Everyone one knows ER docs work shifts.  Many places though have each doc doing a set schedule.  Such as 1 day, 1 evening, 1 overnight or one week with days, one with evenings, and one with nights.

Others, like my hospital, it is a mass jumble. We work all sorts of random shifts at random times, so long as it evens out at the end of the 6 week block that each of us have a similar number of each type of shift.  This is great for flexibility – since everyone is always asking for random time off, both week days and weekends, not to mention formal vacations and holidays.

However, this can suck also.  It means you might work two overnights then have one days off and then back to a 7 am day shift.  Urgh!  You may have off 4-5 days in a row without asking for them but then have 5 -6 in a row.  Thus, we survive by “juggling” our shifts.  As soon as the new schedule comes out, everyone quickly scans theirs for how many hours they are working, which days they suddenly realize they need off, and how balanced or unbalanced the shifts are.   Then we start a mass emailing/calling of each other.

“Hey, can you do my 15th overnight if I do your 22nd overnight and half your day on the 30th?”

Often switches are “double” or “triple” switches, where in able for one to swap and shift with another, a third doc also have to be willing to switch to enable the initial swap.  Often deals are offered.  “I’ll do two of your weekend day shifts if you just do this one overnight for me!” (obviously someone desperate).  “If you make this switch, I’ll throw in $250 cash!”  “Please, do this shift for me, I’ll be your slave next block!” (hmmm … that is interesting).   Half or partial shift switches are also common.

This week I made about 10 switches for the upcoming 4 weeks.  I managed to get out of one overnight, swap a Friday evening for a day, pick up a half shift on a weekday, and split up a night shift over two days.   Win!   The printed schedule in the ER is now completely worthless.

This is a reason, you can’t fight with your colleagues or otherwise not get along.  You just know that the guy you gave a raft of crap for a bad sign out last week is the only one who can swap with you for that wedding that you suddenly need to go to.

ER Stories is an emergency physician who blogs at his self-titled site, ER Stories.

Submit a guest post and be heard.