The older you get, the harder it is ......
The most important aspect of switching shifts is to always have them
progress forward, i.e., days -> pm -> overnight -> days .....
The longer you can stay on any single shift, even if it is nights, the
better it is for your sleep pattern ... but that means you will go through
protracted periods of not being available either to your family or to your
non-clinical ED duties ... it therefore takes a very supportive work and
home environment ... police and fire departments may have it right rotating
to a single shift for a full month
The alternative, if you can do it, is one shift of each, and then a bunch
of time off (i.e., 1 day, 1 pm, 1 overnight, 3 days off, repeat) ... and
try to keep your clock on a "normal" daytime rhythm.
I have found I've done best with a bedroom without windows, away from the
normal activity in my home, and with a "white noise" machine or small fan
to cover all extraneous sounds ... In one home we painted the windows black
and used curtains for the aesthetics ...
Having done 24, 16, 12, 10 and 8 hour shift schedules over a 20 year
career, it frankly is less stressful to your family to work shorter shifts
more frequently. You can, at times, get non-clinical work done on the off
hours ... and see them, too.
Drugs for sleep only work for a limited time. I have seen too many people
get into trouble with long term use ... Stay away! Even the much touted
melatonin only seems to work to readjust your clock to a new, long term,
time zone ... not for shift switching ... same thing for bright lights,
although the data is more interesting ...
The ideal set-up for academic advancement, however, is to have a large
group of young non-academic types doing the nights ... this flies in the
face of who we really want to see kids (moonlighters vs PEM docs) and why
we went into the field ...
The bottom line is there is no ideal schedule, only ones that are more
livable ... we chose this career path because we love what we do and think
we can have an impact ... other medical specialties have their own
negatives, and I wouldn't want them.
Let's see what others have to say ... / Kermit
Steven Lelyveld, M.D.
Associate Professor of Pediatrics and Medicine
Director, Pediatric Emergency Medicine
University of Chicago Children's Hospital
5841 South Maryland - m/c 0810
Chicago, Illinois 60637
(773)702-9087 or (773)753-1880 pager#9333
Fax (773) 702-0414
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