Surviving night duty

Before the night

• Sleep in the afternoon if you can, even for 90 minutes.
• Eat a proper meal and pack food and water.
• Charge your phone and carry a power bank.
• Make sure the guides on this site are saved offline.

Handover

Get a written handover of:

• Sick or unstable patients and their plans.
• Patients not for resuscitation or escalation.
• Pending results and jobs.
• New admissions expected.

Ask "Who are you worried about?" It is the most useful question in handover.

Prioritising calls

Not all calls are equal. Rank them:

Tell the nurse when you will come. A nurse who knows you're coming in 20 minutes will call less often than one left guessing.

Common night calls

• Temperature spike
• Low blood pressure
• Low oxygen saturation
• Chest pain on the ward
• Confused patient
• Patient has fallen
• High or low blood sugar
• Fitting patient

Escalation

Call your senior if:

• You're worried, even if you can't say why.
• The patient isn't responding to your treatment.
• Observations are getting worse.
• You're out of your depth or overwhelmed by calls.

Use a clear structure: who you are, which patient, what is wrong, what you found, what you've done and what you need.

Staying awake and safe

• A short walk or splash of cold water beats a fourth cup of tea.
• Drink water through the night.
• Double-check doses between 3 and 6 am, when errors peak.
• Don't drive home exhausted after a 36-hour duty. Take a rickshaw or a nap first.

After the night

• Hand over clearly, in writing.
• Go home. Don't stay for the next round unless required.
• Sleep in a dark room, then do something non-medical.

Morning handover

Hand over the sick patients first, then the outstanding jobs and any relatives who need early attention. Be honest about what was done and what is still pending. Keep a short running list of open jobs through the night so nothing is forgotten at handover; see handover and notes for a simple structure.

Frequently asked questions