Starting work as a doctor is probably one of the most exciting yet nerve-racking things any new medical graduate would experience. You are being let loose on wards across the country to look after patients you have never met and be responsible for their care.
Many of us anxiously await our first rota to see if we are one of the unlucky few who have been assigned the night on-call shift on our first day. Starting on a night shift doesn’t always mean you’re unlucky. In fact it could be a good thing. For those starting on nights later on in your job; it can still be a daunting experience. So here’s how to make the most of your first night on-call as an FY1.
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Everyone knows that this is your first shift as a doctor, so believe it or not: their expectations are pretty low. When you answer the bleep to go and see your first patient who is NEWS-ing at 6 take a deep breath and ask the nurse for some background information.
In the couple of minutes it will take you to reach the patient you will have had time to think about what could be going on so that when you arrive, you are ready to assess the patient. Even going through the ABCDE components will help jog your memory of what you need to do. Speaking to the patient first is often the most useful thing; don’t go straight for their notes.
The most important thing is not to let your worries show when you are with a patient as that will make them worry too. Look confident, speak confidently and feel confident in your abilities.
Everyone working overnight is there to help and are happy to help. All you need to do is ask. No question is a stupid question so if you’re unsure about something as simple as what is the dose of paracetamol; just ask!
You can get away with asking a lot more basic questions in your first week as a doctor than you would say one month later. So actually those starting night shifts later on are the unlucky ones!
The nurses are a huge resource of information; most of them have been working for a long time and know a lot about a lot. If you think the patient is unwell or you are unsure of what to do – escalate to your seniors straight away.
In all the rush you are in, it is easy to forget to look after yourself. Yes, looking after your patients is your priority but you cannot do that if you are not looking after yourself. Make sure you take a short break whenever you can and have something to eat and drink.
Staying hydrated and well-fed is important to make sure you have enough energy to stay up all night. If the nurses see you rushed of your feet they may even make you that nice cup of tea or coffee and bring you a biscuit. If you are having a quiet night you can even try and get a power nap!
It is important not to forget to document everything you do. Even simple things like prescribing analgesia or IV fluids. Make sure you look at the patient’s notes and latest results to make sure there are no contraindications and document that you have done so.
When you examine a patient to make sure you don’t forget everything you can structure your documentation using ABCDE as your headings. If you are very busy and forget to document as you go along; you can always go back and document in retrospect.
Come up with a clear management plan for what you want to be done overnight and if there is anything you think the day team should do in the morning.
This is the first night of your chosen career. You have worked so hard to reach this stage; so make sure you enjoy every step of the way. There will be tough times, there will be hurdles but don’t let this stop you from enjoying yourself. Make sure you have a hobby or something to do in your spare time to help you de-stress and give you a break from work.
So here are 5 tips to make your first on-call night shift as an FY1 that little bit easier. Just remember to ask for help, don’t panic and look after yourself as much as the patients.
Words: Aysha Gomaa
Want to find out more about Foundation Programmes and life as an FY1 doctor? See more below:
Now that you've finished medical school, it's time to begin your career as a junior doctor. Foundation training is the first step along the postgraduate training pathway, and will last for two years. Find out more here!