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AUG 07/2013

Junior doctors guide to working the night shift

Night shifts can be a daunting prospect for many healthcare professionals, requiring you to change your body's natural routine without compromising on your work.
 
Newly qualified junior doctors are this week beginning their first foundation year in hospitals across the country, meaning they will have to quickly adapt to ensure that they can remain awake and alert when needed.
 
Taking on night shifts is essential in the 24-hour healthcare sector and according to the European Working Time Directive most junior doctors are required to work full 11 to 13-hour shifts during the night as part of their normal rota pattern.
 
This can mean you are expected to stay awake and work throughout the night, rather than remaining on-call.
 

Preparation

It is essential that you prepare for the night shifts to give yourself the best chance of coping effectively.
 
The body is governed by an internal daily body clock in the hypothalamus, which generates the circadian rhythms controlling our sleep. They run over 24-hour periods and at night our bodies prepare for sleep and begin to slow down.
 
Night shifts require you to fight against these rhythms so it is important to get enough rest before you head to work.
 
Try to build up a new sleep routine and get plenty of sleep before your first shift. Consider having a long lie in the night before, ideally until at least midday. Avoid alcohol, caffeine and eating large meals straight before bed which could disrupt the quality of your sleep.
 
Straight before going on duty two-hour afternoon naps are also very useful when trying to stay alert later on in your shift and keep fatigue at bay. On breaks it can also be helpful to have naps of between 20 and 45 minutes, but be careful to set an alarm before you rest.
 
Make sure to eat a balanced meal and drink plenty of water before going on shift so that you are not hungry or dehydrated while working. A high-protein, low-carbohydrate meal is recommended for doctors preparing for working at night.
 

On the job

After coming on duty it is important to make sure that you have a 'lunch' in the middle of your shift in order to keep you going. While it may seem unnatural to eat in the middle of the night it is still the halfway point in your work and you will need to keep your energy levels up.
 
Avoid over-reliance on caffeine by monitoring how much you are having during each shift and remaining aware of the consequences. Do not have any in the four hours before the end of your shift as it could disrupt your sleeping pattern once you return home.
 
In order to stay awake while on shift you can keep your body limber by practicing a few simple stretches which will get your blood pumping around your body.
 
Safety is always paramount when working on the night shift so make sure that you tell other members of staff where you are going at all times and arrange a safe way of travelling to and from work as soon as your shift pattern rota is released.
 

Recovering

After your shift it is essential to get as much rest as you can and to get into a regular bedtime routine with a long lie in.
 
Once you stick to this sleeping pattern and the same daily eating times you will begin to feel that night shifts are more natural and you should feel less tired during the night as your body clock adapts to the new routine.

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