The Consequences of Shift Work | The EM & Acute Care Course

The Consequences of Shift Work by Richard Bukata, MD

KEY POINTS AND RECOMMENDATIONS

1. Although night shift work can have multiple negative effects on everyone, some clinicians are more prone to problems than others and physicians over 50 are particularly at risk.

2. A litany of diseases has been associated with night shift work – however, it would be very difficult to determine causality.

3. Clinical studies have measured a large number of physiologic derangements during night shift work.

4. A link between night shift work and all-cause mortality is particularly distressing.

5. Shift work sleep disorder

6. Falling asleep while driving after a night shift may be interpreted as culpable behavior in the event of an MVA that injures others.

7. Modafinil improves cognitive performance and alertness in sleep-deprived physicians – perhaps even physicians who are not sleep deprived might consider taking it.

8. Melatonin does not promote daytime sleep.

9. Physicians clearly prefer shorter shifts during the night (8-10 hours), but even shorter shifts are reasonable.

10. In general, doing a block of night shifts is a painful way to deal with the night shift burden. Most recommend intermittent night shifts.

11. Casino shift scheduling allows anchor sleep to be achieved by all clinicians – but appears to be a radical departure from current staffing patterns.

12. There are a large number of steps that clinicians can take to mitigate the effects of night shift work in their own lives.

13. To optimize EM clinical careers it is prudent for ED groups to thoughtfully and actively address the negative effects of night shift work in order to optimize the careers of its members.

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[ctropic]

Not having to set my alarm for anything or anyone, feels so good! 😊

[Angel]

Nights are still hard on younger workers, too.

[gowiththeflow.]

With all these research and publications about the devastating effects of sleep deprivation and the medical professionals, why is the healthcare system not doing anything about this????

[ctropic]

I love having the freedom to sleep and get up when I WANT. imagine having to work your WHOLE life 😢

[KrispyLifeBray]

I tried working nights for a week and a half and I felt like I was gonna die. Even when I was able too get a good amount of sleep the effects still lasted. And I would consider myself a night owl.

[undignified]

Night shift seems a blessing for me when I work rotations, 5a-5p 2 weeks and then 5p-5a.... over 15 years and I can tell you; YOU NEVER GET USED TO IT.

[Dad_Brad]

I absolutely loved the 7pm-7am night shift work life. Sunlight literally made me sleepy, and the darkness turned me on and woke me up, including my days off.

[greggae]

I am nocturnist, I absolutely love it. No administration!

The real issue is switching back and forth between day and night shifts and the turn and burn.

[ian]

At first glance I thought the title read “Consequences of shit work.”

[just.playng]

As an IT support working night shift remotely, it really does get lonely. The darkness outside consumes you.

[jasoncardwell]

I'm a nurse and I have worked nights for a year now and I sleep just fine. In fact, the only time I crashed was after a long day shift.

[easyreader]

My issue is I work one day shift, two evening shift, and 3 night shifts every week. Plus I have insomnia and often wake up after 3 hours of sleep

[MelModica]

Night shift is great when you can work alone but over time it will catch up with you and lack of sunlight can cause vitamin D deficiency which can become very serious!

[ctropic]

Not something I need to be concerned about. Thank god!

[danielclark]

I work 2PM to 10:30PM but Ive also work on 3PM to 11:00 PM on the railroad for 3 years and sometimes double so 16 hours. Let me tell you that a shitty deal and it has definitely caught up. There definitely has been some nights were driving home is rough but I tell meself gotta get home to my wife and dogs.

[normantheforeman]

My shifts are different each week as a new paramedic. One time they scheduled me Monday night, then days Wednesday and Thursday that same week. I regret my job choice. I think I’d be better off having a typical full time job and just helping on the ambulance when I can

[Shannon_Robbie]

I'd take night shift over rotating shifts!

[antonSCORCHIN]

I wonder if he did a night shift the night before he did this conference

[benconnolly]

Does work starting am 3am class as a night shift ????

[ctropic]

He looks like he has worked a few night shifts !