12 hour shifts/7 on 7 off/typical 8-5 days

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psychresident14

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Hey SDNers. Just wanted to find out if inpatient psychiatrists/ED psychiatrists prefer doing 12 hours shifts, 7 on 7 off, or the typical 8-5 M-F days. Pros/cons?

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I have never worked 7 on 7 off, but I imagine that would be difficult with kids. You miss half of their evenings (or large parts of them) and half of their weekends. Also, I imagine the 7 on 7 off model is tougher in some ways because of the lack of continuity, coming in and learning a mostly-new census at the start of each week.

Aside from the family considerations, though, I would be all in for the 7/7 model! Especially in CL.
 
PGY-1 -- Please feel free to take my perspective with a grain of salt. I thought I might uniquely contribute because my mentor worked on the inpatient psych unit at a large hospital, and was actually in the process of converting to 7 on/off from working weekdays with coverage by another attending that wanted the extra cash. Now the floor has two psychiatrists, and they alternate the 7 on/off.

With a family this work schedule is less compatible as noted above. IMHO, with families that have children not yet in school or another parent working, you would run into awkward day-care arrangements and have a harder time finding balance both in and outside of work with this schedule. As such, this wouldn't personally be a great fit for me as I see it now. This was one major deterrent for me when I was interested in EM.

Upsides for someone who wants the alone time? Sure, if you have time-consuming hobbies or a desire to solo-travel frequently. I think you'd need something of substance to make losing 1/2 of your weekends worth it.

My mentor is a very seasoned psychiatrist and has handled this change in style with ease. FWIW, I believe they "squeeze" in nearly an entire outpatient practice with their week off. You can do that sort of thing when the kids are grown, and you love your job too much to do much else! I think if they had a the perfect situation however, they would prefer it another way.

Cheers!
 
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I work a Monday to Friday inpatient unit and work the weekends once a month. The call weekends are really the only bad part of the job, because you end up working 5 weekdays + 2 weekend + 5 weekdays = 12 days in a row. Otherwise this job is great. If my hospital would hire locums for the weekends I would be in heaven.

The nice thing about 7/7 is no weekend "on call" per se, and no 12 day stretches. A downside is the lack of patient continuity, even if you do your best to review notes and gather additional information from the patient yourself, I don't think you can really know a patient as well as if you do the admit yourself. Another problem is who covers the phone overnight for your 7 days stretch? It's probably you. So you're actually on call for 7 days too, unless the hospital has another arrangement. The biggest argument against this schedule I've heard from internists is that you "disappear" into the hospital for your 7 days because you have to get in at 7 am and hope to leave by 7 pm; sometimes you leave earlier, but if it's busy you might not leave until 8-9. This may be different in psychiatry, but they're still long days and you're probably not seeing your family or getting to the gym as much as you'd like, and maybe no gym at all.

The only way I think 7/7 would be workable for someone with a family or hobbies is if the hospital required a patient load more typical of a 9-10 hour day, so you can get out at a reasonable hour. Or if you worked "efficiently" and tried to cram 12 hours of work into a 9 hour day.
 
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If my hospital would hire locums for the weekends I would be in heaven.

Two of the hospitals where I work have dedicated weekend staff so the attendings don't work weekends. Even at premium weekend rates its cheaper than locums and you have the continuity of having known, decent providers covering your patient load. Advertising no weekend responsibilities seemed to attract more applicants and the attendings love not having to work weekends. This also provides additional options for coverage during vacations and holidays.

OP I haven't come across any 12 hour shifts in an inpatient setting. In my area attendings normally round on their patients during the week and split overnight call duties so it is essentially a M-F 9-5 type gig. There is one hospital I know where the contract requires ED coverage until midnight but they staff with residents.
 
Another thing to consider is what time your shift starts. Imagine working the 6PM to 6AM psych ER shift? I could not handle that. Also you need to consider the workload, outpatient vs inpatient with police cases coming in 3-4 at a time for hours all night. :/
 
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