The Pros and Cons of Working as a Nocturnist

Night owls, take note: there’s a strong demand among health systems for nocturnists—those go-to hospitalists who work the night shift, usually exclusively.

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Nocturnists are unique among hospitalists because they are often the only doctors on the floor after all of the other physicians have finished their rounds and gone home. Working the night shift, they can enjoy more autonomy and often a quieter working environment. Yet the job isn’t without its challenges.

And the specifics of nocturnist jobs will vary from one facility to the next.

Nocturnists are increasingly common in hospitals, according to the 2016 State of Hospital Medicine Report. Health care systems want to hire nocturnists because they need to have a physician present on the floor at all times to care for patients and produce the best possible patient outcomes.

The presence and consistency of nocturnists also allows hospitals to offer more scheduling options to their hospitalists, which can aid in recruitment and retention.

If you’re intrigued by the possibilities of working as a nocturnist, here are some pros and cons to consider:

The Benefits of Nocturnist Jobs

Higher pay. The pay can be very attractive for many hospitalists considering a nocturnist position. A recent article in The Hospitalist, published by the Society of Hospital Medicine, estimates a 15 percent pay differential for nocturnists’ salaries. According to Indeed.com, the average annual salary for a nocturnist is currently $229,980, compared to $207,565 for hospitalists in general. Other sources put nocturnists’ salaries even higher.

High demand for your services. As the State of Hospital Medicine Report noted, at least 70 percent of hospitalist programs now include a nocturnist. And demand is growing. If you’re looking for nocturnist jobs and have good experience, you may find organizations eager to court you. Locum tenens nocturnists and other hospitalists are also in high demand for temporary assignments.

Fewer (or shorter) shifts. This varies from hospital to hospital, but some facilities will offer shorter shifts—8 or 10 hours, as opposed to 12 hours—or fewer shifts as a way to lure a nocturnist onto their staff. In some cases, you might be able to work fewer shifts per month than a days-only hospitalist might be required to work.

More independence. If you like a lot of independence in your practice, a nocturnist job might be a good fit for you. When it comes down to making clinical decisions, the buck basically stops with you. Yet, in most cases, you still have the option to call in other specialists when necessary.

Camaraderie with the night staff. Nocturnists are not entirely on their own. You’ll work with the nursing staff, possibly a nurse practitioner or two and maybe even a resident. There are also assistants and others working the night shift, and you will likely have interactions with the emergency department staff as they transition patients for admittance. You’ll get to know your fellow night-shift workers well, and enjoy the “we’re all in this together” camaraderie that can develop.

More time to practice medicine. If you’re tired of meetings, rounds and administrative tasks, you might be well-suited to night shift work. While documentation requirements are similar to other shifts, there are generally fewer daily tasks to take up your time, and fewer people coming and going at night. This allows you to be more available to listen to and assess patients, perform procedures and practice medicine.

Time during the day. When you work the night shift, you may have more time during the day to spend with your family, pursue professional development or enjoy other pursuits. Parents who work as nocturnists often appreciate the chance to sleep while their kids are in school, and then pick them up, take them to sports and activities, and share dinner and early evenings together.

The Challenges of Nocturnist Jobs

Working alone. Nocturnists, many times, must be comfortable working alone and be confident in their clinical skills. During the majority of their working hours, they won’t have ready access to other physician colleagues to informally consult, and specialists are normally only called in extreme emergencies. Independence may morph into loneliness for some physicians.

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Day meetings will still be required. Nocturnists have to be flexible with their time. Staff meetings are traditionally held during the day, as are meetings for quality initiatives and other hospital improvement programs. You may have to come in on your day off or stay late after a night shift to attend certain meetings.

Sleep issues. Many studies have shown that working the night shift can interfere with your body’s natural circadian rhythm, especially if you alter your routine substantially on your days off. Some people are able to adjust and find a workable schedule more easily than others. If you struggle with getting enough sleep and your body doesn’t seem to adjust over time, working as a nocturnist may not be the right job for you.

Personal lifestyle adjustments. The people around you will also be affected by your unusual schedule, so engage them in your planning. It helps to post your work and sleep schedule so family members or roommates know when you are trying to sleep and when they can expect to see you. Find a daily meal you can share, whether it’s breakfast when you get off shift or dinner before you leave for work. It may take more effort to stay in touch with friends who work days, as well, but it is important to maintain those relationships and your support system. It is also important to still find time for exercise and to maintain your overall health. 

FIND full-time or part-time jobs for nocturnists and other hospitalists, or physicians and advanced practitioners in a wide range of medical specialties.

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