I started my set of nights very early, within a few weeks of F1. And though I wasn’t particularly happy about it, I reconciled with the fact that it could have been worse. If this is you and you’ve looked at the rota with horror, I hope you’ll find this post useful. Take what you think is relevant and throw the rest away. I’ve split it up into before, during and after so it makes more sense.

‍

Before

• People have different ways they like to handle the day/night before a night shift. Some people try not to sleep the night before so that they can sleep during the day and feel more awake during their night shift. Some people just go to bed as normal, the night before, and have a small pre-night shift nap. Others wake up in the morning, stay awake all day, work the night shift and then go home and sleep, meaning they’ve stayed awake for 24 hours plus. It might take a while to find a routine that works for you but eventually, you’ll find a routine what works for you.
• Prepare meals. The last thing I want to do after a night shift is to hit the kitchen and start making food. So, before a week of nights, I usually make a big pot of something that will last me several days.
• So that your whole routine isn’t completely thrown out of the window, plan when you will run, go to post office, whatever errands that you might need to do, because there’s not a lot of time left over for you to do the things you want to.

During

• Drink plenty of water.
• Healthy snacks: dried mangos and nuts for me. It’d be easy to hit the vending machine and buy lots of junk. I’m partial to the odd cookie, but having some good options makes me feel like I’m not completely falling off the wagon. And it’s also cheaper. I can get into this mentality sometimes where I play victim: ‘I’m on nights, I deserve a biscuit’.
• Take it easy. You’ll be covering a lot of wards and patients. Some nights can be quiet, but on those busy ones, pace yourself. Take breaks. I found when I didn’t, I could be reading the same line in a patient’s notes over and over again and not take anything in.
• If there’s ten jobs waiting to be done, you can’t do them all at once. You’re going to have to prioritise. Sometimes the messages can be so cryptic it can be hard to make a decision. So call ahead and find out what the issue is.
• Group the tasks by location. If you’re going to one ward, you might as well branch across the ward opposite if they need fluids prescribing. It’ll save you walking all the way back.
• Know all the codes to the doors and short cuts. Make your life easy. Keep codes in the notes app in your phone so that you can come back to it. And important bleeps and numbers you need to know, like the medical registrar.
• Try not to cut corners. It might be your fifth falls assessment of the night and doing a neuro exam on a sleepy elderly lady at 2:30 am isn’t the easiest thing to do. Chances are if someone has fallen in hospital, it could complicate their admission. You could be asked later down the line to explain what happened and how you responded.
• If a nurse calls to let you know someone is unwell, give them some instructions of what to do before you get there: bloods, cannula etc.
• Some issues will self-resolve. It’s surprising to me how many people I would be called to see because they weren’t sleeping and would arrive to find said person sleeping.
• Know trust policy or at least know where to find them on the following: electrolyte imbalance (you’ll be prescribing loads of fluids), agitated patients (which benzodiazepine to prescribe), loose stools, fall management plan etc.

After

• I’ve found that I feel so alert when I’m walking towards my car at the end of the night shift but 15 minutes later I’m starting to dip. But when I get tired, I stop. It’s tempting to just try to power through and get home sooner. People have died from being tired at the wheel. You’ll still get home, just a little later.
• Don’t get distracted by anything else. Just sleep. I don’t have an issue with sleeping in bright sunlight, but if you think you might do, get a sleeping mask.

Good luck. And enjoy the free time you have left, don’t spend it worrying. Comment below if you have any questions or other suggestions. Thanks for reading. © Mind The Medic, 2017

The original article can be found at: http://www.mindthemedic.com/how-to-survive-a-night-shift/

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