Scheduling in the ICU

[Ttan]

Wondering how shifts work in general ICUs around the country (no residents, no fellows)

What's the ratio of nights to days worked?
What hours and shift lengths do you work?
2 week on, 2 week off common?

Thanks!

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[jdh71]

Are you asking of those only doing critical care?

I won't go into my schedule as I do pulm as well unless you are interested. The two intensivists in our group do a week on and a week off alternating. 1/3 of those are nights. We run shifts and cover 24/7. 7a to 7p and 7p to 7a.

 

[bigdan]

I'm interested in the responses here as well. My department administrators have questioned the appropriateness of my request for increased time off...

To answer the OP, my primary training is as an anesthesiologist, and I cover CTICU (mixed medical cardiac + surgical cardiac + vascular + thoracic) for 7 days, from 8a-6p in house. Max bed capacity is 16, average census is 10-12 now. I leave when it's "safe", and answer calls/pages all night from 6p-8a, and come back in if any issues that cannot be resolved by phone. True STAT emergencies are covered by in-house MICU attending, but those are rare as we always just stay in house if pts are unstable. No fellows, no residents, no extenders. I get 3 days off after that ICU week. The remainder of the month I work in the ORs doing anesthesia.

Have two good friends also doing anesthesiology/CCM, both at major academic centers. They do 7 days of 12 hr shifts, then get 7 days off, then do 2 weeks in the ORs.

Eager to see how others' work/time off balance is...

 

[MirrorTodd]

I'm interested too as critical care is something I'd like to get into in the future.

 

[Nivens]

Have two good friends also doing anesthesiology/CCM, both at major academic centers. They do 7 days of 12 hr shifts, then get 7 days off, then do 2 weeks in the ORs.

The week-on, week-off thing comes up a lot, but I always wonder- is that a good lifestyle? Seems to me kind of like the red-eye flight. When I'm booking plane tickets six weeks out it always seems like a great idea (saves a whole day!), but sitting in the airport at 11pm the day of it feels like a huge mistake.

 

[Ttan]

How hard are strictly icu jobs to come by that are for only working in daytime?

 

[Nephro critical care]

How hard are strictly icu jobs to come by that are for only working in daytime?

Harder. I have been trying for a day job but really hard to get. Problem is that most ICUs are now moving towards 24 hour coverage and thus somebody has to cover the night shifts as well. And though nights can be less busy nobody still wants to cover them. So usually you will get a 12 hour day rotating with a 12 hr night 7 on and 7 off. Maybe it's a a big 100 bed ICU and you have dedicated nocturnists then you can get a day time gig.

 

[Siggy]

The week-on, week-off thing comes up a lot, but I always wonder- is that a good lifestyle? Seems to me kind of like the red-eye flight. When I'm booking plane tickets six weeks out it always seems like a great idea (saves a whole day!), but sitting in the airport at 11pm the day of it feels like a huge mistake.

 

[jdh71]

The week-on, week-off thing comes up a lot, but I always wonder- is that a good lifestyle? Seems to me kind of like the red-eye flight. When I'm booking plane tickets six weeks out it always seems like a great idea (saves a whole day!), but sitting in the airport at 11pm the day of it feels like a huge mistake.

7 on 7 off grinds. It's work hard play hard. And no it's not as "fantastic" as it appears on paper. The trade off seems to be that when you schedule a vacation week you end up with three weeks off. Have three or four vacation weeks in a year and that is a lot of time off.

 

[Green Man]

7 on 7 off grinds. It's work hard play hard. And no it's not as "fantastic" as it appears on paper. The trade off seems to be that when you schedule a vacation week you end up with three weeks off. Have three or four vacation weeks in a year and that is a lot of time off.

Almost all places I interviewed (CC or Pul/CC) don't give any extra paid-time-off or CME days for 7on-7off schedules. Was told I could accumulate day-offs to create my own two week vacation. Could you please elaborate more on your statement above?

 

[jdh71]

Almost all places I interviewed (CC or Pul/CC) don't give any extra paid-time-off or CME days for 7on-7off schedules. Was told I could accumulate day-offs to create my own two week vacation. Could you please elaborate more on your statement above?

My critical care partners get two additional "work weeks off". Every place is going to be a bit different. But I personally wouldn't take a job that was 7 on 7 off forever, indefinitely, until you quit.

 

[psychbender]

An academic program I just interviewed was week-on, week-off, plus four additional weeks off for full-time ICU. Additionally, the department allowed trading of shifts between attendings, with the schedule being made two months at a time. So, you might arrange with a partner for you to do Mon-Wed one week, have your partner work Thr-Wed, then do Th-Sun the following week, to break things up a bit. Days were 10 hours (8a-6p), nights 14 hours, but paid more. Roughly one in three weeks were nights.

For OR/ICU split folks, it was 10 working days in the OR (M-F, x2), then one week ICU, one week off, and I think got another two weeks off (or maybe they were "CME" weeks). Still roughly one in three ICU weeks were nights, and those were the only nights (no call or weekends in the OR, unless requested for more money).