Just the other day, someone asked me how long I have been working night shifts in the Emergency Department. The question made me think about the amazing way in which time has flown by and that my stint doing the night shift has been for about 13 years. That is just a little more than the lifetime of our oldest cherub, at ten years old. The follow-up question, is inevitable: How do you do it?

When I got finished with residency in Emergency Medicine and started as a new attending with my group, I was fine with doing all the shifts. At the time, I rarely did night shifts because there were dedicated nocturnists or night shift only physicians. It became clear to me that I was not as flexible with the rapid switching that comes with a day and afternoon schedule so I started to inquire about the night shift.

After one year of bouncing around with the seemingly unpredictable day and afternoon schedule, I choose to dive into the night shift life. My group values physicians who choose to do night shifts exclusively and provide a shift and pay differential. Both of these we appealing but the most appealing aspect of going to all nights was having control over the schedule. This, in my opinion, is priceless!

Making the Shift to Night Shift

Before making the shift, I was not sure if the night shift lifestyle would be a great fit. Thankfully, it has been and has turned out to have many benefits not originally anticipated or appreciated. Working nights has allowed me to be available for our three cherubs and their activities. Often, I was one of the few moms in the local mom meetup groups who also had a full-time job. Honestly, I can think of one other mom in our local meetup group who had a job and she was a pilot who worked nights as well. As we outgrew meetup groups, working nights facilitated my participation in their myriad of extracurricular activities. By happenstance or perhaps destiny, we became accidental homeschoolers when our oldest had a difficult experience in preschool. Working nights has allowed me to help out with the education of our three cherubs as well as be actively involved in their personal development.

The patient population that comes to the Emergency Department at night are usually high acuity and often have interesting pathology. For some reason, when my nonagenarians have a crisis they have it at night when they get up to go to the bathroom. Or the illness that the parents have been working on all afternoon by appropriately giving their cherub Motrin has worsened and the pediatrician’s office is not open at 2 am. Then there is occasional elder patient who went to bed normal and woke up at 3 or 4 am with limb pain only to find that the limb is ice cold and pale. At night, there is no paucity of trauma cases to care for. In the situation where we are faced with multiple simultaneous trauma patients, our team goes into high gear and we come together to care for patients in need despite limited personnel. Somehow, we make miracles happen and true teamwork is demonstrated as we get the job done.

Four Reasons For Choosing The Night Shift Life

1. Differential. The night shift comes with a differential because the majority of the world would rather sleep at night instead of work. Given this fact, it is well understood that offering a differential is an incentive to get people to do the night shift and to keep them doing it. The differential can be monetary or a shift reduction.

2. Not a morning person. There is definitely a subset of the population that prefers to not be up and at work at the crack of dawn and would much rather come in later. Clearly, there must be something innate that drives us night owls to be wide awake and highly functional at night.

3. Family. Working nights affords parents to be able to attend evening events for their cherubs and to essentially be like a stay at home parent on off nights. Some have their family life set up where they provide childcare during the day and work at night.

4. Schedule Flexibility. Many night jobs allow for control over the schedule. For me, I get to make my own schedule which is such a precious thing when you have three cherubs working the night shift can sometimes be the only way to get in schooling. Whether you are homeschooling or getting a degree, this is the reality for some night shifters.

On the flip side, there are those in the rest of the world that don’t understand that you are asleep at noon and don’t wish to field a phone call or answer the doorbell. Over the years, and due to much effort on my part, those who are close to me understand my flipped schedule and have been trained to contact me in the evening hours if there is any uncertainty in regards to whether or not I worked the previous night. Our cherubs are well aware to leave mommy alone so that she can sleep post night shift. Fact: they get mommy in the evening on work nights and all day long on off nights.

Over the years, I have learned the optimal conditions for me to get solid REM sleep post night shifts, stay in shape and eat healthy foods while working nights. Staying healthy, getting exercise and eating well makes all the difference in making sure that longevity is maintained as a nocturnist.

Dr Charmine Gregory is a Nocturnist Emergency Physician, mother of three, speaker, podcaster and wellness champion who practices in SE Michigan. She is a co-author of The Chronicles of Women in White Coats and the podcast host of the Women in White Coats Podcast. She can be followed on IG @ffwcharmaine, twitter @CharmsFitDoc and LinkedIn @ Charmaine Gregory MD

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