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Floating nights: a 5-year experience with an innovative ED schedule
B Krakow1, M Hauswald, D Tandberg
1University of New Mexico School of Medicine, Department of Emergency Medicine, Albuquerque 87131-5246.
The American Journal of Emergency Medicine
|September 1, 1994
Summary
Scheduling night shifts in blocks, known as "floats," can improve physician attitudes compared to isolated shifts. However, float physicians consistently experience sleep difficulties, regardless of scheduling, highlighting the need for optimized shift structures and sleep hygiene.
Area of Science:
- Medical research
- Occupational health
- Physician well-being
Background:
- Physician work schedules, particularly night shifts, significantly impact attitudes and functioning.
- The effectiveness of block scheduling for night shifts (floats) in academic emergency settings is not well-established.
Purpose of the Study:
- To investigate whether scheduling night shifts in blocks improves physician attitudes and functioning.
- To compare the experiences of physicians working block night shifts versus isolated night shifts.
Main Methods:
- A survey was conducted among physicians in an academic emergency group.
- Physicians were categorized based on their night shift scheduling: block (float) or isolated nights.
- Data on attitudes, sleep, and recovery were collected and analyzed.
Main Results:
- Float physicians reported poorer attitudes than non-float physicians when working isolated nights (P = .0053).
- Working night floats eliminated the observed differences in attitudes between the groups.
- Float physicians experienced more sleep difficulties, longer recovery times, and increased use of coffee and sedatives (P = .0108).
Conclusions:
- Block scheduling of night shifts can mitigate negative attitudinal impacts.
- Physician adaptability to night work varies, suggesting personalized scheduling strategies.
- Optimal night float duration is 2-4 weeks with shifts under 10 hours, emphasizing sleep hygiene and potentially shorter shifts in larger groups.