Living the Nightlife: Tips for surviving night shifts.
Iām not talking about clinical skills; if youāve gotten this far, you can do it. My tips about the techicalities of night shifts can be found in my Tips for New Junior Doctors post. Nope, itās just hard to get used to night shifts at all. Iāve spent quite a bit of time chatting to various colleagues, and gathered a few things that seem to work for me, so this is a lost of suggestions which might help for those struggling to ease into the world of working nights. Not mandatory, by any means. I donāt really feel itās a complete list, but I do feel like putting it out into the aether. If you have any tips, feel free to add to the list :)
In the lead-up to nights:
Sort out your life admin. On-calls donāt leave much time for other things.
Try to go to bed a bit later than normal. This is easier if you have a weekend or a day off before you start.
Let yourself sleep in late in the leadup to nights. The aim is to shift your body clock closer to when you will be on nights, so that you will feel less of a shock when everything flips.
Tell your friends and family you will be on nights. Anyone likely to text/call/whatsapp you during the day. Not to brag or whinge, but so they know that they shouldnāt disturb you, or sulk if you donāt answer!
Schedule any deliveries for the days before your nights, or only for times you know you donāt plan to sleep on your nights block. There is nothing worse than being woken up by a ring at the door halfway through your sleep. If you wake up it is harder to snooze off again.
Plan your āpacked lunchā. Yup, 12 hour shifts are long, you WILL be hungry. Your doctorsā mess may not be well-stocked. The hot food and vending machines at your hospital may also be broken; always plan in advance; I spent my first night shift snacking on huge piles of shortbread because the machines were broken and there was nothing else in the Mess. Never again.
Get as much sleep as humanly possible.
It may be easier to sleep in until late, then get up and go about your day before your evening shift sets in.
Or, some people prefer to get up at a relatively normal time, and take a nap in the afternoon preceding the night shift. There is no right answer.
Eat a good ābreakfastā before your shift starts. I usually eat ādinnerā in the morning (before bed), then ābreakfastā when I wake up (before work) then halfway through the shift when it is less busy (2-4am) I have ālunchā.
I feel it helps to set out the day pretty similarly to normal days, because it feels less jarring. Trying to eat at reasonably regular intervals also helps avoid that hypoglycaemic feeling of despair and not being able to cope. And the hangry rage.
I also pack snacks because long days are exhausting.
Donāt forget plenty of loose sheets of paper and your clip board, request forms etc.
You will get a pile of jobs as soon as you start. The aim is usually to band to gether as a team to clear them as soon as possible.
Make sure that the person who handed over those jobs gave you all the right infromation.
Make two jobs lists: urgent jobs, and the ones that you ācan do if you find a spare momentā
If you are lucky, it will become more peaceful around 2-3am.
If you are moderately busy, you will catch a breather around 4-5am as people stop wandering around or going to A+E.
You need to eat. If it hasnāt petered out by 2-3am, talk to your counterparts to plan breaks and cover each other.
You donāt need to have no jobs or patients on the list to eat or got to the toilet. If there are no urgent ward jobs, you can eat quickly.
If the patients waiting to be seen on the acute take have been triaged as low risk, are clinically stable, and have not been waiting long, having a cup of tea and a quick sandwich is not harmful. They will be monitored by your nurse colleagues. Just let your senior know so they can crack on with seeing patients.
You cannot look after patients to your best ability if you are exhausted, hungry, dehydrated or bursting to go to the toilet.
You never know when 30 people will turn up to A&E at once, or when 5 patients will fall on the wards in rapid succession. Take it easy when you can.
If itās not bad on your take, help your ward equivalent.
If itās not bad on the wards, check the A+E list for referrals and help your colleague clear patients.
Update the list whenever you have time.
If you donāt have time to eat but are feeling completely exhausted, a hot drink or some juice, or even a cup of water can work absolute miracles.
caffeine in reasonable moderation is your friend.
Do not drink caffeinated drinks after your shift.
ā¦Unless you have a long drive ahead and need it for your safety.
Donāt drive long distances after night shifts. If possible, d not drive or cycle at all: you will be hugely exhausted and sleepy so are at particular risk of accidents.
Eat your ādinnerā when you get home, not long before ābedtimeā. The postprandial effect may even help you drift off more easily.
No matter how awake you feel, go to bed, just as if it was night time.
Donāt get out of bed, even if you donāt feel sleepy.
If you wake up, donāt sweat it. It may be harder to get to sleep, but you can keep trying. Just stay in bed, donāt play on your phone or computer and you are much more likely to drift off.
Read about good sleep hygeine.
Donāt play on your phone; that will only kee you up.
Blackour curtains or a sleep mask are an absolute must.
Put a note on your bedroom door/fridge/etc to let your flatmates know that you are working nights.
Explain to them that being noisy is the equivalent of you banging pots and pans around in the middle of the night for them.
Silence your whatsapp/text/ringtone. Everything that is not your alarm clock should be switched off.
Give yourself a good 7-8 hours of sleep. I always try to sleep more hours on nights than I do normally, by being stricter with myself. It actually means I barely feel sleepy on nights at all!
When you wake up, leave a good amount of time to eat and get to work.
Night shifts are 12=13 hours long usually. Even with sleep accounted for, if you donāt live too far away from work you still get a couple of hours to eat/watch TV/catch up with someone close/chill. Try to de-stress in that time.
But getting your body clock back to normal will be brutal.
Personally, I recommend not sleeping through the day that follows your last night shift, if you can. This will leave you more sleepy when it is night time, and hopefully make it easier for you to go back to normal sleeping patterns.
If you must nap during the day, keep it short and set an alarm so that you donāt end up sleeping the entire day and lying awake all night.
Despite your best efforts, youāll probably find that you feel more sleepy during the next few days, and find it harder to sleep at night. Thatās common, and your body will eventually settle back.
Practise sleep hygeine as best as you can, to settle into a normal pattern quickeer.
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