This POTD is inspired from Chapter 5 of EMRA's Wellness Guide, "Treat Your Body Right".
The Impact of Shift Work
When we were all choosing our specialties, shift work may have been one of the many reasons why we all fell in love with EM. However, there is research that has shown the harmful effects this type of schedule has on general health and wellness. Shift work has a negative impact on diet and exercise. I meaaaan, it is easier to just fall asleep after a long night shift instead of going out for a run. And no time to eat on a busy south side shift? Oh, let me just binge eat whatever I find when I'm finished writing my notes. These actions and effects of shift work could account for the reduction in the average life span among shift workers compared to the general population.
Diet
Variable working hours lead to changes in eating patterns, which have long term effects of food on the body. Night workers, for example, have a decrease in melatonin and other hormonal changes that can account for the disruption of quality sleep, a higher rate of diabetes, and an increase in weight gain. There are also changes in secretion of hunger hormones that account for an increased desire to consume more food at night. Furthermore, the lack of available options during overnight shifts means fewer healthy food alternatives.
In addition, shift workers tend to eat more than those who work a regular day schedule. To exacerbate matters even further, we are constantly busy, with limited or no break time – which incentivizes snacking on food that is nutritionally sparse. Let's be real, it is quite difficult to say no to the millions of snacks in our resident lounge and if your whole ED team is ordering something tasty, it's hard to refuse! The long-term consequences of these changes contribute significantly to an increased rate of metabolic syndrome.
This isn't news, but residents often feel guilty for taking time during a shift to eat. This leads to increased hunger and possibly decreased performance. Enforcing dedicated meal times can increase productivity during the shift and improve long-term wellness. Lois used to actively force residents to go outside for sunlight and a meal and I miss her so much. Eating on shift really is a game changer, so start early in your career and build it into your practice. The 15 minutes you take to grab food and eat will fight the hangry monster and you'll actually have the energy to see patients and finish your work.
Tips and tricks to make eating on shift more of a reality:
Prepare your meals in bulk on off-days before a string of consecutive shifts is time-efficient and means you don't have to cook every night. Most cooked food, particularly meat and vegetables, can be stored up to 4 days in the refrigerator without risk of contamination. Food stored in the freezer can last several months.
Don't wanna cook? An alternative is subscribing to a meal-delivery service. Local and national companies offer a range of options. Meals are usually delivered cooked and prepared, ideal for residents on busy schedules. I personally just tried factor75 and all you have to do is microwave then enjoy.
The wellness guide mentioned the hospital cafeteria, which I won't even bother discussing because 90% of us don't even know where it is. If you do, congrats, I hear you can get some really affordable food there.
A more realistic option: call ahead to our local dining establishments, so all you have to do is run out and pick it up. More time to eat and more time to write your charts. Truly a win-win situation.
Food based beverages and meal replacements are also good options for particularly busy shifts when you do not have time to sit for a full meal. I'm looking at you, resus residents.
Exercise
I don't need to tell you how important exercise is, but I will. Consistent cardiovascular activity can increase your focus during work and can potentially improve your performance. If possible, go for a jog, cycle, or swim before your shift as you may be more exhausted after work. In addition, aerobic exercise also reduces anxiety and rates of depression. Those who exercise regularly report enhanced mood and greater overall happiness. We all know this, but do we do it? Keeping up with a consistent regimen is particularly challenging for busy EM physicians with variable schedules from week to week. So, let's make it more realistic and possible.
Sign up in advance for a workout class on your weekly protected day to better adhere to attendance. Don't want that money you used to go to waste.
Schedule your workout sessions in your calendar for the entire week at the beginning of the week, with exact times.
Pair with a co-resident on a similar schedule each month to exercise together. Go climbing like Mike and David. Run like Lea and Danta. Play some ball like Alex and Victor. Go to a kickboxing class taught by Arroyo. This is probably the most realistic choice for us. You get your exercise done for the week and you get to hang with your maimo fam!
Find a gym that is open late so you do not skip workouts during a series of overnight shifts.
Consider incorporating exercise in your commute to work by walking or biking if feasible.
Can't make time outside of work to exercise? Do it on shift.
Use the stairs instead of the elevator. More realistic if you're on an off-service rotation.
Take frequent brisk walks between prolonged bouts of sitting and documentation. Walk your patients to x-ray and CT with a little more oomph in your steps.
Fidget at your workstation to burn more calories and increase blood circulation in the extremities. This is why I love the small wheelie chairs on south. I'm just fidgeting away into a void.
Download the “7 Minute Workout” app. Or just use those 7 minutes to strut outside and pick up your food from Maimoni.
Lastly, if Melinda can wear ankle weights on her shift, so can you.
Reference:
https://www.emra.org/books/emra-wellness-guide/ch-5.-treat-your-body-right/