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Doctor, Is Working the Graveyard Shift Killing You?

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Sep 30, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    I recently met up with my friend, an anesthesiologist, who said: “Ever since I turned 40, an overnight call is getting tougher and tougher to recover from”. Speaking with other colleagues and friends, I have found the 40-year-old mark to be a common age when people begin to notice the toll on their bodies from overnight work.

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    Bottom line: Call/overnight work is harmful to your health! But somebody has to do it.

    Humans are not nocturnal creatures. Overnight work is unnatural for humans, but the work is a necessity in our modern 24/7 world, especially in the hospital setting.

    There is increasing evidence that overnight work has harmful effects on “virtually every system in the body”. The long-term health toll can be devasting including obesity, Type 2 diabetes, cardiac disease, increased risk of cancer, depression, burn-out….and the list goes on.

    Every night shift you work, your body is taking an internal beating. Your life energy is being depleted faster than normally. At the age of 40, you only have about 16,425 remaining days on Earth (assuming life expectancy to age 85). Night shift is a thief silently robbing a disproportionate amount of your remaining days.

    Don’t fall into the trap of thinking sleep loss is a badge of honour, which is prevalent in the medical training environment. It is not a sign of weakness when your body is telling you it needs to sleep.

    One of the world’s least valuable clichés is that you can sleep when you die. Much truer is: If you don’t sleep, you will die — sooner.
    NY Times

    Can anything be done? Should you resign to living a shorter life-span due to overnight shifts?

    Here are my tips for preventing overnight shifts from slowly killing you:

    1. As a medical student, find out about the call/overnight shift requirements for different specialties. If you are equally interested in 2 specialties, then choose the one with the least amount of call/overnight shifts. Better yet, choose a specialty or family medicine with no overnight shifts, assuming you are interested.
    2. If you are in a specialty with onerous call/night shifts, then obtaining financial independence as quickly as possible is key. My anesthesiologist friend told me he does night shifts because it is so lucrative and he needs the money. Once you are financially independent, you have options. Do less call by going down to part-time work. Sell off your shifts to colleagues (usually the younger docs) who are hungrier for money. Take on a more administrative role rather than a clinical role. Take on an academic position and have residents work overnights for you.
    3. Work overnight shifts in a batch. Studies show it can be healthier for your body, rather than rotating from day to night work frequently
    4. Don’t work the day following a night shift. Financial independence makes this possible.
    5. Drink lots of fluids during your shift. Eat protein-rich foods. Avoid heavy-carbohydrates until after the shift which will help you fall asleep
    6. Sleep is the magic pill to recover. I used to enjoy the post-call high as a younger doc when I would work-out and do a bunch of errands the following day. This is doable in your 20’s and 30’s because your body can recover faster. As you age, recovery is slower. Take care of your body by sleeping following night shifts to allow your cells and immune system to recover from the onslaught of damage done by overnight work
    In summary, avoid and minimize overnight shifts, if possible, as they are harmful to your health especially as you get older. Obtain financial independence so you do not feel indebted to work nights because of money. Sleep is the magic pill to recover.

    What do you do to prevent overnight work from harming your health?

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