Well I just finished my first week of night shifts.
It was a very long week. But that was quite an experience.
Middlemore hospital gets extremely busy over winter. More so than usual.
On medicine overnight, there are 2 house officers to run the entire medicine department of the hospital. This week, we had 3.
Usually 1 person stays downstairs and admits patients to hospital with the registrars, and 2 people stay upstairs managing ward calls from the 12 medical wards.
But this week, there were so many people waiting to be admitted at the start of the night shift, that 2 house officers needed to be downstairs, and 1 house officer managing 12 wards.
Take a wild guess which one I was.
Me and my 12 wards all 4 nights this week.
People having pain, fevers, sepsis, bleeding, crashing, and passing away. And little me being the first to deal with all of them.
My hospital has an online job posting system where nurses post up alerts/jobs about patients who are unwell and need to be reviewed.
On a good shift, this is limited to around 10-15 jobs.
Every night this week, I started on a shift where there were 40+ jobs across 12 wards, with constant phone calls about acutely unwell patients too.
I had a friend of mine (a 2nd year house officer) at a different hospital also rostered on nights this week. He was my cheerleader and support. Which really helped.
But my God was it tiring. The night house officer job is nice in some ways. Such that your main goal is to get people alive through the night before their primary medical team is able to see them.
But the difficult thing is that there are zero resources through the nights and it’s just you and a very busy registrar downstairs making all the decisions.
Meaning if there’s a patient who has been having nose bleeds for 6 hours straight despite several nose packs, your options are to continue trying the nose packs or call the ENT registrar on call at a different hospital who can barely offer any useful advice at all.
But I’ve got to say, I got all my patients through the week.
Last night in particular, I started off the shift with 51 jobs across 12 wards with several acutely unwell patients that the previous on call house officers were unable to clear.
Oh and there were 15 people downstairs waiting to be seen, meaning the registrars and both other house officers were stuck downstairs and no one was available to help me clear said 51 tasks.
I was running the entire medical hospital.
Quite proud to say that by 630am, I had cleared all 51 tasks, put in 8 IV lines, successfully carried out 2 Abgs and kept all my patients alive.
My first night I couldn’t clear 46 tasks and hadn’t eaten or drank anything for the full 10 hour shift. I was close to tears from the exhaustion.
I also didn’t eat or drink anything on my last shift, but I cleared all my tasks.
Sleeping and reflecting afterwards, I felt strangely good.
The feeling was one of actually having accomplished something. And feeling that hey maybe I can handle some things on my own!
Night shifts are weird. I can see why they’re commonly called the graveyard shift.
But honestly, sleep is VERY important for life, people!