Hospitalists work long, demanding shifts that require constant focus, quick decision-making, and sustained mental and physical energy. Meeting those demands takes planning, commitment, and prioritization. Here are strategies some esteemed hospital medicine physicians use to maintain their stamina during long shifts.

Why Hospitalists Must Perform at Their Peak

The hospitalist is not just another member of the team; they play a pivotal role in medical dynamics.

“We are the connective tissue of the entire inpatient ecosystem,” Abhinav Sharma, MD, division chief of hospital medicine, the University of Arizona, College of Medicine – Phoenix in Phoenix. “Every consultant, every nurse, every pharmacist, every family member circles back to us. We hold the full clinical picture when everyone else holds only a fragment. That is an extraordinary cognitive and relational burden, and it demands everything.”

And, beyond the clinical there’s a human element that is ever-present.

“There’s something deeply human about what we do,” Sharma said. “Patients arrive frightened, often at their most vulnerable. They are in an unfamiliar environment, surrounded by strangers in scrubs, stripped of their routines. They need someone who is fully present — not just technically competent. That presence requires physical energy, emotional bandwidth, and genuine mental clarity.”

Hospitalist Fatigue

Fatigue is a real-world issue in hospital medicine; but experts say there are methods to manage symptoms.

“There are ways to combat fatigue,” said James Mendoza, MD, director of Recruitment, Cultural humility, and Wellness for Hospital Medicine, University of Maryland School of Medicine at the University of Maryland Medical Center in Baltimore. “Patient census limits, favorable scheduling, adequate staffing, appropriate compensation, and sometimes pizza are a few.”

Some hospitalist groups are shifting the culture toward these but find limitations in resources amidst increasing patient volumes, he said. “Despite what we can’t control, what we can control is optimizing our physical health, which often improves mental health.”

Of note, he said burnout isn’t going away, hence the term “mitigate burnout” can be the goal of “eliminate.” “Setting yourself up to feel good physically can help mitigate burnout,” Mendoza suggested. Below are some guidelines our experts have laid out:

Eat a healthy first meal. Thriving as a hospitalist requires you to bring your “A Game” daily, said Will Knight, MD, a hospitalist at UVA Health in Charlottesville, Virginia. “Our morning routine is our best chance to hard-wire wellness habits that can help sustain us through a long day,” he said. For breakfast, he includes chia seeds and walnuts in oats for omega 3 fatty acids, and frozen blueberries for a serving of fruit. “I tend to get hungry in the late morning and have a stash of granola bars in case I need something before lunch,” he added.

Make sure you have lunch. “Eat lunch during lunch hours,” said Mendoza. “Unless your patient is having an emergency, that before noon discharge can be an early afternoon discharge.” He also stressed to take 30 minutes to yourself to get nutrition in you. “No one likes a hangry hospitalist,” he quipped.

Monitor caffeine. His personal caffeine intake is about 150-200 mg daily. “A cup of coffee in the morning, and then a smaller one in early afternoon for postprandial somnolence,” he said. Regarding energy drinks, turn to these with caution. “Zero calorie energy drinks have become popular among healthcare professionals. If desperate, I do resort to these, but only drink about half of the can,” Mendoza added. “I try not to drink these too late in the day.”

For fellow clinicians who don’t consume caffeine, he paid them a compliment. “I admire those who can stay awake and efficient without caffeine. They are marvels in my opinion,” Mendoza said.

Fuel Your Energy With Proper Foods

Sharma picks protein and complex carbs at shift start, not sugar, and recommends nuts, a banana, or Greek yogurt — things that release energy slowly.

Physical Exercise and Stamina

Sharma works out on his off days. “A long 7-day block demands recovery, not more output,” he told Medscape Medical News. “On my off days, 45-60 minutes of strength training or a long run reset my nervous system in a way nothing else does. It is also the only time I have guaranteed silence.”

On shift days, especially the demanding shifts, he explained that he does mobility work and stretching — deliberately.

“Hospital floors are physically brutal environments. We stand for hours, round in awkward postures, twist at medication carts. Lower back tightness is nearly universal among hospitalists who ignore this. A 5-minute stretch at mid-shift — hip flexors, thoracic spine, shoulders — makes a measurable difference by hour 10,” he said.

Sleep Is Paramount

Sleep is the nonnegotiable at the center of everything, said Sharma.

“I am unapologetic about a wind-down routine — phone down an hour before bed, no alcohol within 3 hours of sleep, blackout curtains during block recovery,” he outlined. “The research on physician sleep deprivation reads like a horror story. We know the data on error rates. We would never accept those conditions for our patients. We should not accept them for ourselves.”

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