How does shift work work?

[SueC]

I'm totally jumping the gun here, but last night my husband mentnioned that he told an attending he might be interesting in staying there after he finishes. The attending told him they are thinking of having round the clock pulmonology in house and doing 12 hour shifts. He didn't know any more details than that, but does anyone else know how this usually works? If they work 12 hour days, how many days a week do they typically work? Aside from having to be alone overnight sometimes, I think I could get excited about this sort of arrangement. Wouldn't that mean when they are home they aren't on call?

[Rapunzel]

Let me tell you how shift work is done in my husband's residency program:
One week night shift
One week day shift
One week night shift
One week day shift

Night shift schedule:]
Night 1: Sunday 7pm - Monday 10am
Night 2: Monday 7pm - Tuesday 10am
Night 3: Tuesday 7pm - Wednesday 10am
Night 4: Wed 7pm- Thur 10am
Night 5: Thur 7pm - Fri 10am
Night 6: Fri 7pm - Sat 11am
Night 7: Sat 7pm - Sun 11am

The Day shift then begins the next day, Monday, at 7am. Because he "technically" gets off at 7 am on Sunday morning this is considered his 24 hour period off for the week. The fact that he actually stays four hours or more later is covered by the fine print in the rules that up to 6 hours per shift is allowed in addition to the 80 hours/week rules (in other words it really isn't 80 hours/week allowed under the new rules - it's actually closer to 116 hours/week - and the day off every seven days rule is actually averaged out over four weeks - so it is entirely legal for a residency program to work a resident on a tougher schedule than the one I listed for up to three weeks with no 24 hour break as long as they make up for it the fourth week by giving him/her 4 24 hour breaks).

So, Day shift is then Monday - Friday 7am - 9pm. Then the Night shifts starts up immediately the next Sunday night. So, twice a month my husband has a true "day off" in the psychological sense - a full Saturday and Saturday night.

I have a very good friend who's husband is now an ER attending (he just got done with his ER residency last year). His schedule has always been shift work - both for residency and attending. It is really, really hard. His shifts constantly change so his sleep patterns are constantly messed up and oddly enough, he really doesn't have much time with his family. It's been very hard on my friend and I don't know how she copes with this schedule all the time.

Shift work is not all it's cracked up to be.

[peggyfromwastate]

my dad was an er doc for 25+ years (now he works 8 am - 6 pm M-F and gets holidays off in an occupational medicine clinic which he runs-- this is great for him now that he's 57). Shift work from the child's perspective means you never know when your dad is working, the schedule is so complex. You never know if he'll come to your special events. You will go weeks without seeing him, b/c days shifts begin before school and end after bedtime. He and my mom are MUCH happier now that he has a regular schedule. The tragedy is that we as kids never spent much time with him, besides vacations, due to his schedule. Let's not forget the "suicide shift" as we call it. That is when he worked a night shift followed by a days, then did 4 more days shifts. Sometimes he topped this off with another suicide shift on the end, working a night following his last days... For a wife and kids, shift work is hard, but of course you will survive. You'll find a way!

And I'm not sure about the on-call, since I am just speaking from ER shift work background. he wasn't on-call, but sometimes got consulting phone calls from other docs and what not. No big disruption to life. And, since this was post-residency, without moonlighting the full-time ER doc works about 14 shifts a month. My dad averaged more like 18 shifts a month, so there were days off there. Are you asking about a shift work schedule after residency?


Good luck!

Hope my husband doesn't choose ER...

[Auspicious]

Holy cow!

My boyfriend has an acquaintance who's an ER doc and supposedly works two 16-hour shifts per week every week (and still makes six figures). Is that possible or must that be a miscommunication?

[SueC]

This is a post-fellowship job. I guess I need more information about this, because at that point he would be an attending and there would be fellows and residents rotating through to carry the load. I'm glad you guys posted your experiences, especially from the kids' perspective. For some reason, I zeroed in on the "no on-call" aspect and didn't really consider how hard it would be for his schedule to be constantly changing. I really plan on giving my input when it comes time for him to settle into a position after fellowship. Like I said, I'm jumping the gun since he is only in his first year of training, but I know that several of the fellows started looking for jobs in their second year of training (which for us starts in only 2 months). Ever since we got married, he has stressed that he wants to be around more for our kids than his dad was (also a doctor) so I need to remind him of that when it comes time to make the decision.
And Julie, that may not be a miscommunication. We know a guy who took a similar sounding ER position. Lucky bastard!!!

not sure about shift work as an attending, but i currently am on a shift schedule at my journalism job and it's difficult to switch shifts every day and every week...the body does get used to it but it is hard and results in tiredness and irritability. definitely get more info...it might be worth it depending on how many days off he would get and how stable the schedule could be.

[Rapunzel]

Sue, I had the same reaction when I found out about my husband's residency (primarily shift work - call is very, very rare). All I heard was "no call" and got giddy. Unfortunately I didn't realize the drawbacks inherent in shift work. Since this is a post-training job you guys are looking for I would give you this as my opinion:

shift work vs. Q3, Q4, Q5 - shift work wins

shift work vs. Q6 or more - call wins all the way

Hey there, my Dh is an ER attending at a Level 1 trauma center. Shift work is our life. It is not as bad as some may think. Dh works 160 average a month. That is 16 days a week ladies. How many of you would give up a few night shifts and a few missed dinners to have your husband home 14 days out of the month? Working 12 hour shifts may not be that bad as an attending. Now in a Pulmonary group I take it that they may be salaried. Because DH is payed per hour it may be different. they like to work the crap out of salaried physicians.

[Rapunzel]

I think that may be the big difference - hourly pay vs salary. My friend who's husband is an ERattending has been salary pay - and they did and still do work him hard.

[SueC]

I could definitley handle having him around 14 days a month. I hope that is the case and it is not the situation some of the others described!

[Cumberland]

I do shift work in a level 1 trauma center as a nurse practitioner. I work 12 hours a day, 13 days a month, which is full time salaried pay. We do self scheduling, where we sign up for the shifts we want to work, then get shifted around one or two days to make the schedule fit. While the hours are LONG and hard and I cant barely lift a fork to eat dinner when I get home, it sure pays off having 4 days off a week. One of the big perks of emergency medicine is the set number of hours a month with no call.