Surviving Nightshifts

4am is not a normal time to be awake. It just isn't. The people who are awake at that time of night tend to fall into a few categories:

• People with babies

• Prostitutes

• Insomniacs

• Teenagers with an empty house

• Truckers

• Drunk people at a casino hoping to win back what they spent on beer

Being a doctor at 4am puts you somewhere between all of them. Like babies, patients are often wholly dependent on you being sharp to survive. Like prostitutes, you're not paid enough to be doing this. Like insomniacs, you're desperate for sleep. Like truckers, if you actually get it, someone might die. And much like the teenagers and casino punters, sometimes your only solace is sheer dumb luck.

Nightshifts worry folk — and fair enough. But they're also a brilliant learning opportunity. And yes, I know when someone says, "It'll be a great learning opportunity," what they usually mean is, "This is going to be awful for you." But hear me out.

Here's my Top 10 tips for surviving — even thriving — on nightshifts.

10. Alone at Last

One of the defining truths of nightshifts: you'll often be on your own. At first, it's terrifying. Then it becomes oddly empowering. You get to do what you can, think through things a bit more, and then ask for help only if you actually need it.

During the day, there's often a tangle of hands and opinions. At night, it's just you, a nurse, a patient, and a catheter that won't stop bleeding. You're 20 minutes from help. That's when you find out what you're made of — and it's weirdly fun. (Eventually.)

9. Fuel Your Brain (No Lucozade sponsorship here)

Don't underestimate how much basic nutrition matters. Nightshift food tends to be a cross between a child's birthday party and a petrol station at 3am. That won't help you.

Caffeine and sugar give you the illusion of energy, right up until your brain hits the Lull — that 30-minute void when your body stages a full protest and your IQ plummets. Instead, eat like it's a normal day. Protein, hydration, something warm. Treat your body like it's working — because it is.

8. Sleep, Perchance to Be Less Useless

"Should I nap beforehand? Stay up? Lie in? How do you prepare?"

There's no magic answer. The first night usually hurts the least — adrenaline does the heavy lifting. But then the Lull hits harder. By the second or third night, your body's clock starts booting off. I personally stay up until around 3am the day before, then sleep hard. Works for me. Find what works for you.

Just remember: it's night. You're not supposed to be awake. Feeling tired is normal.

7. The Overlap

Never assume the day team "nailed it" and that your shift will be a breeze. That's a false metric. A good shift isn't "no jobs left" — it's "patients didn't get worse". Try not to get salty about handovers unless it's persistently sloppy. Most of the time, the day team's been through their own private hell.

And if you do keep getting shafted with handovers that seem… odd, talk to someone. But don't start your shift bitter.

6. The Lull

The Lull hits around 4am. Everything's quiet. No bleeps. No movement. It feels like maybe you could just sit down for a minute. Maybe just… rest your eyes…

Don't. This is the danger zone. The Lull is where tiredness overtakes adrenaline, and one missed observation turns into a very bad morning.

5. The 7am Flurry

Right after the Lull, like clockwork, comes The Flurry. At 6am, the night is almost over. You're dead behind the eyes. And then — bang — all the morning obs roll in.

Suddenly everyone has a temp. Every hypoxic patient needs cultures. Someone's unresponsive.

You might even be called to certify a death. Prepare before the Flurry. Caffeine, food, stretch — whatever gets your brain back online.

4. The Frothy Stuff

You will see sick patients. That's part of the job. Some will look like hell. Some will actively try to die in front of you. The good news? It's all formula.

ABCDE assessment. Over and over again. You've been trained. Use it. If someone's properly crashing, it gets easier — the protocol kicks in. Adrenaline does the rest. If someone's arrested?

Even more formulaic.

Lead if you have to. Ask for help if you need it. It's better to be bossy than to balls it up.

3. Strangers in the Night

Nightshift teams are random grab-bags of people who may have never worked together.

Solidarity makes a huge difference.

Introduce yourself. Offer help. Learn people's names. Know the wards you're covering. Show up, be seen, be human. Nurses won't trust you just because you've got a lanyard — they need to know you've got their back. And if they trust you, they'll save your arse when you need it.

2. There's No "I" in Team – But There Is in "Think"

Every nightshift culture is different. Some are meritocracies. Some are autocracies. Some are complete anarchy. The best ones I've seen are semi-structured. People do what they can, escalate when they should, and don't panic call the reg every time a patient farts.

Learn your local escalation policies. Practice the question: "What else can I do before I ask for help?"

1. The 6 Ps

Proper Preparation Prevents Piss Poor Performance.

Get your act together before the shift starts:

• Set out-of-office emails

• Plan your sleep and meals

• Coordinate childcare or home stuff

• Pack snacks, caffeine, phone charger, and layers

• Know who's on shift

• Eyeball the sickest patients early

The more you prepare, the more you can survive — and maybe even enjoy it.

Final Thoughts

Nightshifts are hard. They always have been. They always will be. But they're also one of the few times you get a real glimpse at how much of this job you can do on your own — and how much better it feels when you do it right.

If you're struggling with nightshifts, talk to your educational supervisor. There's no shame in it. Some people build entire careers avoiding them.

But if you are doing them, do them right. Be human. Be ready. Be safe.