By Patti Van Leer, MD
The good news is that there are ways to combat the evils of night shifts. A few suggestions are listed here, but we’d love to hear from you about the methods that work for you.
This one seems obvious, but sleep needs to be a priority. The day after an overnight is not the best time to have your cleaning lady running the vacuum in every room of your house. Don’t schedule a meeting in the middle of your daytime sleep and assume “I’ll be ok.” Be selfish with your sleep! Let family and friends know that you are out of commission until a certain time and request that they avoid texting or calling during your sleep times. ACEP President Jay Kaplan, MD, FACEP, recommends setting an alarm to remind you when you need to go to sleep.
Our bodies want to sleep when it is dark. Create a dark place for daytime sleeping. Think about installing black out shades on your windows to create nighttime. One overnight attending in the Bronx wears blackout goggles on his way home from work to avoid seeing the bright sun and throwing off his sleep cycle. (Just to paint a picture, he is a 6’5” man riding the subway home during morning rush hour in a hooded sweatshirt and black, metal goggles.)
A schedule that bounces from day to night then night to day without a second to breathe is going to be hard for anyone. Ask your scheduler if it is possible to group your night shifts together instead of putting night shifts randomly throughout the month.
Talk to Your Boss
It is possible that some people just can’t do night shifts. One emergency medicine program just implemented a policy wherein employees do not have to do nights in the third trimester of their pregnancy. Many hospitals do not require physicians over a certain age to do night shifts. Other medical and psychiatric conditions are also likely affected harder by overnights, for example, seizure disorders or depression. Does your practice have specific guidelines for who is not required to work night shifts? Perhaps you should.
The reality of emergency medicine is that night shifts are not going to disappear. Further, most hospitals are trying to make money 24/7 and not just during weekday, business hours, which will lead more and more people to work non-traditional hours in the future. We will need to know how to treat this disorder not just for ourselves but also for our patients.