Overnight shift survival guide

Dr Mirsada Prasko BSc Hons, BMedSci/MD

Tuesday, 31 May 2022

Doctor in hospital corridor at night time

I’m just 16 weeks into my internship, and I’ve checked my ECG to make sure I’m still alive … just kidding, safe to say I’m surviving with my head well above water.

Being a junior doctor is hard enough, and it’s even tougher rostered on the overnight shifts. It can feel like you’re the only doctor looking after over a hundred patients, and pagers are going off constantly. Not to mention MET calls, code greys and trying to find time to get your own medication – that much-needed caffeine.

The first shift is always the hardest

When I did my first overnight shift, I felt overwhelmed even before I started it. The responsibility for even the most trivial of things weighed heavily on my mind.

I often thought it was my junior status letting me down and slowing me down. I’ve cried, laughed (deliriously at times), and sometimes felt silly and dumb.

Now with a few more overnight shifts under my belt, I’m comfortable taking the calls I once dreaded. I guess you can call it the ‘steep learning curve’ you hear thrown around.

Always learning

After only doing a few overnight shifts, I now know how to do fluid reviews like the back of my hand, catheter insertions are as easy as a cannula, and I feel more comfortable managing MET calls and knowing when to call them.

Surprisingly the traits I thought were bringing me down in the first few months of my internship turned out to be my greatest strengths.

Here are some tips that helped me survive the overnight shifts.

  • Be comprehensive – no doubt you will review the patient’s liver function tests for paracetamol or melatonin. Or you’ll spend a ridiculous amount of time looking up medications and their adverse effects. What type of doctor would you rather have treat you? The doctor that charts medications from memory or the doctor who is aware they’re junior and double-checks using a reliable and approved source?
  • You’re not alone – it might feel like you are, but there are always senior doctors rostered on with you.  I had two senior registrars on call during my first overnight shift who would answer my calls and messages no matter how silly I thought my question was. Every doctor has been through an internship and needed help on the shift themselves, so don't shy away from asking for help.
  • Look after yourself – when looking after patients, sometimes we neglect ourselves. In hindsight, I’ve learned that when I have plenty of sleep, rest and hydration I’m a better doctor for my patients. It’s in their best interest that I take five minutes before I review them to drink my water, so I don’t get an acute kidney injury while treating theirs.

Useful resources

Medical records - the essentials

Imposter syndrome: feeling like a fish out of water

Video: Coping with nightshift – Interview with Dr Sonia Henry

More information

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.

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This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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