Will I ever get used to shift work?

[TylerDurden]

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I am a fourth year that is hoping to apply in EM. I am on my rotation now and love everything about the speciality except for the fact that I feel extremely jet lagged after completing every round of circadian shifts. I end up spending nearly every moment of the days I have off feeling exhausted or sleeping. I am not sure if I can spend the rest of my life with this feeling that I am constantly hungover, because I used to really enjoy being able to get a good night of sleep.

Will this possibly improve with time or are some people just unable to get used to the shift changes? Also, how often are you expected to work night shifts as you get more senior in the field? Are their residency programs that do not use the circadian pattern for their shifts? Thanks for the help.

 

[Sessamoid]

How rapidly are they cycling you on your shifts? Give us some idea of what your schedule looks like to see whether what you're experiencing is typical of our work schedules.

 

[NinerNiner999]

I used to really enjoy being able to get a good night of sleep.

Hmm, residency may be a tough adjustment 😀

Seriously though, like Sessamoid suggested, a better idea of your current scheduling would be helpful for a good answer to your question. I think that the best types of schedules are the ones where you work a few nights in a row, switch to evenings, and then progress to days and mornings over three or four shifts, and then work days for a few shifts. Usually, a day off in between the progression from days to nights and vice-versa works well to keep somewhat of a rhythm. Four days and four nights with middle times in between usually ocurrs over a two-week schedule.

As for "getting used to it" is concerned, fear not - neither students nor residents should expect to work as many hours and as many shifts as they do when they are attendings. 12-14 shifts/month as an attending is fairly common, which is clearly better than 18-22 as a student or resident...

 

[Sessamoid]

I think that the best types of schedules are the ones where you work a few nights in a row, switch to evenings, and then progress to days and mornings over three or four shifts, and then work days for a few shifts.

Actually, most groups that do a circadian shift go forwards. Going backwards is extremely difficult, and will lead to you eventually pulling out your hair assuming you have any left. In other words, don't go nights -> evenings -> days.

Go days -> evenings -> nights -> days.

 

[NinerNiner999]

Actually, most groups that do a circadian shift go forwards. Going backwards is extremely difficult, and will lead to you eventually pulling out your hair assuming you have any left. In other words, don't go nights -> evenings -> days.

Go days -> evenings -> nights -> days.

Err, yeah - that's what I meant. I guess days to nights eventually becomes nights to days in the circle of life....

 

[roja]

I rarely have a problem (I love sleeping) but on the rare occasion I do, I use ambien for the first 'switch'. Works well and switches me quickly (usually going from days to nights and needing to sleeep some during the day).

Also, a few things that help, if you are on nights, don't sleep all day. Go out and get some fresh air for an hour at least. Excercise - you'd be amazed at how much this helps.

Eat healthy. Avoid drinking much if you know you are switching.

Corny stuff but it all adds up.

 

[Sessamoid]

Excercise - you'd be amazed at how much this helps.

Eat healthy. Avoid drinking much if you know you are switching.

Corny stuff but it all adds up.

I'm going to give a hearty second to the advice to exercise. It's been proven that shift workers who exercise regularly suffer from less "circadian lag" between shifts. Same advice goes for avoiding alcohol.

 

[jpgreer13]

Yes. You do get used to it.

I tend to work exclusively the late swing shift and nights in my ED months (by request). I used to think I'd never get used to it.

Now I hate and fear the sunlight, and I never want to work another day shift again.

You can adapt to anything.

Also, things like exercise and eating healthy and socializing are nice, but you can also live without those. Trust me.