To supplement their "Emergency Physician Shift Work" policy statement, the American College of Emergency Physicians (ACEP) has put together a policy resource and education paper (PREP) with the title: Circadian Rhythms and Shift Work.
The ACEP believes patients' interests are better served when ER doctors practice in an equitable, fair, and supportive atmosphere.
The ACEP is a professional corporation of emergency medicine doctors in the U.S. It has a Washington, D.C. office and is headquartered in Irving, TX. The ACEP has over 31,000 physician members as of 2013.
The ER doctor's well-being is critically important to longevity and success in an emergency medicine career. Constantly rotating shifts can have a negative impact on well-being. Rotating shifts on the ER physician schedule have cumulative effects and represent one of the most essential causes of doctors leaving the specialty. Therefore, the ACEP endorses these following concepts:
Schedule physician scheduling shifts, whenever possible, in a way that's consistent with circadian concepts as circadian disorders can lead to burnout. Scheduling fairly long series of night shifts or isolated night shifts, for most settings, is recommended. Avoid unusually long stretches of shift scheduling or overly long shifts on consecutive nights whenever possible. Shifts shouldn't last more than 12 hours in most settings. You should take each doctor's total number of worked hours and the intervals of time off between each shift into consideration. The ACEP urges that physicians have regularly scheduled periods of a minimum of 24 hours off work.
Rotating emergency medicine scheduling shifts in a clockwise manner is preferred, such as day to evening to night. This should also occur regardless of intervening days off.
Carefully design night shift employees' schedules to accommodate for anchor sleep periods and daytime responsibilities of those employees should be at an absolute minimum. Consider different incentives you can offer physicians to compensate for when they work predominantly night shifts.
Emergency physician schedules should take certain factors into account, such as non-clinical responsibilities, ED patient volume, individual doctor's age and patient acuity levels relating to the nursing care attention the patient needs.
Provide a place where doctors can sleep after night shifts before driving home. Having a designated sleep room is preferred so each physician can have a quiet place to retreat to rest and sleep.
Implementing automated physician scheduling software can help you keep your ER adequately staffed so patient's needs are always met and your physicians don't burn out. It can also help you to support the scheduling concepts the ACEP endorses.
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