Dr. Brian Goldman

I've worked night shifts for four decades and found it stimulating for a lot of reasons, but also difficult because of its physical and mental impacts.

Casino shifts are one tactic ERs are using to address those impacts.

Not surprisingly, given the name, the idea was borrowed from casino employees who typically work a six-hour shift from 10 p.m.

until 4 a.m.

or from 4 a.m.

until 10 a.m.

The theory is that having two doctors split the 12 to 14 hours of the night shift is better than having one work all night because it allows both MDs to sleep at least part of the night in their own beds when their bodies are telling them it's time to sleep.

And if you read The Night Shift, I'm a veteran insomniac.

I'm a professor of insomnia, although I think I sleep a little better than I did back when I wrote The Night Shift.

But yeah, it helps if you don't sleep.

Yes, absolutely.

The casino shift was not just, it was pilfered from the casino industry, but it was adopted by some very smart emergency physicians at QE2 Health Sciences Center in Halifax.

And they actually started using it about 15, 20 years ago.

So around about the time of the night shift was first published.

And it's not just, as Matthew said so eloquently in that excerpt, it's not just that you sleep a couple of hours in your own bed or two or three hours.

You get an extra two or three hours of daylight where you're up and about.

And the daylight exposure is so important to synchronize your circadian rhythms.

And I can tell you, I did night shifts back when I started working Emerge.

I did 10, 12 night shifts a month.

And there's nothing more debilitating than doing a run of three or four night shifts in a row, which I used to do.