Abstract and Introduction
Abstract
Background: Night shift work is an integral component of the practice of emergency medicine (EM). Previous studies have demonstrated the challenges of night shift work to health and well being among health care providers.
Objective: This study was undertaken to describe the self-reported experience of emergency physicians regarding night shift work with respect to quality of life and career satisfaction.
Methods: The 2008 American Board of Emergency Medicine (ABEM) Longitudinal Study of Emergency Physicians (LSEP) was administered by mail to 1003 ABEM diplomates.
Results: Among 819 participants in the 2008 LSEP Physician Survey, most participants responded that night shift work negatively influenced job satisfaction with a moderate or major negative influence (58%; n = 467/800). Forty-three percent of participants indicated that night shifts had caused them to think about leaving EM (n = 344/809). Most participants responded that working night shifts has had mild negative effects (51%; n = 407/800) or major negative effects (9%; n = 68) on their health. Respondents were asked to describe how working night shifts has affected their health. Common themes included fatigue (36%), poor quality of sleep (35%), mood decrement/irritability (29%), and health maintenance challenges (19%). Among participants in the 2008 LSEP Retired Physician Survey, night shifts were a factor in the decision to retire for 56% of participants.
Conclusions: Emergency physicians report negative impacts of night shift work, including fatigue, poor quality of sleep, mood decrement, irritability, and health challenges. Night shifts have a negative influence on job satisfaction and can be a factor in the decision to retire.
Introduction
Throughout history, doctors have traditionally been available to their patients at all times of the day and night. Providing medical care at night has become a standard component of the specialty of emergency medicine (EM). To accomplish this, many EM physicians work their share of night shifts along with other day shifts, often in a random fashion, throughout each month. Rotating shifts leads to circadian disruption. This desynchronosis and the resultant decrement in the health and well being of our nation's emergency physicians have been described previously. However, there are also benefits to shift work, including limited hours and availability during routine work days. Because of these perceived advantages, EM is often considered to have an appealing lifestyle within the field of medicine.
According to the American College of Emergency Physicians' Wellness Section, "The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field". Goldberg and Thomas, in a study on "Issues of Concern in Pre-retirement Years," a 5-year comparative report, found that 74% of respondents felt that recovery from night shifts was worse to much worse. The perspective of emergency physicians (EPs) regarding night shifts with respect to quality of life and career satisfaction has not been described previously.
This study was undertaken to describe and evaluate the perspective on night shifts of EPs currently practicing EM, as well as those who have retired or changed from EM to an alternate career.