FY2 Dr Christine Bolton draws on her own experience for what to do to get through your first set of nights.

Few trainees are steely cool before their first night shift; the idea of roaming the hospital alone, bleep going into a frenzy and 250 patients under your care is fairly terrifying.

But don't worry – you'll be dealing with prescriptions and reviewing patients independently in no time. Hopefully these pointers will ease your worries before your first shift.

ABG nerves

To start with, your most used piece of equipment is likely to be the trusty ABG needles, so it's worth carrying at least five. As soon as your bleep starts going off about a NEWS call, your primary role is nearly always to get and then run the ABG sample, with or without local anaesthetic.

A lot of trainees worry about getting the sample, given our weighty average experience of puncturing plastic arms or failing to obtain even one as a student.

Within a few hours you will probably have more ABGs under your belt than three years at medical school and will be marvelling at your own unanticipated skill. Plus at a NEWS call, there is always senior backup if you miss.


Some hospitals' technology has accelerated into the 20th century with the use of text message referrals for jobs.

If you are still on the old system of bleeped referrals and getting overwhelmed on night shifts with bleeps and jobs, ask nurses to do tasks before you can get to them, preparing the equipment you will need ('Can you get the catheter ready?') or getting information ready ('Can you do an ECG or check blood sugar?').

Never commit to how long it will take you to get to them, because you cannot predict it when so much can change in five minutes. When taking referrals from other doctors, pin down the parameters and action required so you know exactly what is expected of you.

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Night practicalities

Your handover list will disappear and reappear or take a full sabbatical every five minutes unless you religiously put it in your pocket or bag every single time you need to do something.

Keep it away from tables and desks where unforgiving stashes of notes will pile on top of it. Save yourself the stress of losing your list of jobs – once is enough to imprint the necessity of this on you forever.

While hopefully you will have taken the phone numbers of your registrar and FY2 doctor before you start, sometimes they will be too busy to answer.

A common dilemma is reviewing a patient who probably needs a ceiling of care in place, but nothing has formally been documented or put in place. As an FY1, if you cannot get hold of the registrar, you have to assume the patient is for full escalation until you have successfully contacted a senior. Legally it is difficult to defend making that decision yourself, as an FY1, even when it seems so obvious.

Prep practicalities

Practically, there are a few steps you can apply to stave off the aggressive crank that you become at 3.43am when a nurse bleeps to ask you for an 8am antibiotics prescription.

Prepare food and dinners in advance before on-call stints. Different doctors try to adjust their sleeping pattern in different ways; the key is getting a nap the day before the night shift begins, but you have to make yourself sleepy for this. Some people stay up late the night before and others wake up early the day the nights begin.

After the night shifts end, don't spend that day in bed. Nap for a few hours, then try to maintain a normal wake-sleep cycle to help you quickly adjust to normality again.

So there we are – good luck and bon voyage!

This page was correct at publication on 05/07/2018. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.