VA Hopeful Dr

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Jul 28, 2004
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Our night float started at 5pm and my husband (and friends) didn't get home from work until after then. So no, we didn't ever have dinner together when I was on night float. Did your night float really not start until 8pm at night? Yes, I often got some sleep on night float, didn't make me hate it any less!
It wouldn't surprise me. My adult night float started at 8pm while peds and OB night float started at 6.

Like you when I was on the 6pm nights I never saw my wife even when she was on easy rotations because she'd be working 8a-530p and factoring in travel tie for us both.
 

mvenus929

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Jul 6, 2006
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The argument is over sleep deprivation. You're not necessarily sleep deprived working a night float schedule. People do it all the time in other jobs like grocery stores, gas stations, and truck drivers. You notice none of those folks work 24-hour shifts? You also notice hospitals don't generally require their attendings to do 24s? They get away with it with residents because residents have no choice but to do what they're told.

I worked 24s as an attending (sometimes q2), and multiple of my attendings (especially in NICU and PICU) did as well. EM attendings were on a rotating schedule which I'm also not sure was super great for sleep because just as they'd get used to one shift, they'd be flipped to another, and sometimes would have to attend meetings during the day even when they were on nights. Not to mention that many attendings take call, and sometimes those call nights can be rough (getting paged every 1-2 hours overnight), and they're still expected to work a full day the following day. Heck, multiple jobs that I'm looking at have attendings on for a week at a time--one bad night and you can't rest well the rest of the week because you're still on call. My friend is a NICU attending now and covers 3 hospitals for 72 hour call--there are nights when she doesn't get any sleep either. Attendings aren't immune to sleep deprivation.

I'd argue that we should follow the science and as far as I know, there is no legit scientific evidence that sleep deprivation allows you to work better in a high-stress, high-risk work environment. In fact, the studies say exactly the opposite.

That's not the argument I'm making. I don't think it's necessary to 'train' to do 24 hour shifts. I do think it's important to work nights, and for quality of life for everyone, sometimes it's better to work an occasional 24 hour shift rather than more 12-16 hour shifts. I'm not saying q3-4 24 hour call is the way to go. I'm not saying night float isn't the way to go. But saying we should never do 24 hour shifts also doesn't take into account that it may actually result in an improved quality of life compared to no 24 hour shifts.

The "day off" after a 24 is spent sleeping and/or in a sleep-deprived haze.

Or, if you're able to get a few hours of sleep, can be spent taking care of life things during regular business hours. Going to a bank, for instance. Getting a plumber to come over and fix the leak you've been trying to manage for the past x months on your own. Going to the doctor yourself, or going to the dentist. Or getting an eye exam. Or spending time with family, as @PTPoeny stated above.

I'm not understanding this statement. You mean the hospital is working within the confines of its resources?

I mean, the answer to staffing isn't simply 'hire more people'. The money may not be there. For residents specifically, there might not be enough cases (however that looks) to hire more residents. Perhaps there's no space for someone to work who isn't a resident--finding a computer on the floor can be awful and there might not be office space for more people to get work done. Perhaps the attendings are short staffed and despite having an opening for 2 years, they can't find anyone to fill it because no one wants to live there, or they can't pay well enough to attract someone... So, when working with scheduling residents, the residency program works within the limitations it has for staffing while still trying to make sure that residents get a well-rounded education so they can practice independently upon graduation.
 
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Mass Effect

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Feb 23, 2012
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I mean, the answer to staffing isn't simply 'hire more people'. The money may not be there. For residents specifically, there might not be enough cases (however that looks) to hire more residents. Perhaps there's no space for someone to work who isn't a resident--finding a computer on the floor can be awful and there might not be office space for more people to get work done. Perhaps the attendings are short staffed and despite having an opening for 2 years, they can't find anyone to fill it because no one wants to live there, or they can't pay well enough to attract someone... So, when working with scheduling residents, the residency program works within the limitations it has for staffing while still trying to make sure that residents get a well-rounded education so they can practice independently upon graduation.

My last word on the subject will be this: staffing is a universal issue. Yet, miraculously, no nurse or MA or CNA is required to work 24 hour shifts. Only the most vulnerable, the ones who can't advocate for themselves for fear of being flagged as a problem - the residents - are expected to pick up the slack, sleep be damned. If us attendings aren't bothered by the way that works out, there's a problem that will never be fixed.
 
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