I really detest night on-calls. They are exhausting and put anyones sleep-wake cycle out of sync. But alas, this is a part of the career we chose and makes up a significant chunk of our job role. During my internship I had to do an on-call night shift every other day or once in 3 days which was both physically and mentally taxing. Even when doing a night shift that is calm with no admissions, getting any sleep is rare knowing that at any moment an emergency could be heading your way.

Artwork by me – I spoke too soon, post-internship I still do first on-calls because I live that NICU life!

Here’s are few tips for surviving an on-call shift:

• Adjust your sleep wake cycle

Working an on-call hospital shift is similar to flight travel – the jet lag/post-call blues is real and no sleep does not make me a happily functioning doctor. To combat this I always take a few hours nap before the shift – ideally the junior doctor who does the night on-call shift gets to leave a few hours earlier. This is the ideal time for a quick nap. You can never predict what a night shift will turn out to be and so sleep whenever you can, wherever you can. Therefore when you do find a few spare hours before your on-call shift – take a nap – don’t go into a coma, just take a 2-3 hour nap! Change your sleep-wake cycle to ensure that you get a rest before your shift and you can also get some sleep during your shift. If you have too long of a nap then you won’t be able to sleep during the shift so nap smart!

• Keep snacks on hand

Fuel will keep you functioning so make sure you pack a dinner to take with you or take snacks – energy bars, chocolates, fruit, whatever. Hopefully you will get small breaks inbetween in order to eat. Remember you need to keep your energy levels up! If you can’t get a hot meal – ramen noodles or cup noodles will do the job as all you have to do is pour in some hot water so definitely invest!

• Ensure a functioning senior is on hand

As an intern the last thing you would want is to get stuck in an emergency with no help on stand by. Make sure that you have the correct on-call senior’s phone number and if not at least your consultant’s phone number (use wisely or expect the wrath of your consultant). Never be afraid to inform you SHO/MO though because not informing your senior will have worse consequences than informing them.

• Wear comfortable clothes 

In the night, dress to rest! I mean there will be the wake up calls and the emergencies to run off to, but in the name of adequate sleep, dress comfortable. Nothing too tight or stuffy that can make you overheated and uncomfortable. Always wear slip on shoes/sandals which do not require any fastening so that in the case of an emergency you just slip it on and run! My favourites to wear are flowy skirts, loose tops and pants (I ignore the Sri Lankan no pants rule for women) – easy to sleep in and easy to run in.

• Take fresh bedding with you

You can never guarantee that the bed sheets will be fresh – you don’t know where they have been or what has gone on. So do yourself a favour and always take a fresh bedsheet, pillow case and blankie. It is more likely that the patients have better bedding than the doctor so please take a fresh set with you for all your oncalls. If the mattress is uncomfortable you can talk to the in-charge ward sister about it because no joke but serious back pains will occur.

• Keep the mosquitoes at bay

I cannot even begin to describe the amount of bug types I have now come across after working in a more rural area. Dengue is rampant and with the constant supply of dengue patients throughout the year, you can never be sure about the presence of mosquitoes. They may not always be seen, but the bumps on your skin the next day will tell a different story. Take a mosquito repellent with you – instead of coils which expel fumes, get one that you can plug in and vapour will be emitted or just splash some citronella oil around the room (warning – it has a very strong odour!).

These are just a few of the tips that I utilise when I’m on-call in addition to doing a countdown of the number of hours left of my shifts. I also try to implement a basic skin care routine whilst I’m doing a shift – cleanse, tone and moisturise minimally! I hope these tips will help you have a somewhat easy on-call shift. About the 101 calls you get however, the only advice I have is to pray!