Life as a Hospital ‘Nocturnist’

As the sun sets, a portion of the medical team awakens. They’re not vampires, even if they have to suck up strange vials of blood. These night creatures spend their traditional sleeping hours practicing medicine.

Nocturners, also known as night hospitalists, work night shifts in inpatient hospitals and emergency departments, usually from 6:00 or 7:00 pm to 6:00 or 7:00 am.

Long working hours and sleep deprivation are nothing new for hospital doctors, but it may seem counterintuitive for medical professionals to solve this problem. Choose A path that disrupts sleep and eating schedules while providing limited resources at work. At night, hospitals are often stripped down to the bone marrow. Fewer patients and visitors, fewer staff and fewer departments open. The hall tends to be empty and is lit only by fluorescent lights.

It’s part of the appeal. And some say the benefits, including higher wages, make the unorthodox environment and time not only worth it, but desirable.

“In my opinion, the hospital is stunningly beautiful at night,” said Dr. Nina Lam, a family doctor who occasionally works the night shift. , it makes treating real patients a lot easier, sometimes it hurts my back because these departments are closed and not providing all the services that patients need, but for me are better at patient care with less caregiver distraction.”

Reasons for hiring night shifts

In 2011, Washington Post He detailed the emergence of “a new class of subspecialists called ‘nocturners'”. A 2008 study found that hospitalized patients who experienced cardiac arrest had a higher risk of death during nights and weekends than during the day shift.

A number of similar studies have been conducted, leading to calls for night walkers. A 2020 Survey of Resident Physicians found that 61.3% of respondents who stay up late said that they “always have enough energy to ensure patient safety at night.” monitored”, compared to only 40.5% of respondents who do not stay up late.

Today, there remains a need for experienced medical professionals to work night shifts. Healthcare facilities tend to offer pay increases of 15% on average and encourage doctors to work night shifts.

Of greatest concern is the potential impact of extended nighttime schedules on physician health and lifestyle. “At some point, when health, quality of life, well-being and family stability become a concern for doctors, I think money is no longer an incentive,” Lamb says.

Dr. Charmaine Gregory

Still, some night hikers have found that an evening schedule improves their quality of life. “I wanted to take back control of my life,” said Charmaine Gregory, M.D., an emergency medicine doctor who had been a nocturnal person for 17 years. I started because I wanted to be able to work to live, not the other way around.”

The decision to become a nocturnal is often related to personal needs and lifestyle factors such as stage of life, family responsibilities, and career priorities.

“I recommend it for doctors who are in the early stages of their career, just out of residency, like me,” says Matthew Nguyen, M.D., an internal medicine specialist who has been using nocturnal therapy for two years. I think it’s really good for people in the early stages of becoming a doctor, because [you get to practice] more medicine. His main duties at night are examining patients, preparing orders, and accepting hospital admissions. . At night, it’s strictly practice. ”

that annoying sleep problem

A key point of skepticism about working as a nocturnal is the sleep schedule that comes with it. While trying to get enough sleep, night-wanderers may have to face daytime disturbances such as sunlight, barking dogs, construction noise, and family members or roommates who work opposite schedules.

Dr. Matthew Nguyen

Nguyen finds it easier to sleep during the day, sometimes with the help of aids like melatonin, eye masks and blackout curtains. But he also speaks to a colleague who says his sleep schedule is getting in the way of his family life. “For example, if I go to bed at 10 a.m. and have to pick up my kids from school at 3 p.m., I have to wake up in four or five hours,” he says. I have to.”

But Gregory found that her nocturnal schedule helped her family life. In the past, she was able to homeschool her children and take them on excursions and plays.Now that her children are older and in school, she can attend sports games and after-school activities. can go to “I think being nocturnal really helps with having a family,” she says. “I can do everything a stay-at-home mom traditionally does. I could be there, noon or afternoon.”

Gregory’s job as a nocturnal is facilitated by the fact that she can sleep in a quiet or noisy house. proposes a device that produces white noise to keep bedrooms cool.

Are there any health hazards?

It is important to note that night shift workers have a 25% to 40% higher risk of depression and anxiety, as their sleep and eating schedules can disrupt their circadian rhythms. Nocturnal people often feel forced to adapt their diets to their chaotic sleep schedules, making “midnight snacks” more of a necessity than a novelty.

“When I work at night, I’m not making healthy decisions about my nutrition,” Lam says. When I do, I often go to the vending machine for a snack, which is not my normal practice during the day.”

Both Lam and Nguyen say that planning ahead can limit the negative effects of a nocturnal lifestyle on nutrition. Lam says she’s “most successful” when she prepares meals ahead of time to eat during her shift, and Nguyen also prepares mid-shift meals such as chicken and rice. , suggest that eating only during the day and not at night at all can prevent ‘mood vulnerability’ in night shift workers.

Gregory also points out the importance of drinking plenty of water and intentionally exercising during the night shift. Yes, restroom and stretching breaks are minimized. “Even if it means climbing stairs to another part of the hospital or doing jumping jacks for a few minutes, it can be sedentary, so you need to incorporate movement into your daily routine,” she says. “For me, that’s what hurts you the most. You have to really keep moving and stay active, even though you’re awake at night when other people are asleep.” ”

At times, when it feels like the whole world is squashed into bed, nocturnalists share the understanding that the need for effective medical care never sleeps.

“We tend to be very team-oriented, probably because we have less resources,” says Gregory. “No matter what happens, we can solve the problem and make it work because of it. We have to get it done. We have to figure out a way. That motivational attitude — I love that about night shift workers..”

And when they’re not busy banding together to solve late-night problems, nocturnals may find themselves at peace and quiet.

“Often I’m alone at 4 a.m., wandering the quiet halls of a quiet night,” says Nguyen. “I’m used to it. It’s even weirder to get a shift during the day when the hospital is overcrowded and there’s a lot of chaos and noise. You actually have to wait to use the elevator.”

Molly McGilbert Freelance writer and editor based in Brooklyn.

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