FM Student’s Guide to Surviving Third Year Night Shifts
Almost all guides to night shifts are the same.
The #1 rule to remember is: this is part of your education, but also part of everyone else’s work day or hospital experience. Be engaged – interact with patients and your staff, and don’t get grumpy if you get tired. Don’t complain, because all the staff you’re working with have been doing night shifts longer than you. Don’t be excessively noisy – your patients are trying to sleep.
I don’t have a clever mnemonic, but you should sleep, snack, drink, do cardio, go ten more minutes, drive safe and eat before bed.
The Seven Steps to Surviving Your First Night Shift
- Sleep the day of your shift. Even if you don’t think you can, put on some rainy mood, close the drapes and relax into snooze land.
- Snack snack snack. My pockets and overnight bag (which is the same messenger bag I use on day shifts) are always full of snacks. Or bring lots of dollar bills to shove in the vending machine, because the cafeteria will be closed. I don’t eat anything super heavy before a shift because it makes me tired, so snacks are doubly important if you share that trait.
- DRINK WATER. I know plenty of times you get in trouble for hydrating, but figure out where you can stash some beverages and keep sipping. When I’m sleepy, sips of ice cold water is the best mental punch in the face to snap me alert. You can keep a water bottle stashed, or use the patient ice/water machine and chug.
- I don’t drink coffee, so I don’t recommend caffeine. I drink a tea before shift and once it wears off resort to water and snacks to keep going. Instead, get a bit of cardio in. There’s a great bit in the first season of Elementary wherein Watson does some heart-pumping squats to stay awake. It really does work.
- Ten minute mantra. As you get grumpy sleepy tell yourself “I will go ten more minutes” – repeat until shift ends. You can do anything for a mere ten minutes, so setting those mini milestones can help. I also promise myself things like “If I make it another hour I can get a less healthy snack out of the vending machine” once a night.
- Post shift – I have rubbish night vision, so if a night shift ended before sun up often I usually waited a good ten minutes outside for my eyes to adjust. If it was just too dark (no moon, no light) I didn’t make the drive. Finally, don’t drive tired, it’s as bad as being intoxicated. You CAN get ticketed in many states as if you were, or worse end up in a ditch.
- Do eat when you get home. I just have a bowl of cereal and crash out, but some people recommend more of a light pre-bed snack. Whatever works for you.
References
AMA: 5 Tips for Night Shift Success
MedicalProtection.org Surviving a Night Shift
Medscape’s Night Shifts in EM
ALiEM’s Top 10 Night Shift Tips