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

The Consequences of Shift Work by Richard Bukata, MD
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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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#shiftwork #emergencymedicine #physicianstaffing

[@Angel454533]

Nights are still hard on younger workers, too.

[@gowiththeflow.88]

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????

[@bethharvey8272]

They care about profits more than the health of their workers, we are just a number to them and not a human being.

[@seanmurray8051]

People still need treatment overnight so what do you do?

[@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.

[@undignified2843]

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.

[@NazriB]

Lies again? AMWF Chinese

[@oleksua74]

Do you notice any health issues from rotating ?

[@thevally6127]

​@@oleksua74 sleep apnea, I am going through it now

[@CB-ob5vh]

I'm a rotating Respiratory Therapist. I'm only 27years old , and I'm getting an accomodation to only work days. Rotating shift work has messed me up pretty good.

[@Dad_Brad]

Same for me but I was 7pm-7am two weeks then 7am-7pm for two weeks. I was under 30 years old too. Anyways, I hated working days because I didn’t like getting up super early. It’s much more approachable to just stroll into work at 7pm after sleeping all day and feeling relaxed, and then your work shift just seems like you stayed up late at a party. Go home, eat, shower, crash, cash the paycheck.

[@greggae2735]

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.

[@kathysmall6303]

That's what I have. It's rough.

[@bicmitchum1368]

Yeah they shouldn't force ppl to switch back and forth between days , just find ppl like you who like nights and keep them on nights permanently lol

[@greggae2735]

@@bicmitchum1368 What a crazy idea/ concept!

[@eddymontiel4153]

And how long have you been working nights? Cause at first I loved it and now after 5 years I’m sick and tired of it

[@greggae2735]

@@eddymontiel4153 about 5 years as well. Still love it. Some nights are busy, some aren’t. I work at 3 different sites. The variety and the occasional break from busy, ass-kicking shifts also helps.

[@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.

[@stevenedwards7070]

You might be feel alright for now but give it a few years you won't be enjoying it don't think

[@ChiekoGamers]

wait till you hit 40s. humans are not made to sleep on the day

[@Dad_Brad]

You guys are probably right. Luckily I left that job (Georgia Pacific in Muskogee, Oklahoma) when I was 29 after a little under 6 years. That was in 2011 so I’m probably looking back with rose colored glasses too.

[@Melanie3581]

I agree I been doing it 20 years it takes a toll

[@ian837]

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

[@easyreader66]

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

[@oleksua74]

No wonder, the best sleep aid is to sleep at the same time

[@benconnolly4258]

I called sick today I was down for a 12hr early shift (airport worker) 0330am 1530pm, went to bed at 2000pm by 0200am still wide awake and thought, 👎 I can't come in today 😢. I think I need to look for a new job

[@just.play1ng]

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

[@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!

[@kathysmall6303]

Should I send this to management?? 🤣

[@greggae2735]

Send it on a note with a push pin, I know just where to stick it!

[@JGG1701]

Do you think they would care?

[@Shannon_Robbie]

I'd take night shift over rotating shifts!

[@seanmurray8051]

I do rotating shifts including nights. Have for 19 years. I'm done in by it. Time to change career.

[@gerdachristophe3953]

I have to quit

[@AndreTheGiantDuran]

How'd it go?

[@normantheforeman9866]

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

[@teresgregory9389]

As an EMT or Paramedic look at jobs in the hospital such as ER tech that will get you out of shift work. I’m telling you all that shift changing will cause havoc on your body.

[@jasoncardwell6849]

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.

[@antonSCORCHIN86]

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

[@Vegas.-]

Its shit jobs, Ive done it fews years. Prefer be paying less than sacrifices years of my life for a company

[@AndreTheGiantDuran]

I'm in a dilemma. $20/hr for 10-12 hour day shift with company van and tools provided, Sunday thru Thursday or $38/hr 10 hr night shifts 7pm to 530am Monday thru Thursday.

[@Vegas.-]

@@AndreTheGiantDuran Its up to you bro, I know money its very important for living. From my experience I feel more happy to work during the day, and I am way more healthier than before But your job is a good pay indeed, do it maybe for few times but not your entire one.

[@benconnolly4258]

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

[@JamesGerzon]

DISAGREE!!! - I've turned down days for years because I hate it. Every time I did work days my health greatly declined and nights are great! Now, flip the narrative and use a real shift schedule that will hurt, and that is rotating shift. Now that's a bad shift, Six days days 2off, six days afternoons 2off, and six days nights 2off, and go figure that it only got better when we went against the experts and changed it to days/afternoons/nights.

[@JamesGerzon]

Correction - That's days/nights/afternoons.

[@ENStranger]

I guess they should close the ER every night.

[@greggae2735]

Who wants to be a director?! Eff dat noise!

[@greggae2735]

Bizz-buzz…

[@CCSABCD]

Funny how he is talking about how hard this style of life is, yet he still makes fun of regular day work, pretty hypocritical