243 Comparing Moods Amongst Emergency Medicine Residents Based on Shift Times and Rotation

Abstract

Emergency medicine residents deal with shift work as an added stressor while trying to maintain a healthy work-life balance. Shift work results in many negative health effects including decreased sleep and an increased risk of mental health disorders and illness. EM residents must also rotate through different specialties, some of which are more intensive and time consuming than others and can negatively affect mood. The goal of this study was to evaluate the emotional wellbeing of EM residents during different shift times and rotations. This was an IRB-approved, prospective, observational study wherein EM residents logged information including mood (rated -10 to 10) and current rotation for up to 6 months. 25/34 eligible EM residents completed some of their logs and 14/34 completed their entire log with decreased participation attributed to the COVID-19 pandemic. These logs were blinded to researchers. Emergency department shifts were 8-10 hours long and coded as either day (starting between 6a-10a), evening (starting between 11a-4p), night shift (starting between 9p-12a), post-night (day after night shift), or off. Rotations were grouped into ED, ICU/trauma, and elective/off-service. In order to isolate the effect of rotation on mood while at work, vacation and days off were excluded from analysis when comparing rotations. One way ANOVA test was used to compare moods. Afterwards, post hoc analysis using a Bonferroni Correction was performed to determine between group differences. There were statistically significant differences found between the moods based on shift, F(4, 1888) = 39.1, p = 1.82E-31). Mood was highest during days off (M=5.19), and lowest on night shifts (M=2.36). There were statistically significant differences when comparing night (M=2.36, SD=4.11) vs post-night (M=4.24, SD=3.58), p=0.0007 and day (M=3.60, SD=4.09), p = 0.0015. There were also significant differences between off (M=5.19, SD=3.27), vs day (M=3.60, SD=4.09), p = 2.24E-10, evening (M=2.92, SD=4.46), p=3.01E-26), and night (M=2.36, SD=4.11), p=2.24E-23). There were also statistically significant differences between the moods based on rotation (F(2,1764) = 26.08, p = <.001). Mood was highest on elective/off-service rotations (M=4.63, SD=3.00) and lowest on ICU/Trauma (M=2.36, SD=3.97). There were statistically significant differences comparing mood while in the ED (M=3.00, SD=4.32) vs ICU/trauma (p=.014) and elective/off-service (p=<.001), and between ICU/trauma vs elective/off- service (p=<.001). Night shift and ICU/trauma months resulted in the lowest moods reported by EM residents, while days off and elective/off-service rotations resulted in the highest mood. Shift work remains a significant stressor on EM residents’ work-life balance. Additionally, the more intensive rotations can negatively affect residents’ moods, further worsening work-life balance. Future studies can investigate methods to improve mood on night shifts and rotations associated with decreased moods.