after a year?
Seems exhausting to cross cover >60 average patients overnight, cover rapid response, and be expected to admit all these patients. I'm not sure if it's worth 300K. Thank your input.

 

[Osteoth]

What is the average number of admits?
Is there a cap on admits?
Have you had a lawyer look at the contract?
Is there any APP support for cross cover?
What does your contract say about raises?
Would you prefer a 1 year contract?

 

[cr46100]

What is the average number of admits? Expect 8-10 admissions. Up to 12 on a bad night and as low as 4-6 about 1-2x/week on a good night
Is there a cap on admits? No caps
Have you had a lawyer look at the contract? Considering it. Not sure yet if it's worth the money
Is there any APP support for cross cover? no
What does your contract say about raises? Doesn't state any raises on the contract.
Would you prefer a 1 year contract? I think I would prefer one year, but they prefer 2 years.

 

[Osteoth]

What is the average number of admits? Expect 8-10 admissions. Up to 12 on a bad night and as low as 4-6 about 1-2x/week on a good night
Is there a cap on admits? No caps
Have you had a lawyer look at the contract? Considering it. Not sure yet if it's worth the money
Is there any APP support for cross cover? no
What does your contract say about raises? Doesn't state any raises on the contract.
Would you prefer a 1 year contract? I think I would prefer one year, but they prefer 2 years.

I would consider adding a cap or a bonus above a certain number (8-10).

Lawyer is always worth it, usually county medical societies will have a rec for a couple hundred.

They would be able to talk about raises, at least inflation adjust your salary.

Lawyer would also be able to help you with contract length.

 

[yakattack16]

Fresh graduate considering a nocturnist position in Los Angeles: 7 on/7 off schedule 12 hrs, 8-12 admissions, floor calls, rapid response calls, intensivist support overnight. What is the typical salary for nocturnists in LA and is the job description above typical for nocturnists?

I would hard pass this without midlevel or resident support to handle some of the floor nonsense.

 

[JustPass]

Hard pass on that floor calls...
I have PTSD from pagers going off and messages from nurses during nights.

 

[dozitgetchahi]

Im not sure about salary, but I would hope its quite high if the cross cover is >40 pts while still having to do 8-12 admits. We have a moonlighting resident/attending/PA (whoever wants it) to cross cover at night (110-130pts) and they get blown up with pages, 1 page every 2-3 mins, and can have 0-5 rapids per night. it looks exhausting. I can't imagine doing that and trying to admit at the same time.

This kinda reminds me of one of the hospitals we covered at my residency…big community hospital (800+ beds) that we didn’t spend much time at. We only covered general wards (about 500 of the 800 beds) during the day. At night, those 500 beds got cross covered by one nocturnist and two NPs. We were told to not even bother signing out to the night team as they were too overwhelmed to handle following up things etc - “just tuck in your patients real good so they don’t have to follow things” etc. It was insane, and needless to say the quality of care at night was questionable at very best. The residency stopped sending us to cover those wards halfway through my time there…

 

[tantacles]

This job sounds miserable. Cross cover + 8-12 per night isn’t a superhuman task but definitely will wear you out… but the real bad news here is 7 on 7 off. That’s 14 of those miserable shifts per month.

I mean, great to have intensivist “support” but what does that mean? Closed icu? Or you have to specifically call them if someone is dying?

That’s a 350k job minimally, and for me kind of a no brainer - wouldn’t take it. If they want to work night people that hard, they can have their day staff work nights and just burn them out instead.

 

[collegestud2013]

What is the average number of admits? Expect 8-10 admissions. Up to 12 on a bad night and as low as 4-6 about 1-2x/week on a good night
Is there a cap on admits? No caps
Have you had a lawyer look at the contract? Considering it. Not sure yet if it's worth the money
Is there any APP support for cross cover? no
What does your contract say about raises? Doesn't state any raises on the contract.
Would you prefer a 1 year contract? I think I would prefer one year, but they prefer 2 years.

I wouldn't take it unless you at least have an APP to cover pages and rotate in for admissions for at least the first part of the night (where it's usually the busiest).
I also generally would not recommend positions that don't offer an RVU bonus/incentive since you'll have the incentive to do the least amount of work while your employer will have the incentive to dump more work on you.
The pay would be low for the work you're doing in most part of the country, but since it's in LA and the job market there is probably already highly saturated what they're offering you might be competitive. You can try negotiating but if this position is with a large health system in LA they probably won't budge much if any all.

 

[Splenda88]

385k/yr is what people got at my shop. Average 10 admits per night and they are about to bring a PA/NP to do cross cover. However, location is below average from what people would consider desirable.

I don't think you are getting a fair deal.

 

[wamcp]

They're offering a base 300K, W2 contract. The contract is for 2 years. Does this mean I can't request a raise after a year?
Seems exhausting to cross cover >60 average patients overnight, cover rapid response, and be expected to admit all these patients. I'm not sure if it's worth 300K. Thank your input.

You need to paid at least $2000 a night for the work you describe, if in a desirable location. If it is open ICU then you need more than that.

So minimum $365K

 

[CCM-MD]

He/she said this job is in LA not BFE. Not gonna get 385k for that job in that location. Y’all need to come back down to earth.

 

[cr46100]

I asked around and apparently, the salary is competitive in LA. A friend told me that salary is about $120/hr as a new graduate at less busy hospitals. Those positions that offer a much higher salary are outside of LA like in the desert-Palmdale, Bakersfield, etc.
I am worried that as a fresh graduate I would be too slow as a new attending. I'll consider other positions before I take this offer. Thank you, everyone!

 

[Osteoth]

385k/yr is what people got at my shop. Average 10 admits per night and they are about to bring a PA/NP to do cross cover. However, location is below average from what people would consider desirable.

I don't think you are getting a fair deal.

Jesus for that type of scratch fly me in…

 

[tantacles]

I asked around and apparently, the salary is competitive in LA. A friend told me that salary is about $120/hr as a new graduate at less busy hospitals. Those positions that offer a much higher salary are outside of LA like in the desert-Palmdale, Bakersfield, etc.
I am worried that as a fresh graduate I would be too slow as a new attending. I'll consider other positions before I take this offer. Thank you, everyone!

Whether it's competitive or not, the offer is still trash.