Diary of an FY1
Written by Junaid Fukuta
With my first night on call looming, this period of the day usually reserved for partying and sleeping takes on a whole new feel. Many of my colleagues have already done their set of nights and I had asked around to see how they found them. The answers ranged from sleeping for six hours in the mess to feeling like you had just finished 12 rounds with Mike Tyson, so in summary it looked like anything could happen.
So I changed into my scrubs, donned my stethoscope and loaded my folder with three cereal bars and stepped into the unknown. I entered the handover room with the day team handing over jobs to the night team and started writing my ‘to do’ list. After 30 minutes it seemed more like a ‘never ending’ list as I entered the details of bloods to chase, patients to review and drugs to prescribe. Then in a flash the day team vanished and I was ready to hit the wards. Well I was until my bleep went off. As I responded to my bleep and take the details of yet another patient to see my bleep goes off again! I then spend the next hour answering bleep after bleep literally unable to leave the phone as seemingly every ward in the hospital needs someone to be reviewed. So as my never ending list gets even longer, I feel like I am going to have a night more akin to 12 rounds with Mike Tyson, and I have only just finished round one. The bleeps finally finish and I dash off to hit the wards. “I saunter off the ward with my head held high and my chest puffed out. I want to go tell someone what a good job I have done but as I leave I notice something about nights: the hospital is eerily quiet”
When I arrive at the first one, the scene I am confronted with seems similar to something from the 1800s. It is an open plan ward with rows of patients all sleeping, the lights are switched off except for one desk lamp located at the nurses’ station. All that was needed to complete the scene was a nurse with a candle to approach me. I squint my eyes as a nurse approaches out of the darkness, but rather than a candle, she is holding an obs chart for a patient very short of breath. Luckily my stint of nights have happened quite late into my rotation so I am now used to seeing sick patients. I quickly decide that this very short of breath patient has probably gone into flash pulmonary oedema, so the protocol now drilled into my head kicks in and I reel off my standard list of investigations and make a plan. The patient picks up and so does my confidence. I saunter off the ward with my head held high and my chest puffed out. I want to go tell someone what a good job I have done but as I leave I notice something about nights: the hospital is eerily quiet. During the day there are literally hundreds of nurses, porters, relatives and doctors bustling about the hospital like a beehive but during the night, it feels like a ghost ship. So I saunter on like a shadow moving from ward to ward having to contain my little bit of pride as there is literally no one to talk to.
4:00am comes surprisingly quickly. The wards are all locked down, my jobs list is finished, and I haven’t had any bleeps for an hour. My body has stopped resenting me for not being in a warm bed and there is complete silence. I am unnerved and unsure what to do;; never in my past four months at work have I not had anything to do. I wonder through the hospital like a lost soul and this feeling of being alone is new and uncomfortable. 6:00am arrives and like a bear coming out of hibernation the hospital starts to stir. The nurses filter in for the start of their shifts and the traffic outside starts to build up and right on cue the bleeps start up again. Now, the problem with the early morning bleeps is that you are extremely cranky and with all the ward teams arriving soon it takes something very serious to get you to go and review something. I start to run something akin to an NHS direct service hand- ing out advice over the phone and by 8:30am the cavalry arrive and I know I am on the home straight. Finally at 9:00 my shift is over and I handover my bleeps to the day team, head back to my empty house, chow down some cereal and then head to bed. There is a feeling of loneliness but there is also a great feeling as you know that whilst you are sleeping everyone else is at work. It’s the little things that count on nights.
Found this article interesting - Tweet or Facebook to share with your friends and followers!