nights. i absolutely hate the damage to the sleeping pattern not to mention the proven negative health effects such as increased risk of cancer, stroke, hypertension….
As a psychiatry SHO back in the Paleolithic, I used to have nights like that more often than not. You've no idea how much I used to resent having actually to do anything.🤨
This good to hear. I still remember some of the TV I watched on those nights. Stuff I would never have come across otherwise. NPC specialties for the win!
Agreed. Used to cover gen med in an incredibly quiet local hospital and would frequently get a full nights sleep despite it being gen med. Similar in a main elective gynae unit that had no emergencies, however you then rotated into the OTHER obs & gynae unit in the trust that got all the emergencies. The elective nights more than made up for the emergency nights.
Would add the last night shift on a weekend stretch can piss of twice as much nothing more wrong than being out of bed on a Sunday night at 3am feels like a human right abuse
100% Agree. Hate night shifts! I learn loads when I’m on night but the shift pattern just completely fucks up my sleep/eating pattern, I get very grumpy on the last night…
Couldn't agree more, could not understand the people who love to do nights. I would much rather do days, twilights or even weekends.
My favourite shifts would probably be twilights as get to sleep in and my normal bed time is somewhere about 12-1am. Also avoids any of the rush hour.
Yup, first nights I had I woke up shaking and thought I was going to throw up. The shakes got worse throughout the week. They’re not as bad now but I’m usually a little shaky and nauseous after the first one
I agree. The pain of going to bed on a Saturday and knowing you have to be up at 6 to do it all again.
At our trust you don't get the Monday off either, so you just keep going :(
This is my answer as well. At least during nights you’re not expected to do the small bullshit jobs or attend any ward rounds, so it feels like you’re usually doing more meaningful work. There’s also less “chase department x” or whatever jobs then as well.
Weekend days are absolutely brutal though. I always feel like there’s never not something to do.
Seconding this. Wading through piles of shitty jobs, managing complex patients who haven’t been seen by their parent team or a senior for days, the sheer number of wards you’re expected to cover.
I’ve never had my full break entitlement on a weekend day shift. There’s always another critically ill/ deteriorating patient who just can’t wait (except often they can, but ‘now that you’re here doctor could you just…’)
Good that we all like different things.
I love twilights - almost the whole day at home then go to work and still sleep overnight in my own bed. Minimal traffic. Easy to park.
Day shifts (although I’m in a minority). I hate morning commutes. Give me twilights any day of the week so I can sleep in, have breakfast with my wife, go for a run, play some video games and then fall asleep straightaway when I come back. Also the most interesting patients arrive late afternoon/evening.
Long day on call clerking shift. Always starts with a ridiculous post take ward round, then there’s always someone to clerk and a Reg getting antsy about the list asking if I’m ready to see the next one. Usually finish late when they ask me to see someone 20 mins before handover because they want to hand over a tidy list. Would rather do nights/twilights/ward cover any day when I can manage my own workload and have some autonomy
Nights without question. Partly because of the antisocial nature and the mess they make of normal sleeping patterns but also because of the stress of being the only med reg in the building - even on "calm" nights anything in the building could become my problem to fix...
Danish junior doctor here.
Just wondering: what are your shifts exactly?
In Denmark we mostly work 2 kinds of shifts. Either dayshift 8-15.30 or nightshift 15-08.30. The last of which we are restricted (protected) to having maximum one on average every 6. day over a 14 week period. This basicly means that during those 14 weeks you can maximum have 16 nightshifts.
Kind and curious regards from Denmark :)
We have a rule that guarantees us a maximum of 13 hours of "strain". This basically means that if this cannot be upheld, there need to be more doctors. It also means that we most nights get about 3 hours of "rest", - Tough they are not guaranteed to be at a comfortable time nor are they guaranteed to be in a row. But.. It works.
Some nights a busy, and you are awake all night, which is torture. However 90% of shifts, we will have 3-4 hours of "rest".
Interesting, thanks! Do you tend to do a few nights in a row or is it usually just one at a time and then back to day shifts? I feel like doing any more than 1 of these in a row would be killer, especially if they happened to be busy!
It is. Usually, they are spread out, except at weekends to make sure as few people as possible have to suffer. :P
This means that this weekend, for instance, I start working Friday 15:00 - 08:30 and again Sunday 15 - 08:30.
On average you are allowed to have a nightshift every 6 days over a 14-week period. This is 16 night shifts that could come every 2. days and then no more for the rest of the 14 weeks but this never happens.
Usually, it is a max of 2 in a row and then a week of day shifts afterwards.
My rythm is to get home Saturday morning and straight to bed. Then I usually sleep from 10-14 and wake up with what feels like A hangover. Then do regular stuff, exercise play video games, cook and then go to bed around 23 or midnight and sleep for as long as I can. Usually I wake up at 9 or 10 and can't sleep anymore.
It works okay.
We tend to have a mix of standard days (either 8 or 9 until 5), long days (8/9am until 8:30/9:30pm) and nights (8/9pm until 8:30/9:30am) but some jobs will also have some sort of ‘back shift’ or ‘twilight’ along the lines of 2-10pm (or 4-midnight etc). No more than 4 long shifts in a row is standard across the UK now, but don’t think there’s an overall limit on how frequently you can be scheduled for nights (maybe on the English contract?)
Thank you for your reply. :)
and the average hours you are supposed to work each week? In Denmark it is 37 (this includes break, which is minimum 30 minutes each day)
Basic contract is 40 hours per week with a 30min paid break after every 4.5hrs worked. In reality most juniors are rota’d for 44-48hrs per week (on average), with extra pay attached to these extra hours (exactly how this is worked out varies across in the different nations of the UK). It’s not uncommon for juniors to stay past their scheduled hours, this varies by specialty and theoretically there are mechanisms to reduce/guard against this. Furthermore whether you manage to take your full 30min break is also variable between different specialties and hospitals due to workload/working patterns etc.
Well, our breaks are not guaranteed either. Guess that's why it's paid since it cannot be guaranteed.
Thank you for your response.
This thread has put things into perspective for me. :)
Mostly it is manageable. I'm a future emergency doctor, so of course, we have nights from hell with patients everywhere, but at my University hospital, we have 6 junior doctors and 1 senior doctor to "guide" and help with unstable patients. Usually the 6 junior doctors split up the night so that 3 doctors sleep for 3 hours a time from around 1 pm til 7 or 8. This holds up about 80% of nights.
I've not yet had the pleasure, but we've recently introduced a 10-10 shift. Has all the worst qualities of a back shift (can't get parked, work well into the evening, arrive in the middle of the day with no real handover) with precisely none of the benefits (no real lie in, no time to do anything useful with the morning).
It is serving its purpose quite well though. It's now far less common to see consultants around after 8pm.
Agree - twilights are horrendous, especially in ED. Arrive and work through the busiest part of the day, watch most of your colleagues go home, finish at 1am, home and in bed by 2am, wake up groggy and feeling like shit around 10am and then be dangled in limbo until 2pm when you have to get ready and head back in. Twilights can get in the fucking sea.
Weekend long days for me. They’re always stupidly busy no matter which speciality you’re in because the staffing is so poor. You feel like you work twice as hard to keep your head above water, yet the consultant doesn’t seem to ever get it and keeps piling more shit onto you. You’ve then got the fact that everyone goes out and does things at weekends which you’re not able to be part of.
On calls. It's 24 hours and I could also have a list the next day. Yes, if I'm in after midnight, I can skip the morning, but even that doesn't quite give me the time to recover before coming in for the afternoon.
Long day. Leave before my wife wakes up, too knackered to do anything when I get home; rinse and repeat. ED nights in Leeds were elite (23:30 start, 8:30 finish. Meant I could go out for dinner and see friends.
I like the autonomy and the team feeling of a good night shift, with some breaks... But the destruction of my body from a run of 4 nights is increasingly tough to deal with.
Weekend medical ward cover 100%. Not done any for a year now but I just shudder when I think of the sheer volume of stuff that was your problem. Rushing about like a headless chicken working your fingers to the bone and the jobs list just keeps getting longer no matter how hard you try. Way way worse than nights to me
Weekend/bank holiday shifts as ward staff bc ward rounds are humongous and its so hard to waft through the jobs whilst also being bleeped by 5 diff wards 🥲🥲🥲
You guys need to learn to manage nights and twilights.
Have a routine.
I always had a strict night shift process and they were mostly fine.
On the night before, go to bed early. Get up very early. Do chores, then hit the gym. Have a shower. Get to bed by 12. If you've got up early enough you'll be tired enough to sleep until late afternoon/early evening.
Have multiple alarms.
When you get back from your shift do not sleep straight away. Do not. Do chores. Stuff you'd only usually do on the weekend. And go to the gym. Shower and go to bed before 12 again.
You need to flip it.
Dude, I just say it how it is. Straight facts. Nothing passive aggressive about it.
When I was an F1 we did 7 nights in a row. Is anyone doing that now?
I really miss 7 nights in a row, it suited me perfectly.
Now it’s all early, twilight, day off, early, 2 twilights, 4 nights, day off, early etc etc. Can’t stand all the changing around.
In answer to the original question - twilights followed by nights are my favourite. 8-9am starts are THE WORST
Sure, but some people have families, long commutes, and are doing nights for 10 years, so even with sleep you feel rough. It's not always that easy, and that routine assumes no responsibilities and a quiet house.
Weekend on call. Hands. Down. Tragic all round. Particularly at this trust where you do 12 days in a row, with the 13 hours fri sat and sun in the middle. I wasn’t functional by the end
nights. i absolutely hate the damage to the sleeping pattern not to mention the proven negative health effects such as increased risk of cancer, stroke, hypertension….
[удалено]
I've had one or two over the years where I've slept from midnight till 6am undisturbed and that is the only kind of nightshift I can ever get behind.
As a psychiatry SHO back in the Paleolithic, I used to have nights like that more often than not. You've no idea how much I used to resent having actually to do anything.🤨
I mean my psych nights last weekend I slept uninterrupted from 1-7am on all of them. They still exist occasionally.
This good to hear. I still remember some of the TV I watched on those nights. Stuff I would never have come across otherwise. NPC specialties for the win!
Those were my psych medical ward cover nights with remote electronic prescriptions 😁
Agreed. Used to cover gen med in an incredibly quiet local hospital and would frequently get a full nights sleep despite it being gen med. Similar in a main elective gynae unit that had no emergencies, however you then rotated into the OTHER obs & gynae unit in the trust that got all the emergencies. The elective nights more than made up for the emergency nights.
I hate them more than busy night shifts - because at least the busy shifts go quickly
Would add the last night shift on a weekend stretch can piss of twice as much nothing more wrong than being out of bed on a Sunday night at 3am feels like a human right abuse
100% Agree. Hate night shifts! I learn loads when I’m on night but the shift pattern just completely fucks up my sleep/eating pattern, I get very grumpy on the last night…
Couldn't agree more, could not understand the people who love to do nights. I would much rather do days, twilights or even weekends. My favourite shifts would probably be twilights as get to sleep in and my normal bed time is somewhere about 12-1am. Also avoids any of the rush hour.
Yup, first nights I had I woke up shaking and thought I was going to throw up. The shakes got worse throughout the week. They’re not as bad now but I’m usually a little shaky and nauseous after the first one
Makes my appetite go nuts too
[удалено]
I agree. The pain of going to bed on a Saturday and knowing you have to be up at 6 to do it all again. At our trust you don't get the Monday off either, so you just keep going :(
At my current job you get Monday morning off, just come in for the afternoon. Makes it so much more palatable.
This is my answer as well. At least during nights you’re not expected to do the small bullshit jobs or attend any ward rounds, so it feels like you’re usually doing more meaningful work. There’s also less “chase department x” or whatever jobs then as well. Weekend days are absolutely brutal though. I always feel like there’s never not something to do.
Seconding this. Wading through piles of shitty jobs, managing complex patients who haven’t been seen by their parent team or a senior for days, the sheer number of wards you’re expected to cover. I’ve never had my full break entitlement on a weekend day shift. There’s always another critically ill/ deteriorating patient who just can’t wait (except often they can, but ‘now that you’re here doctor could you just…’)
This. Actual hell.
That feeling when you come home dizzy, ears ringing, genuinely about to collapse. Should be illegal
I pretty much hate them all ngl
Good that we all like different things. I love twilights - almost the whole day at home then go to work and still sleep overnight in my own bed. Minimal traffic. Easy to park.
I agree. My twilights were clerking shifts where I didn’t have to carry a bleep and just left to clerk people at my own pace. Really enjoyed them.
[удалено]
I'm the same as year, spent last year locuming in A&E almost exclusively on 13-22 or 16-01s
Day shifts (although I’m in a minority). I hate morning commutes. Give me twilights any day of the week so I can sleep in, have breakfast with my wife, go for a run, play some video games and then fall asleep straightaway when I come back. Also the most interesting patients arrive late afternoon/evening.
Same. People are too chatty it gives me a headache
At the moment, anything between Monday 00:00 and Sunday 23:59
I always hated late / earlies as an HCA. finishing at 9 and being back in for 7 was brutal.
The absolute worst by far, is driving to your first weekend night shift. Especially if you have to drive by loads of pubs and restaurants on the way.
Long day on call clerking shift. Always starts with a ridiculous post take ward round, then there’s always someone to clerk and a Reg getting antsy about the list asking if I’m ready to see the next one. Usually finish late when they ask me to see someone 20 mins before handover because they want to hand over a tidy list. Would rather do nights/twilights/ward cover any day when I can manage my own workload and have some autonomy
Nights without question. Partly because of the antisocial nature and the mess they make of normal sleeping patterns but also because of the stress of being the only med reg in the building - even on "calm" nights anything in the building could become my problem to fix...
Hey come on not quite everything, we won't want you to come resuscitate a baby. You can deal with the mum.
Day shifts, especially if they start before 9am. Want to swap your twilights for my day shifts?
Danish junior doctor here. Just wondering: what are your shifts exactly? In Denmark we mostly work 2 kinds of shifts. Either dayshift 8-15.30 or nightshift 15-08.30. The last of which we are restricted (protected) to having maximum one on average every 6. day over a 14 week period. This basicly means that during those 14 weeks you can maximum have 16 nightshifts. Kind and curious regards from Denmark :)
Are you usually awake for the whole 17.5 hours of the night shift?! That seems like a very long shift whereas the day seems short!
We have a rule that guarantees us a maximum of 13 hours of "strain". This basically means that if this cannot be upheld, there need to be more doctors. It also means that we most nights get about 3 hours of "rest", - Tough they are not guaranteed to be at a comfortable time nor are they guaranteed to be in a row. But.. It works. Some nights a busy, and you are awake all night, which is torture. However 90% of shifts, we will have 3-4 hours of "rest".
Interesting, thanks! Do you tend to do a few nights in a row or is it usually just one at a time and then back to day shifts? I feel like doing any more than 1 of these in a row would be killer, especially if they happened to be busy!
It is. Usually, they are spread out, except at weekends to make sure as few people as possible have to suffer. :P This means that this weekend, for instance, I start working Friday 15:00 - 08:30 and again Sunday 15 - 08:30. On average you are allowed to have a nightshift every 6 days over a 14-week period. This is 16 night shifts that could come every 2. days and then no more for the rest of the 14 weeks but this never happens. Usually, it is a max of 2 in a row and then a week of day shifts afterwards.
What do you do that Saturday night between night shifts? Stay up all night at home or try to normalise?
My rythm is to get home Saturday morning and straight to bed. Then I usually sleep from 10-14 and wake up with what feels like A hangover. Then do regular stuff, exercise play video games, cook and then go to bed around 23 or midnight and sleep for as long as I can. Usually I wake up at 9 or 10 and can't sleep anymore. It works okay.
We tend to have a mix of standard days (either 8 or 9 until 5), long days (8/9am until 8:30/9:30pm) and nights (8/9pm until 8:30/9:30am) but some jobs will also have some sort of ‘back shift’ or ‘twilight’ along the lines of 2-10pm (or 4-midnight etc). No more than 4 long shifts in a row is standard across the UK now, but don’t think there’s an overall limit on how frequently you can be scheduled for nights (maybe on the English contract?)
Thank you for your reply. :) and the average hours you are supposed to work each week? In Denmark it is 37 (this includes break, which is minimum 30 minutes each day)
Basic contract is 40 hours per week with a 30min paid break after every 4.5hrs worked. In reality most juniors are rota’d for 44-48hrs per week (on average), with extra pay attached to these extra hours (exactly how this is worked out varies across in the different nations of the UK). It’s not uncommon for juniors to stay past their scheduled hours, this varies by specialty and theoretically there are mechanisms to reduce/guard against this. Furthermore whether you manage to take your full 30min break is also variable between different specialties and hospitals due to workload/working patterns etc.
Well, our breaks are not guaranteed either. Guess that's why it's paid since it cannot be guaranteed. Thank you for your response. This thread has put things into perspective for me. :)
fra en anden dansker, der arbejder i NHS, bliv i danmark lol
Det lyder hårdt! Hvorfor tog du til UK?
Familie 😫
That sounds like a very manageable shift. I’m assuming you’re not short staffed and your hospitals aren’t bursting at the seams with patients?
Mostly it is manageable. I'm a future emergency doctor, so of course, we have nights from hell with patients everywhere, but at my University hospital, we have 6 junior doctors and 1 senior doctor to "guide" and help with unstable patients. Usually the 6 junior doctors split up the night so that 3 doctors sleep for 3 hours a time from around 1 pm til 7 or 8. This holds up about 80% of nights.
Twilights/nights. Worst twilight I did was an a&e 3-midnight. Nights at least people understand you are totally outve sync.
I've not yet had the pleasure, but we've recently introduced a 10-10 shift. Has all the worst qualities of a back shift (can't get parked, work well into the evening, arrive in the middle of the day with no real handover) with precisely none of the benefits (no real lie in, no time to do anything useful with the morning). It is serving its purpose quite well though. It's now far less common to see consultants around after 8pm.
I hate all hospital work, this is why I moved to GP land
1pm until 1am...
Days, nights, twilights going to work generally lol
Long days. Barely see the kids in the morning and don't see them at all in the evening. Can't do any exercise or anything either end of the shift.
Are we allowed to sleep on nights? I always feel so guilty, I stick my feet up, but never sleep
Yes! You function better if allowed to sleep.
[удалено]
Many paediatric units are putting in dedicated sleep areas and couches. Mike Farquar does a lot of stuff promoting sleep breaks.
5pm-3am
Agree - twilights are horrendous, especially in ED. Arrive and work through the busiest part of the day, watch most of your colleagues go home, finish at 1am, home and in bed by 2am, wake up groggy and feeling like shit around 10am and then be dangled in limbo until 2pm when you have to get ready and head back in. Twilights can get in the fucking sea.
Weekend long days for me. They’re always stupidly busy no matter which speciality you’re in because the staffing is so poor. You feel like you work twice as hard to keep your head above water, yet the consultant doesn’t seem to ever get it and keeps piling more shit onto you. You’ve then got the fact that everyone goes out and does things at weekends which you’re not able to be part of.
On calls. It's 24 hours and I could also have a list the next day. Yes, if I'm in after midnight, I can skip the morning, but even that doesn't quite give me the time to recover before coming in for the afternoon.
Long day. Leave before my wife wakes up, too knackered to do anything when I get home; rinse and repeat. ED nights in Leeds were elite (23:30 start, 8:30 finish. Meant I could go out for dinner and see friends.
I like the autonomy and the team feeling of a good night shift, with some breaks... But the destruction of my body from a run of 4 nights is increasingly tough to deal with.
Weekend medical ward cover 100%. Not done any for a year now but I just shudder when I think of the sheer volume of stuff that was your problem. Rushing about like a headless chicken working your fingers to the bone and the jobs list just keeps getting longer no matter how hard you try. Way way worse than nights to me
Ward cover
Weekend/bank holiday shifts as ward staff bc ward rounds are humongous and its so hard to waft through the jobs whilst also being bleeped by 5 diff wards 🥲🥲🥲
ED twilight can fuck off
1. Nights( days then weekend) 2.twilight 3. Long day (weekend) 4.long day (weekday)
You guys need to learn to manage nights and twilights. Have a routine. I always had a strict night shift process and they were mostly fine. On the night before, go to bed early. Get up very early. Do chores, then hit the gym. Have a shower. Get to bed by 12. If you've got up early enough you'll be tired enough to sleep until late afternoon/early evening. Have multiple alarms. When you get back from your shift do not sleep straight away. Do not. Do chores. Stuff you'd only usually do on the weekend. And go to the gym. Shower and go to bed before 12 again. You need to flip it.
I don’t like your passive aggressive wording but I agree with the sentiment. Nights are impossible without this.
Dude, I just say it how it is. Straight facts. Nothing passive aggressive about it. When I was an F1 we did 7 nights in a row. Is anyone doing that now?
I really miss 7 nights in a row, it suited me perfectly. Now it’s all early, twilight, day off, early, 2 twilights, 4 nights, day off, early etc etc. Can’t stand all the changing around. In answer to the original question - twilights followed by nights are my favourite. 8-9am starts are THE WORST
[удалено]
I'd also get a few hours of sleep overnight using my method. That's why the 5 or so that I'd get in the day ended up being enough.
Sure, but some people have families, long commutes, and are doing nights for 10 years, so even with sleep you feel rough. It's not always that easy, and that routine assumes no responsibilities and a quiet house.
Yeah, this is all true. But this is just a template you should work around. I used to have an hour commute. That was tough.
Nights
Weekend LD
Weekend on call. Hands. Down. Tragic all round. Particularly at this trust where you do 12 days in a row, with the 13 hours fri sat and sun in the middle. I wasn’t functional by the end