No night shifts?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Redrox

Full Member
10+ Year Member
Joined
Oct 28, 2008
Messages
291
Reaction score
82
How rare is it to work for a group that doesn't require you to work overnights?


I'm a couple years out of residency, been thinking bout jumping ship for a variety of management, administrative reasons.

Thing is, I have it pretty sweet in that we have a bunch of nocturnists and I'm strictly day and swing shifts. Kinda nervous about starting somewhere else if it means working a buttload more nights.

What's it like for the rest of y'all? How many nights a month you guys working?

Members don't see this ad.
 
  • Like
Reactions: 1 user
How rare is it to work for a group that doesn't require you to work overnights?


I'm a couple years out of residency, been thinking bout jumping ship for a variety of management, administrative reasons.

Thing is, I have it pretty sweet in that we have a bunch of nocturnists and I'm strictly day and swing shifts. Kinda nervous about starting somewhere else if it means working a buttload more nights.

What's it like for the rest of y'all? How many nights a month you guys working?

Most of my colleagues are working / will be working at places that require between 10-25% nights.
 
  • Like
Reactions: 1 user
How rare is it to work for a group that doesn't require you to work overnights?


I'm a couple years out of residency, been thinking bout jumping ship for a variety of management, administrative reasons.

Thing is, I have it pretty sweet in that we have a bunch of nocturnists and I'm strictly day and swing shifts. Kinda nervous about starting somewhere else if it means working a buttload more nights.

What's it like for the rest of y'all? How many nights a month you guys working?

If you're jumping ship for financial reasons I don't believe it'll be worth it - I think you have it pretty good. No amount of money to me is worth the circadian rhythm disruption, which is sure to cause burnout. Having a good nocturnist setup is definitely one way to ensure career longevity.


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: 1 users
Members don't see this ad :)
25% of the shifts in our division are night shifts (10p-6a) and another 12.5% are the late swing (6p-2a). I work the second but not the first. That costs me a fair amount of money. About half of my group doesn't work after midnight at all, almost exclusively the older, more senior, more financially stable docs.

I don't think it's that uncommon to not work nights, but how it is decided who works them and who doesn't is what varies quite a bit. Typically, you simply get paid more to work nights, thus the existence of nocturnists. But it can also be decided by seniority or age.

How about you just don't go work for a group that will require you to work nights?
 
  • Like
Reactions: 1 user
How about you just don't go work for a group that will require you to work nights?
Because those don't exist. Period. A full 1/3 to 1/2 of the day is effectively night. Even if you have all the night shifts covered, what happens when one of those goes on FMLA. Or gets sick. Or moves away for family. Or whatever? They've got to be worked. Sure, you might be able to buy your way out of them, but somebody has to work them. Unless you're in Australia or the UK. Then they're just covered by residents and you're on call for them if needed. The US doesn't have every hospital covered by registrars though. Or a system where people are allowed to wait for their doc.
 
Perhaps you could swing a locums deal that does not include nights.
 
At our shop 1/3 of the shifts are overnights, so 1/3 of the typical shift burden is overnights. Exceptions for director/assistant director who may work a couple of overnights a month, but for most of the group it's about 5 a month. If this is important to you, you should think hard about it, no nights is very uncommon (although if you've been taking a big paycut to do so maybe you want to switch it up).
 
Because those don't exist. Period. A full 1/3 to 1/2 of the day is effectively night. Even if you have all the night shifts covered, what happens when one of those goes on FMLA. Or gets sick. Or moves away for family. Or whatever? They've got to be worked. Sure, you might be able to buy your way out of them, but somebody has to work them. Unless you're in Australia or the UK. Then they're just covered by residents and you're on call for them if needed. The US doesn't have every hospital covered by registrars though. Or a system where people are allowed to wait for their doc.

He's not asking about a job where there are no night shifts. He's asking about a job where he doesn't have to work them. I guess you can believe that sort of a job doesn't exist. Meanwhile I'll just keeping working it. Would a screenshot of my clinical schedule this month help? Does that mean I'll NEVER work a night shift again? Probably not, but I haven't worked one in over a year despite parental leave, injuries, family deaths etc. Even if I have to work one or two a year, that hardly counts.
 
Last edited:
At our shop 1/3 of the shifts are overnights, so 1/3 of the typical shift burden is overnights. Exceptions for director/assistant director who may work a couple of overnights a month, but for most of the group it's about 5 a month. If this is important to you, you should think hard about it, no nights is very uncommon (although if you've been taking a big paycut to do so maybe you want to switch it up).

The bigger the shop the less common this is. For example, a really tiny single coverage shop might have two 12 hour shifts. So 1/2 of your shifts are overnight. A little larger single coverage shop might do three 8s- 1/3 are overnights. But as you add double and triple coverage, that coverage tends to be put onto the swing shifts, not the overnight shift. So one of our shops has five 8-hour physician shifts a day, starting at 6a, 10a, 2p, 6p, and 10p. 1/5 of the shifts are overnight. Between our two shops, 25% of our shifts are overnight shifts. So my "share" if I'm working 12 shifts a month, is 3 of them. Since we have some docs that work them exclusively, one of them might work his own share, my share, and the share of 2 or 3 other docs. Thus 3/4 of the docs aren't working nights.

If this doesn't exist at your facility, and you would like it to, I would submit that you can probably change things to make it possible. Bear in mind the financial price may be quite heavy to get another doc to work your share of nights though, but perhaps not as high as you might think. If an average shift pays $2000, and a night shift pays 25% more than an evening shift like ours does, and you are trading 4 night shifts for 4 evening shifts, then it really only costs you about $2K a month or $24K a year. Depending on where you are at in life, that may be trade you are willing to make. Earlier in my career, I made the trade going one direction. Now, as additional money has lower marginal utility, I make it in the other direction.

I suspect there are very few places this arrangement cannot be done, either formally or informally. Try it. Call up one of the other docs and see if he'll swap all your night shifts for his evening shifts. I assure you that most docs have their price when they really think about it.
 
He's not asking about a job where there are no night shifts. He's asking about a job where he doesn't have to work them. I guess you can believe that sort of a job doesn't exist. Meanwhile I'll just keeping working it. Would a screenshot of my clinical schedule this month help? Does that mean I'll NEVER work a night shift again? Probably not, but I haven't worked one in over a year despite parental leave, injuries, family deaths etc. Even if I have to work one or two a year, that hardly counts.
Who is covering those shifts when people aren't there? And when the night doc calls in sick, who covers it? Is there a call schedule?
I mean, sure, you might work very, very few of them. They exist. But the nights are being worked. A new guy coming in to only work days? I can't say it's common.
I agree that it is worth it to buy up/buy down those shifts. Too many places won't though. And while being nocturnal is great while you're at work, it sucks for when the mower/UPS/mail/family/whatever is around. So you're still having some circadian swings unless you are literally a bachelor. All days is a blessing. Or a job where you can sleep nights. Either or.
 
Last edited by a moderator:
I don't work nights. Haven't since I came out in residency. It's very rare, but you have to find the right group. PM me for more info
 
Who is covering those shifts when people aren't there? And when the night doc calls in sick, who covers it? Is there a call schedule?
I mean, sure, you might work very, very few of them. They exist. But the nights are being worked. A new guy coming in to only work days? I can't say it's common.
I agree that it is worth it to buy up/buy down those shifts. Too many places won't though. And while being nocturnal is great while you're at work, it sucks for when the mower/UPS/mail/family/whatever is around. So you're still having some circadian swings unless you are literally a bachelor. All days is a blessing. Or a job where you can sleep nights. Either or.

In my group? Usually the other nocturnists. Like I cover the day shifts when those people aren't there or call in sick. No, we don't have anyone on call because people just step up and cover the shifts.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
Different people have different ideas what is night and what is not.

Some feel any shift after midnight is a night shift, I don't.

But if you really want to avoid a true night shift (ending at 6-7am), it is possible. Most groups (CMG or SDG) would be happy to accommodate this to keep their doctors happy.

But it will cost you Money.
You can vote as a group and put it in the scheduling software where you stipend the night docs. If there is not enough pressure to do this, just find some docs that would be willing to work your night shifts for $$$$. You WILL be able to get rid of your night shifts for the right price. There is always a dollar amount to get this done.

I hated 6am shifts, so I traded all of my 6am shifts for 9am shifts as some liked to get home in time for dinner.

I am even sure you can work the same shift such as the 9am shift if you make agreements. Trade your overnight, early am shift with docs who are willing to do it for the right amount of $$$$.. Its not that difficult to achieve.

Until I started Locums, I may have done 5 true overnight shifts in 10 yrs.
 
is it common or possible to do a nightshift month or two and get all your nights out of the way in one large chunk? Figured in a group of 24 you could have double coverage where one doc works 2-3 months of nights straight.
 
is it common or possible to do a nightshift month or two and get all your nights out of the way in one large chunk? Figured in a group of 24 you could have double coverage where one doc works 2-3 months of nights straight.

Has been discussed on here before. This doesn't work for a number of reasons.
 
The more things change, the more they stay the same.

Schedule. Location. Money.
Pick two.
 
  • Like
Reactions: 5 users
But if you really want to avoid a true night shift (ending at 6-7am), it is possible. Most groups (CMG or SDG) would be happy to accommodate this to keep their doctors happy.

But it will cost you Money.
You can vote as a group and put it in the scheduling software where you stipend the night docs. If there is not enough pressure to do this, just find some docs that would be willing to work your night shifts for $$$$. You WILL be able to get rid of your night shifts for the right price. There is always a dollar amount to get this done.



Not a big financial burden, really, not doing night shifts. The true overnight only gets a 100 dolla bonus which after taxes and divided over a 9 hour shift ain't much.

Every group's different and we just happen to have a group of nocturnists who prefer working at nights because they got young children with a working spouse and it helps to balance things out.

Lotsa, lotsa financial and hassle problems on the horizon with the group, though; been a really difficult decision staying or going. Even though it's only been a couple years, it's getting harder to remember how annoying switching days to nights was in residency.
 
is it common or possible to do a nightshift month or two and get all your nights out of the way in one large chunk? Figured in a group of 24 you could have double coverage where one doc works 2-3 months of nights straight.

In a previous job, we had this setup. One nocturnist plus everyone else working two "night shifts months" a year. It might have worked if the group had made a concerted effort to concentrate shifts into a couple of five day blocks. Since they didn't, all it ended up doing was concentrating all your circadian rhythm transitions into one month.

I'm all for pay differentials for nights and holidays. People get to choose whats important to them.

Oh, and

For example, a really tiny single coverage shop might have two 12 hour shifts. So 1/2 of your shifts are overnight.

Don't underestimate the significance of this if you are signing on someplace that has only two 12 hour shifts on the schedule. Working 5-6 nights a month for the rest of your life is going to shorten it significantly.
 
is it common or possible to do a nightshift month or two and get all your nights out of the way in one large chunk? Figured in a group of 24 you could have double coverage where one doc works 2-3 months of nights straight.


That sounds absolutely terrible to me, i suppose anything is possible, but I would NOT want that to be my group's policy.
 
That sounds absolutely terrible to me, i suppose anything is possible, but I would NOT want that to be my group's policy.

Why do you say that? Seems like if the scheduling is done efficiently, this setup dramatically cuts down on the number of day-night transitions you have to do.
 
Why do you say that? Seems like if the scheduling is done efficiently, this setup dramatically cuts down on the number of day-night transitions you have to do.
This has literally been asked and answered in detail recently. It is always someone who is either not a doctor yet, or not in EM who thinks its a good idea, and then it's every single EM doc on the board responding why it isn't.
 
This has literally been asked and answered in detail recently. It is always someone who is either not a doctor yet, or not in EM who thinks its a good idea, and then it's every single EM doc on the board responding why it isn't.

The guy who proposed it was then unsatisfied with our experienced responses, and proceeded to claim that we all had difficulty with mathematics and reading comprehension. Haven't heard from him after that.

In brief, if you're going to have 1 or 2 dedicated "night months", and then no nights for the rest of the year, you're going to need/have more docs on your roster than can all fit in the remaining dayshifts once they're done with the nights.
 
  • Like
Reactions: 1 user
The guy who proposed it was then unsatisfied with our experienced responses, and proceeded to claim that we all had difficulty with mathematics and reading comprehension. Haven't heard from him after that.

In brief, if you're going to have 1 or 2 dedicated "night months", and then no nights for the rest of the year, you're going to need/have more docs on your roster than can all fit in the remaining dayshifts once they're done with the nights.

It might work in residency. Not in attending life due to the lack of a constant roster.
 
Top