Home From The Editor Surviving the graveyard shift

Surviving the graveyard shift

December 2011

Published in the December 2011 issue of Today’s Hospitalist.

Our cover story this month focuses on one of the basic facts of life for hospitalists: Working nights is tough. While that isn’t exactly news, our coverage points out that even hospitalists who willingly choose to work nights “nocturnists “are having big problems.

You might think that overnight shifts are relatively quiet, and that may be your experience when you cover nights. But nocturnists say that when they’re on duty, the pace is anything but relaxed.

Skyrocketing numbers of admissions, along with pages, cross coverage and codes, are pushing some nocturnists to the brink. One group, for example, found that during a two-week period, its two nocturnists ad- mitted almost 300 patients, fielded more than 1,500 pages from nurses and entered nearly 15,000 electronic orders.

How did nocturnists, who until recently were relatively uncommon in most hospitalist groups, become so overwhelmed? As hospitalist groups have seen their patient volumes surge, so have nocturnists.

But while groups have aggressively hired daytime physicians, many haven’t been able to hire more dedicated doctors for the night shift. And as hospitalist groups have become indispensable in hospitals, more specialists are clamoring to have hospitalists admit their patients at night, relieving specialists’ call schedules. For nocturnists, that means not only a higher level of patient acuity than many daytime physicians may admit, but more business than they feel comfortable handling.

It looks like hospitalist groups and hospitals are beginning to take notice of surging night-time volumes. That stems from concerns about physician burnout and retention “and about patient safety.

Groups are responding by looking for ways to take some of the load off their nocturnists. That’s good news for everyone, but especially for physicians who don’t like working nights.

edoyleEdward Doyle
Editor & Publisher