Why don't many EPs work only nights?

[DeadCactus]

Maybe I'm just getting an inaccurate perception, but based on reading threads here I get the impression that EPs who only work nights fall into the "that guy" category. That is to say most groups have one or two, but they're a quirky anomaly.

Is that accurate? If so, why? One of the biggest complains about EM seems to be the constant screwing with circadian rhythm. So why not just stick with nights until a time when you have the seniority to do all days?

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[alreadylernd]

Maybe I'm just getting an inaccurate perception, but based on reading threads here I get the impression that EPs who only work nights fall into the "that guy" category. That is to say most groups have one or two, but they're a quirky anomaly.

Is that accurate? If so, why? One of the biggest complains about EM seems to be the constant screwing with circadian rhythm. So why not just stick with nights until a time when you have the seniority to do all days?

And why not just work every Saturday and Sunday to ensure a regular schedule?

Ok, kidding aside, not only does exclusive nights really cramp your personal life, but seeing the sun every so often is good for the body and the mind. Remember too, that even if you were completely adjusted to a nights-only schedule, it's never easy to sleep during the day - and I say this with a small room in my basement set up deliberately so I can sleep during the day after an overnight.

I am sure there will be many other eloquent reasons from other posters...

 

[dotcb]

basically it's bad for your personal life and health...

 

[DeadCactus]

I can see how it wouldn't be ideal, but I would have to imagine that a constant nocturnal schedule would be better for your health than the frequent switching.

And it would seem that most of the daylight you're going to get either way would be before or after the shift, with the rest of your day spent basking in the soft glow of fluorescent lighting.

But I guess you're not going to find many people who want to go to the zoo at 300am, so you'd be stuck shifting schedules either way...

Back to the drawing board I guess.

 

[TysonCook]

..I'm currently trialing a 4month stint of only nights.

Here are the reasons that I did it....
1) I get to choose my schedule (huge since its summer and I want to take trips.
2) I get a 20% reduction in shifts (works great as I still work with a private group on the side).
3) ALL my shifts are same time (family can plan).

There are a lot of reasons I don't like it (beyond the obvious)....

Most groups offer either a shift reduction, pay increase, both, or other benefits that make it "worth it".

for me ultimately it came down to I wanted large blocks of time off, and this was a way to achieve it other than trying a 22 way trade every month

 

[deleted6669]

I work the vast majority of my shifts at night. higher acuity/lower volume/more money/regular schedule/no admin types around. what's not to like?
I work when my kids sleep. I sleep when they are at school. when they are home and awake so am I.
I did years of rotating day/swing/night and all nights is much better tolerated.

 

[DeadCactus]

For those of you doing all nights, do you find it difficult to spend time with family and friends who are on a normal schedule? Do you have a hard time shifting to a day-time schedule when you go on vacation or such?

 

[DrMom]

higher acuity/lower volume/more money/regular schedule/no admin types around. what's not to like?

I work all nights (12 hr shifts) and the (bolded) issues you mention definitely come into play for me. I don't quite have a regular schedule, but it's much closer to regular than my day shift partners. The all-night docs in my group (5 of us) get scheduling priority and a shift differential. Because my group has a double coverage shift that only overlaps my shift by 3-4 hours it is not unusual for me to see more patients than the day shift doc, so I can't count on lower volume, but I do definitely have some random very low volume nights.

For those of you doing all nights, do you find it difficult to spend time with family and friends who are on a normal schedule? Do you have a hard time shifting to a day-time schedule when you go on vacation or such?

I get up mid afternoon when I'm working and have dinner with my family before heading in. When I'm ending a run of shifts I just sleep until lunch time and then have the rest of the day with them.

I don't have a hard time switching back to days when I'm on vacation, but I also switch back to a day schedule whenever I have a day or more off. My disclaimer to that is that I generally take lunesta the first night I'm sleeping to make sure I sleep a decent amount. I find that helps me transition better.

I do miss out on some "normal life" activities because I work at night, but I can definitely find time to socialize. I honestly think the 12 hour shifts are more disruptive to "normal life" than the night shifts alone are.

 

[DeadCactus]

I've always been a night person; if left to my own devices, I go to sleep at 500am and wake up at 100pm. I just like the night and working when fewer people are up and about. Throw-in better pay, a more regular schedule, and higher acuity and working all nights (at least for the few part of my career) always seemed appealing. Glad to hear it's pretty manageable...

 

[SoCuteMD]

I can see how it wouldn't be ideal, but I would have to imagine that a constant nocturnal schedule would be better for your health than the frequent switching.

And it would seem that most of the daylight you're going to get either way would be before or after the shift, with the rest of your day spent basking in the soft glow of fluorescent lighting.

But I guess you're not going to find many people who want to go to the zoo at 300am, so you'd be stuck shifting schedules either way...

Back to the drawing board I guess.

Regarding the bolded. Most EPs work somewhere between 13 and 20 shifts a month. So most people have a pretty generous amount of time off, and will end up switching back to days whenever they have a couple days off, so you would probably switch between days and nights frequently.

The attendings at my program's community site only work 2 nights/month even though there is nobody who works dedicated night shifts.

 

[Arcan57]

I think it also depends on the night shift. Both of the night shifts at my current shop start at or before 8pm, which is a completely different feel than having a night shift that starts later. I used to love 11-7 shifts because I could spend the night with with my wife before heading into work. A 6p-4a shift makes all kinds of sense in terms matching staffing to volume but is hideously painful because you don't really get to see your SO in the evening and you get home to late to get meaningful sleep in before the family wakes up.

 

[Daiphon]

I work all nights (12 hr shifts) and the (bolded) issues you mention definitely come into play for me. I don't quite have a regular schedule, but it's much closer to regular than my day shift partners. The all-night docs in my group (5 of us) get scheduling priority and a shift differential. Because my group has a double coverage shift that only overlaps my shift by 3-4 hours it is not unusual for me to see more patients than the day shift doc, so I can't count on lower volume, but I do definitely have some random very low volume nights.



I get up mid afternoon when I'm working and have dinner with my family before heading in. When I'm ending a run of shifts I just sleep until lunch time and then have the rest of the day with them.

I don't have a hard time switching back to days when I'm on vacation, but I also switch back to a day schedule whenever I have a day or more off. My disclaimer to that is that I generally take lunesta the first night I'm sleeping to make sure I sleep a decent amount. I find that helps me transition better.

I do miss out on some "normal life" activities because I work at night, but I can definitely find time to socialize. I honestly think the 12 hour shifts are more disruptive to "normal life" than the night shifts alone are.

As always, Dr. Mom says it better than I ever could. I'm in 2 departments (plus a moonlighting gig on the side), one I'm strictly nights & the other I rotate. The strictly night place is easier on my schedule, I get to call my own schedule for the year (because we separate the nights from everything else), and the 4-5 of us that work the nights exclusively are pretty happy doing so. No admins, no "guest services" people, no clinic dumps... plus I get paid more, my RVUs go up because of single coverage, and truthfully - I enjoy it.

It all depends on your particular constitution. For me, nights are the way to go. Plus, it frees up most of my mornings to do my academics (toxicology) and run whatever errands I need while the 9-5ers are stuck in their offices... I guess I am "that guy."

Cheers!
-t

 

[EctopicFetus]

Just to add.

I work all nights and in my group of 40 docs (staffing 3 hospitals) we have 8 dedicated night docs.

The benefits are as mentioned though in my group we get a 30-35% increase in pay. I like the acuity, comraderie and the fact I work all my shifts in a row. I can work as little as 12 shifts a month but we have folks who do less. The control of my schedule is amazing.

Our nights are either 6p-6a or 10p-6a.

The extra benefit is 1) I can plan my life knowing Ill be awake and off of work every day from 3p-5p (before having to go into work).

2) I am able to have dinner with my family every day. This might seem silly it is important to me, my wife and our family.

As mentioned it isnt the best thing for your health (no argument there) so Ill probably do it for another 18 months or so and then call it quits unless it still works for me. I have been on all nights for nearly 2 years.

 

[n2b8me]