Night shift differential?

[IcuPAC]

Hey everyone, my hospital is looking at having PAs work nights in the ICU along with an attending physician who is also in-house. Census around 25-35 patients, a couple admissions per night. Expected to do procedures such as central lines, art lines, etc.

What is an appropriate night-shift differential to ask for? 

Thanks in advance.

[polarbebe]

In my experience…

I have typically seen 10% but turnover will likely be high.  You can expect many APPs leave after 2-3 years and then having to train the replacements.

Nocturnal APPs have more autonomy this requires more experience/training… thus a challenge to keep them after a couple of years.  
 

I have heard of 20-30% differential to reduce staff turnover for dedicated night providers. 
 

 

[MediMike]

Our team was designed for nocturnist work to begin with and have gradually started to cover some day shifts so we're in kind of the opposite situation that you are.  I can say that when comparing salaries to other systems we generally are somewhere between 15% - 25% above their compensation.

At my prior institution they would offer 30% increases in pay to work nights.

Like @polarbebesaid, nights are tough for some folks.  It may be a good idea to ask if there are people who would choose to work that shift as opposed to switching back and forth.  I will trade out of every day shift possible as night-walking is way more my thing. We have lost people due to physical intolerance of nights in the past.

[TJuanKenobi]

My hospital pays us $50 per night shift, so for the few who decide to work only nights, this adds up to ~7% or less than our base salary.

Hope your hospital treats you better than this!

Cheers.

[ohiovolffemtp]

In EM, at various locations I've seen night differentials as low as $5/hour and as high as $20/hour.

[EMEDPA]

Speaking from an ER perspective, nights have pros and cons:

pros: often more money, autonomy, less interference from admin, drink coffee at your desk, etc, regular schedule if you work as a designated nocturnist ( I did for > 10 years), sometimes you get to sleep.

cons: you are on an opposite schedule from everyone you know, you miss a lot of dinners, concerts, movies, etc that normal people do in the evenings. The flip side of autonomy is an inability to get help when you need it. people are often on call instead of in house and are less likely to want to help at 3 am than 3 pm, ancillary services may be limited as well (no mri at night, no one to place zio patches, etc) 

[ohiovolffemtp]

6 hours ago, EMEDPA said:

Speaking from an ER perspective, nights have pros and cons:

pros: often more money, autonomy, less interference from admin, drink coffee at your desk, etc, regular schedule if you work as a designated nocturnist ( I did for > 10 years), sometimes you get to sleep.

cons: you are on an opposite schedule from everyone you know, you miss a lot of dinners, concerts, movies, etc that normal people do in the evenings. The flip side of autonomy is an inability to get help when you need it. people are often on call instead of in house and are less likely to want to help at 3 am than 3 pm, ancillary services may be limited as well (no mri at night, no one to place zio patches, etc) 

Especially ultrasound!

Another thing I've found now that I'm working in CO and AZ: the availability of transport units for patient transfers is VERY limited.  Weather seems to be worse at night.  Flight and ground crews hit time out limitations, etc.  Also, receiving hospitals are often "discharge dependent", and no discharges happen at night.

Another con: it's not so much the working at night, it's the complete reversal of your internal clock every time you switch between work life and family life.

Still, I'm glad I'm a nocturnist.

[CritCareICU]

I work night shift ICU. Census around 30-35; 40+ in season (I work in Florida).  Night time shift diff is 10 dollars an hour for us. Also we are hourly with time and half for OT if this helps. 

[IcuPAC]

Hi everyone, thanks for the replies. As an update….. the initial offer from administration is $120 extra per 12 hour night. We haven’t agreed on final terms just yet though.

[ChrisPAinED]

On 9/10/2022 at 6:09 PM, EMEDPA said:

Speaking from an ER perspective, nights have pros and cons:

pros: often more money, autonomy, less interference from admin, drink coffee at your desk, etc, regular schedule if you work as a designated nocturnist ( I did for > 10 years), sometimes you get to sleep.

cons: you are on an opposite schedule from everyone you know, you miss a lot of dinners, concerts, movies, etc that normal people do in the evenings. The flip side of autonomy is an inability to get help when you need it. people are often on call instead of in house and are less likely to want to help at 3 am than 3 pm, ancillary services may be limited as well (no mri at night, no one to place zio patches, etc) 

I agree I personally work night shifts only in ED and ICU now. I don't really have a family but I got a few friends that works nights with me.  At my hospital we got 4 ED physicians on every night but only 1 in house at all times. And our MRIs also close at 9:30 which at my old hospital it closed even Earlier so I completely agree