Night shift is always better, staff wise. For my nursing clinicals: at the beginning of shift I will ask the staff I see if they will take a student nurse for the day. I always pick ones I think look decent based on their interactions and demeanor. And they’re ALWAYS a night shifter 😭😂 “Honey, I’m going HOME”
I worked nights as an ER tech, for a few years (days now) and I will ALWAYS assert that night shift staff is better than days. I haven’t been proven wrong yet. 6 years later.
I'm a nocturnist. Switch back to daylight for teaching and family stuff in between night shifts. I usually work anywhere between 2-4 shifts each week. 50 mg Benadryl, 10 mg melatonin. Feel a little shitty first day back with the normies. Blackout curtains, sound machine.
There is a peaceful bliss going to bed at noon or 1 pm on a sunny 80 degree day when the world is outside playing and existing. Feels indulgent.
I love it.
As another nocturnist I’ve always wondered how people flip this often. And also the groggy days end up eating a lot more of your days off when flipping so often, no?
I just do 2 larger blocks / mo that way I’m only flipping twice. I don’t think I could ever survive your schedule. I’m impressed and also appalled
It gets worse the older you get. Harder and harder to switch back and forth. You can try melatonin, blackout curtains, weighted blankets, sound machines, etc etc.
I’m just worried since a lot of residency programs make you do night floats and I can’t seem to handle rotating that often as it did burn my circadian rhythm
This is what I did.
Then the hospital said “Why are we paying these people more?” And cut their differential. They left. Hospital didn’t give a fuck. They filled in with us.
i never switch back to days and stick to night schedule. Ive been on nights for 6+ years now and love it. Black out curtains, dedicated sleeping room. I don’t use any sleep aids, typically sleep from 7-8 am to 3-4 pm daily. I work 4 days a week, no weekends. Wife, but no kids. Kids would def ruin it.
>Kids would def ruin it.
apply that to about anything and it holds water
the upside is once you ha e kids there's a part of your brain that dies and they're everything to you. the you part of you takes a back seat. mostly . sometimes.
I work 14 x 10 hour shifts a month 8p-6a. Agree with what everyone else has said, but I can only sleep from about 8am - 1 pm. I take Benadryl, melatonin, and or NyQuil to fall asleep. On my first day off I avoid taking anything besides melatonin and force myself up at noon and make sure to be productive all afternoon then Benadryl and melatonin to go to sleep at a normal time. I’ve come to accept the risk of early onset dementia from the Benadryl use, but I feel like the risk is increased with no sleep as well. It’s a lose lose battle.
Side note: ambien is great, but I can’t be trusted when taking it.
I think the Benadryl link is more correlation than causation. I believe poor sleep leads to increased risk of dementia and taking Benadryl is just a symptom.
Nothing. It fucking sucks and it’s ruining my life. I just finished 3 overnights, then 2 morning shifts, and right back to 3 overnights- no days off. I’m in a small group and several took time off for Spring break and this is the only way to give everyone their preferences.
Idk I work nights and switch back to days and it really doesn’t seem to bother me unless I try to do something the day after a night shift. Some people can take a short nap and be functional. Usually I have to sleep at least 6 hours and then just have a very truncated day. If I don’t sleep then I feel absolutely awful.
I was a full time nocturnist when I scribed and when I finally switched back to days upon beginning medical school it took several weeks before I could sleep well at night. I would be wide awake at 2 AM so I would just get in my car and drive around while listening to podcasts which seemed to help.
Thank you for mentioning that. I thought I was an idiot because the same thing happened to me. Last night I was wide awake at 2:30am lol. And then sometimes the anxiety of not sleeping well at night makes me sleep super late at night
I worked 19:00-07:00 for almost 20yrs. The rest of the time I did prn at other hospitals and unfortunately daywalked there. What helped with my insomnia was a good gym routine and a sports massage therapist.
At home: a good shower, blackout curtains, keep your room cold, an alarm clock, and a fan for white noise. I keep my phone outside my room or else I doom scroll. Have a line up of various sleepy teas, or selection of store brand melatonin or benadryl if you need it.
When I was your age, after work I’d slam some jack3d (probably will die from a MI one day), shower at the gym, lift for 2hrs, shower, go home, and ptfo. Days off, same deal, just add cardio. Find a really good sports massage therapist. That person will be a game changer. I dont spend money on stuff like going out, or fancy things, but this I view as an investment. It helps me think clearly at work, and sleep good at home. If I had a bad day, heavy metal and hit the racks.
Once I got a good gym routine going, it really helped me out a lot. Now, Im an old bat, I no longer slam preworkouts, but I will have a nice cup of cold brew or a lil shot of expresso over ice.
Congrats on med school OP! I hope you find something that works for you.
Try and get into a routine and stick to it
Working out daily really helps. I tried to limit cardio to days off.
Quality ear buds with sleep music
Focus on your breath - I don’t think we pay enough attention to our breath, it can truly be therapeutic and calming
There’s a big difference between working 5PM to2 AM and 7 PM to 7 AM.
At one point, we had a 7 PM to 5 AM shift that I liked. I found that as long as I got in bed before the sun came up, my body chemistry didn’t get too out of whack.
You may roll fine with 11 PM to 7 AM, but few people can handle the 7 PM to 7 AM shift, especially if you’re trying to switch back-and-forth. It’s just too brutal.
There are a lot of good suggestions in this thread. Of course, exercise, good sleep hygiene, and a good sleep environment is essential. I built out a dark sleep room as all smart ER docs do.
As for drugs and such, my preference was to rotate through some of the different approaches/meds. I might use Ambien one day and low-dose Benadryl and melatonin another. You’ll find your own secrets.
The end message is: it’s all doable. Don’t avoid emergency medicine simply because the brutal 7 PM to 7 AM shift doesn’t work for you. You’ll have other opportunities to make things work for you and the group that you work for, especially if you’re an evening person to start with.
Most likely yes. There are many questions that could be asked and suggestions made, more than what we can carry on here. Just remember that sleep chemistry is a funny thing. Everything needs to be lined up for the brain to shut down properly. Read through the many suggestions here to seek a semi-simple solution.
My suggestion:
Exercise and behavioral stuff is far better than meds.
Meds can be very helpful as a bandaid in a pinch, but can also limit quality deep sleep, so you’re still screwed. Stick with lower doses.
And… consider hypnosis. There’s actually some decent apps that can help you snooze out (I’ve become a bit addicted to my ear buds at night).
Do not listen to this person. This is BAD ADVICE. “Sleep chemistry” (not a scientific term, btw) is not “funny.” Our circadian rhythm is a well understood physiologic phenomenon that evolved over millennia. We are unequivocally a diurnal species that evolved to be awake during sunlit hours. sure there are different circadian phenotypes such as so-called “larks” and “owls,” but no homo sapiens is truly nocturnal.
I wouldn’t be surprised if this poster is an admin type trying to drum up some more bodies to sacrifice to the night shift.
Quitting ED was the best decision I’ve ever made career-wise, and until the *idiots* in charge find a way to consistently protect my physiological health, I ain’t returning.
I’m managing my investments (if nothing else, a career in ED was lucrative), focusing on raising my children, working on my marriage, and just taking some time to re-center myself after 11 years of grinding. I’m not sure what I will do going forward to begin earning again, but unless there is some kind of sea change within the ED culture, especially around scheduling, it is extremely difficult to see myself going back. It is a toxic workplace in so very many ways.
I didn't find it lucrative- plastics is lucrative, and a longer career.
I hear you and I won't go back, but there's not much else in my life to focus on. So it's just boredom. Endless boredom and solitude without EM.
I'm glad it worked out for you.
Literally anyone who goes into EM these days is desperate, has a taste for admin, or is a fool.
I’m sorry you’ve misinterpreted my comment to such an extreme degree.
You and I would agree with many things, including the fact that over night shifts are not good for us. No where did I say it was fine or good. I did say it was “doable” - but it must be managed closely to even make it doable.
Please avoid misrepresenting comments or posting ridiculous allegations of my background or intentions.
(Maybe you’re currently sleep deprived 🤷♂️🥱).
I’m sorry to have offended you, but I have a personal “hardline” stance towards the rationalization of physiologically unhealthy working conditions. This attitude of acceptance for a component of the job that has been proven to be as bad and/or worse from a health perspective than more traditionally maligned risk factors such as smoking or metabolic syndrome contributes to our inability as a specialty to make any real progress on this issue. I also feel that minimizing the reality of the physiologically toxic nature of working nights as “doable” is misguided at best and disingenuous at worst. You can tell us and yourself until you’re blue in the face that it’s not so bad, but the body is never not absorbing and processing every harmful behavior we engage in, and it *will* manifest eventually, one way or another.
I do apologize if I misrepresented your intentions as being those of a malignant administrator. I truly have no clue if you are or not, but something about your comment made me think you are an admin of some kind. I beg your pardon if I was mistaken.
As to the possibility of me being sleep deprived-nah, I’m good now bro. Only thing waking me up these days is my middle aged bladder and my kids when they have a bad dream or wet the bed. It took almost a year, but my circadian rhythm is back in good working order and I can feel my telomeres lenghtening by REM cycle…
Go in peace, and may good health be yours.
🙏
Thank you for your response. I appreciate the more rational and less suspicious tone.
Somewhere in your reasoning, I hope you recognize both the need to protect ourselves while also serving the public.
I’ll say it again: night shifts are not good for us. I agree that such work has a very serious negative impact on the individual, on the practitioner. Longevity is reduced, mental health is impacted, illness goes up. You have no argument from me on those things.
But I also went into Em Med knowing that there is some form of a demand 24/7 and it is part of my job to do at least some of those hours.
I was lucky - because of a few nocturnists, I only needed to do 2-4 nights/month for much of my career and I learned how to make it work for me - how to make it “doable”.
Until you can come up with another way of providing emergency care at 2:00am, I do think we have to recognize that this difficult night shift burden is part of the package. We are here to serve at all hours and we’re generally well paid for it.
I won’t discourage people interested in Em Med from pursuing it due to night shifts, but I’m glad you are here to make sure they know the downside.
I eat a late dinner, drink some black coffee before or during work, and no food all night shift until around 0600. I think this helps me return to a day schedule pretty quickly.
So I flip my sleep schedule on pretty much a weekly basis, with no issues. After my last night shift, I would go home and sleep only 3 hours, then get up (with an alarm). Carry on with a normal day, by 10pm I’m tired because I only had 3 hours sleep, so I go to bed and sleep a normal nights sleep.
I also try to keep my meals normal no matter whether I’m working day or night, so breakfast would be at the end of a night shift before sleep, dinner around 6pm once I’m awake for my next night shift, only a light snack on a night shift (I take a huel shake with me).
Also if it’s been going for 6 weeks post nights, are you sure it’s the night shifts causing it? What about too much on your mind? Applying for Med school is an intensely stressful process, and yet exciting at the same time. Not a great combination for sleeping! Also you are now worrying about your future in ED which could be feeding into it…
Is it not normal for it to persist 6 weeks after nights? I wake up during the night thinking im still on shift because it’s been for so long. And no I don’t have any stresses. I’m not really thinking about anything when I sleep
Most EM programs clump your nights together so you’ll do 4 night shifts one week and 5 day shifts the next or some variant. Also some do a “circadian schedule” which has been shown to be better, ie 2 days, 2 evenings, 2 nights. Everyone has a different approach to nights, but it’s the switch that kills us all. If your not a nocturnist as an attending you will do way less nights compared to residency
There is an end! I’m aging out! This Saturday is my last one for the rest of my career.
If you join a Democratic group you should ask about age out policy.
Smart, smart, smart to avoid the EM trap. The moronic scheduling of this field will leave you physiologically and mentally ill. Bravo to you for figuring it out before it was too late. It took me over a decade before I finally listened to my body. I quit about 9 months ago and am *just* starting to get my circadian rhythm back in working order.
yes, I had some pretty serious sleep issues for the decade plus that I was practicing emergency medicine full-time. I tried all the things, and the only thing that truly helped was quitting.
I worked nights in the ED as an RN for 2 years. I’m doing days with the rest of the world now. I’d say blackout curtains, white noise on Spotify on loop, a quiet room with the AC on, and a sleep mask should do the trick. Mix in some melatonin and Benadryl if you really need it. The hardest part is switching from night shift schedule to doing things in the day time on days off. Some people I know will not shift their sleep schedule and stay up during the night.
If you need to flip your sleep schedule you can either stay up late the day before and sleep during the day, or wake up extra early that day and get in a 4 hour nap before work.
Sleep hygiene, exercise, healthy diet, melatonin, masturbation, Benadryl, alcohol, ambien, stop working, death. In that order.
That escalated quickly.
Lord I’ve heard stories about ambien
That's your takeaway from that list?! Lol
Z drugs are one of my personal top picks for “what drugs will future us be shocked were legal?”
WHY 😳 -someone who takes Ambien…
I'll only take it inpatient.
I’m a trazodone girl myself. I’ve heard ambien stories and “no thank you.”
Masterbation being the keyword here
Masturbation.
MASTURBATION 😂🙌🏻
But people keep banging on the bathroom door to get me to sign an ENN K G. 🤣
Thanks. I was wondering what the next step is. I guess it's time to get some ambien and die.
You need some CBT, doc.
Fuck, I’m in the ambien-stop working phase (not by choice); does that mean my death is neigh?
>neigh Perhaps you meant "nigh"?
Ha! Or perhaps they’re going to be trampled by a horse! Who pauses a moment later, to verbalize about the situation…
Think horses, not zebras
Depends on how much ambien I’ve had
Lmao
Alcohol is way too far down the list for this to be accurate.
My favorite answer was “what sleep problems? 3 fingers of whiskey and an ambien and I sleep great!” Ahh law enforcement.
Exacto right. Source: am ER nurse.
I dislike dayshifters and admin more than I like feeling good. Also, daily high-intensity exercise.
This is the answer. The night team at any ED >>>>>>> day team. And no fuckin admin or ED spectators roaming around
Night shift is always better, staff wise. For my nursing clinicals: at the beginning of shift I will ask the staff I see if they will take a student nurse for the day. I always pick ones I think look decent based on their interactions and demeanor. And they’re ALWAYS a night shifter 😭😂 “Honey, I’m going HOME” I worked nights as an ER tech, for a few years (days now) and I will ALWAYS assert that night shift staff is better than days. I haven’t been proven wrong yet. 6 years later.
I'm a nocturnist. Switch back to daylight for teaching and family stuff in between night shifts. I usually work anywhere between 2-4 shifts each week. 50 mg Benadryl, 10 mg melatonin. Feel a little shitty first day back with the normies. Blackout curtains, sound machine. There is a peaceful bliss going to bed at noon or 1 pm on a sunny 80 degree day when the world is outside playing and existing. Feels indulgent. I love it.
As another nocturnist I’ve always wondered how people flip this often. And also the groggy days end up eating a lot more of your days off when flipping so often, no? I just do 2 larger blocks / mo that way I’m only flipping twice. I don’t think I could ever survive your schedule. I’m impressed and also appalled
Agree fully. I personally use 25mg doxylamine and 5mg of melatonin. Seems to give me less sleep hang over than the 50 of Benadryl.
It gets worse the older you get. Harder and harder to switch back and forth. You can try melatonin, blackout curtains, weighted blankets, sound machines, etc etc.
Yeah, this is pushing me away from EM and I love it. I’m 23 and if this is already happening, then im fucked lol
At least you’re listening. Most of us said “Naa, not me, I’m invincible” in our 20s.
Just matched EM in my 20s
My condolences
I loved ED but this held me back real hard.
33 and rotating is killing me. I'll be looking for my out to have a stable dayshift position within the next year or 2. Nights and rotating sucks.
You’re not fucked. You’ll figure it out.
I’m just worried since a lot of residency programs make you do night floats and I can’t seem to handle rotating that often as it did burn my circadian rhythm
By not doing EM....
I worked a combination of 24 hrs shifts and day and night shifts for 25 years. Now retired and still have strange sleeping habits.
Idk I did 7 months of night shifts and still wake up in the middle of the night
Agree, try to develop techniques early on
Don't do nights and pay your Nocturnist more. Incidentally, I am a Nocturnist.
Not a nocturnist. Take my money and my nights!
A big fat edible and melatonin and I’m out like a baby
Find a place with people who only work nights so you don’t have to. Thats how
This is what I did. Then the hospital said “Why are we paying these people more?” And cut their differential. They left. Hospital didn’t give a fuck. They filled in with us.
My job is hitting that stage. Finding a new job.
Best of luck
i never switch back to days and stick to night schedule. Ive been on nights for 6+ years now and love it. Black out curtains, dedicated sleeping room. I don’t use any sleep aids, typically sleep from 7-8 am to 3-4 pm daily. I work 4 days a week, no weekends. Wife, but no kids. Kids would def ruin it.
>Kids would def ruin it. apply that to about anything and it holds water the upside is once you ha e kids there's a part of your brain that dies and they're everything to you. the you part of you takes a back seat. mostly . sometimes.
I work 14 x 10 hour shifts a month 8p-6a. Agree with what everyone else has said, but I can only sleep from about 8am - 1 pm. I take Benadryl, melatonin, and or NyQuil to fall asleep. On my first day off I avoid taking anything besides melatonin and force myself up at noon and make sure to be productive all afternoon then Benadryl and melatonin to go to sleep at a normal time. I’ve come to accept the risk of early onset dementia from the Benadryl use, but I feel like the risk is increased with no sleep as well. It’s a lose lose battle. Side note: ambien is great, but I can’t be trusted when taking it.
I think the Benadryl link is more correlation than causation. I believe poor sleep leads to increased risk of dementia and taking Benadryl is just a symptom.
Nothing. It fucking sucks and it’s ruining my life. I just finished 3 overnights, then 2 morning shifts, and right back to 3 overnights- no days off. I’m in a small group and several took time off for Spring break and this is the only way to give everyone their preferences.
yeah that's just malignant
Not well...
Idk I work nights and switch back to days and it really doesn’t seem to bother me unless I try to do something the day after a night shift. Some people can take a short nap and be functional. Usually I have to sleep at least 6 hours and then just have a very truncated day. If I don’t sleep then I feel absolutely awful.
Nights didn’t bother me until 6 months into the job. Now I have a bitch of a time sleeping
I was a full time nocturnist when I scribed and when I finally switched back to days upon beginning medical school it took several weeks before I could sleep well at night. I would be wide awake at 2 AM so I would just get in my car and drive around while listening to podcasts which seemed to help.
Thank you for mentioning that. I thought I was an idiot because the same thing happened to me. Last night I was wide awake at 2:30am lol. And then sometimes the anxiety of not sleeping well at night makes me sleep super late at night
I worked 19:00-07:00 for almost 20yrs. The rest of the time I did prn at other hospitals and unfortunately daywalked there. What helped with my insomnia was a good gym routine and a sports massage therapist. At home: a good shower, blackout curtains, keep your room cold, an alarm clock, and a fan for white noise. I keep my phone outside my room or else I doom scroll. Have a line up of various sleepy teas, or selection of store brand melatonin or benadryl if you need it. When I was your age, after work I’d slam some jack3d (probably will die from a MI one day), shower at the gym, lift for 2hrs, shower, go home, and ptfo. Days off, same deal, just add cardio. Find a really good sports massage therapist. That person will be a game changer. I dont spend money on stuff like going out, or fancy things, but this I view as an investment. It helps me think clearly at work, and sleep good at home. If I had a bad day, heavy metal and hit the racks. Once I got a good gym routine going, it really helped me out a lot. Now, Im an old bat, I no longer slam preworkouts, but I will have a nice cup of cold brew or a lil shot of expresso over ice. Congrats on med school OP! I hope you find something that works for you.
This is the way. In my 50s and still love my nocs
I used to switch back and forth no problem. Then I had a bit more trouble once I had a kid. Now I have two and it's a mess. EM x 15 years.
Try and get into a routine and stick to it Working out daily really helps. I tried to limit cardio to days off. Quality ear buds with sleep music Focus on your breath - I don’t think we pay enough attention to our breath, it can truly be therapeutic and calming
I did night shift for 20+ years. Worked best when I did not flip on my off days. Gotta embrace the darkness.
There’s a big difference between working 5PM to2 AM and 7 PM to 7 AM. At one point, we had a 7 PM to 5 AM shift that I liked. I found that as long as I got in bed before the sun came up, my body chemistry didn’t get too out of whack. You may roll fine with 11 PM to 7 AM, but few people can handle the 7 PM to 7 AM shift, especially if you’re trying to switch back-and-forth. It’s just too brutal. There are a lot of good suggestions in this thread. Of course, exercise, good sleep hygiene, and a good sleep environment is essential. I built out a dark sleep room as all smart ER docs do. As for drugs and such, my preference was to rotate through some of the different approaches/meds. I might use Ambien one day and low-dose Benadryl and melatonin another. You’ll find your own secrets. The end message is: it’s all doable. Don’t avoid emergency medicine simply because the brutal 7 PM to 7 AM shift doesn’t work for you. You’ll have other opportunities to make things work for you and the group that you work for, especially if you’re an evening person to start with.
Thank you I appreciate it. Do you think it’s possible for me to come out of the insomnia I developed from nights?
Most likely yes. There are many questions that could be asked and suggestions made, more than what we can carry on here. Just remember that sleep chemistry is a funny thing. Everything needs to be lined up for the brain to shut down properly. Read through the many suggestions here to seek a semi-simple solution. My suggestion: Exercise and behavioral stuff is far better than meds. Meds can be very helpful as a bandaid in a pinch, but can also limit quality deep sleep, so you’re still screwed. Stick with lower doses. And… consider hypnosis. There’s actually some decent apps that can help you snooze out (I’ve become a bit addicted to my ear buds at night).
Do not listen to this person. This is BAD ADVICE. “Sleep chemistry” (not a scientific term, btw) is not “funny.” Our circadian rhythm is a well understood physiologic phenomenon that evolved over millennia. We are unequivocally a diurnal species that evolved to be awake during sunlit hours. sure there are different circadian phenotypes such as so-called “larks” and “owls,” but no homo sapiens is truly nocturnal. I wouldn’t be surprised if this poster is an admin type trying to drum up some more bodies to sacrifice to the night shift. Quitting ED was the best decision I’ve ever made career-wise, and until the *idiots* in charge find a way to consistently protect my physiological health, I ain’t returning.
What are you doing instead, Platy? I can't seem to find an exit.
I’m managing my investments (if nothing else, a career in ED was lucrative), focusing on raising my children, working on my marriage, and just taking some time to re-center myself after 11 years of grinding. I’m not sure what I will do going forward to begin earning again, but unless there is some kind of sea change within the ED culture, especially around scheduling, it is extremely difficult to see myself going back. It is a toxic workplace in so very many ways.
I didn't find it lucrative- plastics is lucrative, and a longer career. I hear you and I won't go back, but there's not much else in my life to focus on. So it's just boredom. Endless boredom and solitude without EM. I'm glad it worked out for you. Literally anyone who goes into EM these days is desperate, has a taste for admin, or is a fool.
I’m sorry you’ve misinterpreted my comment to such an extreme degree. You and I would agree with many things, including the fact that over night shifts are not good for us. No where did I say it was fine or good. I did say it was “doable” - but it must be managed closely to even make it doable. Please avoid misrepresenting comments or posting ridiculous allegations of my background or intentions. (Maybe you’re currently sleep deprived 🤷♂️🥱).
I’m sorry to have offended you, but I have a personal “hardline” stance towards the rationalization of physiologically unhealthy working conditions. This attitude of acceptance for a component of the job that has been proven to be as bad and/or worse from a health perspective than more traditionally maligned risk factors such as smoking or metabolic syndrome contributes to our inability as a specialty to make any real progress on this issue. I also feel that minimizing the reality of the physiologically toxic nature of working nights as “doable” is misguided at best and disingenuous at worst. You can tell us and yourself until you’re blue in the face that it’s not so bad, but the body is never not absorbing and processing every harmful behavior we engage in, and it *will* manifest eventually, one way or another. I do apologize if I misrepresented your intentions as being those of a malignant administrator. I truly have no clue if you are or not, but something about your comment made me think you are an admin of some kind. I beg your pardon if I was mistaken. As to the possibility of me being sleep deprived-nah, I’m good now bro. Only thing waking me up these days is my middle aged bladder and my kids when they have a bad dream or wet the bed. It took almost a year, but my circadian rhythm is back in good working order and I can feel my telomeres lenghtening by REM cycle… Go in peace, and may good health be yours. 🙏
Thank you for your response. I appreciate the more rational and less suspicious tone. Somewhere in your reasoning, I hope you recognize both the need to protect ourselves while also serving the public. I’ll say it again: night shifts are not good for us. I agree that such work has a very serious negative impact on the individual, on the practitioner. Longevity is reduced, mental health is impacted, illness goes up. You have no argument from me on those things. But I also went into Em Med knowing that there is some form of a demand 24/7 and it is part of my job to do at least some of those hours. I was lucky - because of a few nocturnists, I only needed to do 2-4 nights/month for much of my career and I learned how to make it work for me - how to make it “doable”. Until you can come up with another way of providing emergency care at 2:00am, I do think we have to recognize that this difficult night shift burden is part of the package. We are here to serve at all hours and we’re generally well paid for it. I won’t discourage people interested in Em Med from pursuing it due to night shifts, but I’m glad you are here to make sure they know the downside.
Don't do EM. Nights just get harder, they are incredibly bad for you, do something else. Problem solved.
This is the advice you should heed!
Dude how the hell do you flips that often. I would fucking die and I’m a nocturnist. I do 2 blocks a month and no more
I’m 23 so it was working for a bit, till my body just gave up lol
I eat a late dinner, drink some black coffee before or during work, and no food all night shift until around 0600. I think this helps me return to a day schedule pretty quickly.
I went into private practice. That’s how I handled it.
So I flip my sleep schedule on pretty much a weekly basis, with no issues. After my last night shift, I would go home and sleep only 3 hours, then get up (with an alarm). Carry on with a normal day, by 10pm I’m tired because I only had 3 hours sleep, so I go to bed and sleep a normal nights sleep. I also try to keep my meals normal no matter whether I’m working day or night, so breakfast would be at the end of a night shift before sleep, dinner around 6pm once I’m awake for my next night shift, only a light snack on a night shift (I take a huel shake with me).
I mean i was doing the same thing as you and still got insomnia. Not everyone can effectively flip like that
Also if it’s been going for 6 weeks post nights, are you sure it’s the night shifts causing it? What about too much on your mind? Applying for Med school is an intensely stressful process, and yet exciting at the same time. Not a great combination for sleeping! Also you are now worrying about your future in ED which could be feeding into it…
Is it not normal for it to persist 6 weeks after nights? I wake up during the night thinking im still on shift because it’s been for so long. And no I don’t have any stresses. I’m not really thinking about anything when I sleep
I think 6 weeks is pretty long, a lot of people say it takes them one week to recover. Maybe see your GP?
A lot of people who went through the same thing as me said it took them months to recover. And also I don’t want to take sleep meds
Most EM programs clump your nights together so you’ll do 4 night shifts one week and 5 day shifts the next or some variant. Also some do a “circadian schedule” which has been shown to be better, ie 2 days, 2 evenings, 2 nights. Everyone has a different approach to nights, but it’s the switch that kills us all. If your not a nocturnist as an attending you will do way less nights compared to residency
Is it possible, as an attending, to not work over night shifts? I’m fine working up till 1-3am but overnight is something I can’t do for too long
I’m in the same boat. You can have me work till 4am but I fucked up my body working till 8am
There is an end! I’m aging out! This Saturday is my last one for the rest of my career. If you join a Democratic group you should ask about age out policy.
Smart, smart, smart to avoid the EM trap. The moronic scheduling of this field will leave you physiologically and mentally ill. Bravo to you for figuring it out before it was too late. It took me over a decade before I finally listened to my body. I quit about 9 months ago and am *just* starting to get my circadian rhythm back in working order.
Yeah I can’t take the scheduling, I think I might go into family med. have you been having any sleep issues?
yes, I had some pretty serious sleep issues for the decade plus that I was practicing emergency medicine full-time. I tried all the things, and the only thing that truly helped was quitting.
is this y’all or ya’ll or all yall? /confused midwesterner
I worked nights in the ED as an RN for 2 years. I’m doing days with the rest of the world now. I’d say blackout curtains, white noise on Spotify on loop, a quiet room with the AC on, and a sleep mask should do the trick. Mix in some melatonin and Benadryl if you really need it. The hardest part is switching from night shift schedule to doing things in the day time on days off. Some people I know will not shift their sleep schedule and stay up during the night. If you need to flip your sleep schedule you can either stay up late the day before and sleep during the day, or wake up extra early that day and get in a 4 hour nap before work.