The Hospital At Night

It’s 0445am on Saturday 11th July and I am having a rare lull in my night shift. …

You know, the hospital at night is a unique, thought-provoking experience. It’s the time when all the hustle and bustle of the full complement of the daytime staff, relatives and heavy footfall across the WELCOME sign of the hospital disappears in the wake of silence and shadows. Instead you are left with a handful of nurses, doctors and cleaning staff echoeing their footsteps around the hospital corridors and wards. In a place which, during the day, you are side-stepping prams, patients, wheelchairs and stretchers, you can, at night you can stand uninvaded in the ground you hold.

That is one of the many reasons that I love night-shifts.

Now don’t get me wrong. This doesnt make me some daytime recluse, shying awaying from human contact – and daylight for that matter. I love it for it leaves my mind largely unitterupted to drift outside the box and ask – and try to answer – the questions that occupy my mind. Questions, that during the daytime, are drowned out by the emotional, physical and audible noise of hospital life.

For that reason, for me, at least there is a zen like state about night-shifts. You are one of a handful of doctors and healthcare members covering some 300 or more hosptial beds. You will – and do – get called to anything and everything. On a typical night I can expect to get called to a cardiac arrest (when someones heart stops), to possible new strokes, patients who fall out of bed, drug charts that need re-writing, family’s who need to be called to say their loved one is dying and they need to come in, and to write pain relief medication. All of these things indeed have happened since I started my shift at 9pm on Friday night.

As I go through a night shift, I find a very precious time. It’s a time to think about medicine, my career choices, – my life choices even. There is no magic to this – it is quite simply the silence of the night shift lets me do that. And to be honest, in a world that is as noisey as ours – with mobile phones and emails keeping us constantly connected – I welcome the opportunity for some peace and quiet. Of course, yes, the down side is that when it all goes wrong, and patients get really sick, and you are exhausted at 4am trying desperately to get a needle into their vein, the zen is gone, and the stress levels rise. You take the rough with the smooth.

I am sure I will be told I’m a little dramatic (well, my mum always says I have been one for theatrics even since I was a talking table in the school play) but I see the night shift as an adevnture! It is also a challenge for yourself. I like to see how well I can cope with the lack of sleep, with my body’s desperate desire to make me shut down into a low-power setting, and with the knowledge that I am part of only a small medical team and there is very little support outside of this. It teaches a certain degree of autonomy as a doctor and it pushes you to make decisions in the dead of night that during the daytime you could very easily defer to someone else. That ‘push’ makes us better doctors – and I would hope that means better patient care.

[15 minute pause in writing this]

As I have just learned too – the night shift is a rare opportunity to practice the things you don’t often get to do in the daytime; Like, as I have just done, to put a cannula into the vein of a screaming 4 year old boy. Now putting a cannula (they’re the tube that go into the veins to give medicine and fluids) in a adult can be tricky enough but when you are faced with an arms flairing, lungs open and vocal cords roaring, 4 year old grissler – it is an alltogether more challenging task. Still, after using two nurses and one mother to help me (and I must confess, on the second attempt), we managed to get the cannula in. In a vocal range that could rival Maria Carey, all it took to appease this little one was a sticker with a smiling panda on it. To be 4 again.

The sun is rising and the London is waking up once more. You may not all have a night shift to find your zen peace and quite but do try and find some part of your day or week that allows you the time to properly digest your thoughts rather than let them fester and give your brain indigestion.

Right, time for a coffee and a stroll of the wards….

Nick