By Rebecca Mills

I would describe my first night shift to you but, truthfully speaking, I don't actually remember it clearly. Ironically, it’s one of those events many doctors have permanently ingrained in their memory – a rite of passage, baptism through fire. Yes, there were night shifts I’ll never forget; memories so vivid I merely have to close my eyes and I’m almost standing there, faced with making those same decisions and, I’m glad to say, I think they were the right ones.

But what I remember about the first one, far more vividly, was the anticipation I felt leading up to it. Sure, I’d worked ward cover, on-calls and normal day shifts… but night shifts? They were uncharted territory.

I had already received very comprehensive and in some cases, didactic advice regarding the exact time to wake up before starting a run of nights, the snacks I should prepare to maximise energy and fight fatigue, the timing between coffee intervals, and exactly how long I should force myself to stay awake post-nights in order to restore my circadian rhythm as quickly as possible. It sounded exhausting. The amount of preparation required, if anything, only heightened my apprehension. I would have undertaken that amount of preparation for a marathon.

With time, however, I began to appreciate just how differently other doctors approached their nights. Some advocated fasting the entire night through (as though somehow tricking their body into believing that, really, these nights were no different from normal). Others brought a veritable buffet of food – breakfast, lunch and dinner.

Everyone finds their own little ways to make the night more tolerable, or dare I say it, enjoyable. For there’s a certain tranquillity that creeps over the hospital during those early hours that is very different from the hustle and bustle of daylight.

One of my fondest memories, during the height of the COVID pandemic, was of sharing one single, precious slice of white bread with another doctor – when the shopping aisles were empty and I’d found days earlier, horrifyingly, that you couldn’t source any bread, pasta or milk in the stores. It’s moments like that when you realise the little things matter the most!

After the initial flurry of activity that characterised the start of a night shift had ebbed, most, if not all, would try to catch breaks in the middle of the night. This is particularly important because, as it approaches dawn and the rest of the hospital wakes up, it begins to get busy once more. This time is perhaps the most critical, as it’s also the time, towards the end of your shift, when you begin to feel fatigue the most.

Caffeine often helps, with food and drink brought from home in advance – there is nothing worse than starving on a night shift, only to realise that (of course!) the canteens are all closed.

Some find it helpful to control other factors affecting sleep: mobile phone usage/screen time, activities prior to sleeping, hot drinks, gradually shifting your body clock, well-placed naps, good quality food to optimise energy levels.

Ultimately, however, I began to realise there isn’t really one set way to go about a night shift. What’s more important is to realise that everyone’s body clock is different and what may work well for one person may not necessarily work for another. And that’s OK.

Most importantly: see what works for you, rest when you’re able to, prioritise and plan your tasks, as you would a regular shift, and most importantly remember that, even though nights can feel lonelier than day shifts, support is still available – never hesitate to ask for it.

And one final positive note about nights: they’ve led to some incredible sunrises.