Night-Shift in a Daytime world.
What a crazy week! Night shifts are strange and they completely mess up all rhythm. You get home exactly as everyone else is leaving or getting up to leave.
Sunrise occurs as you drive over the bridge and brings that comfortable, strangely hopeful and happy feeling. Its buoyed by a attention starved kitty who welcomes you home and the cool sea-seasoned air through windows you open to enjoy it. Your tired, hopefully in a pleasant manner, but after the ER you still need maybe 30-60 minutes of calm before sleep is going to be a fruitful endeavor rather than an exercise in frustration and attempt at Not staring at the ceiling. Sleep comes interrupted off and on by the noisy nature of day-time, this week it’s motorcycle galore! When you wake up it’s the afternoon and part of you can’t help but chastise yourself as if you’ve slept in – even though you’ve probably gotten less than the optimal 8hrs and most of it interrupted so a cruddy less than 8 hrs. And its starts again.
Time becomes a meaningless number without context and basics like eating, etc are all random.
ER at night becomes strange-er.
Small things that people live with all day become ’emergencies’ at night, things that happened two days ago come in now because they want to ‘avoid the lines’ as well as big things that they’ve put off &/or true ‘events’.
Time becomes totally relative – a watch with the date and the day is ESSENTIAL! and if you’re familiar enough with military time then that’s probably helpful as well. Dictating charts and histories alone turns into a complex word problem like out of your math book from 7th grade but worse, where you must untangle something like: Pt retired to bed last night at 9pm without symptoms but had experienced epigastric pain similar to heart burn with possibly some shortness of breath starting four hours before that and ending about an hour before bed in a waxing and waning nature; she then awoke 2 hrs later with pain epigastrically, across left chest and in left shoulder which went away as she walked around her house for a half-hour and then re-occurred with chest tightness a few hours after the resolution of first incident at which point 2 dosing trials of nitroglycerin reduced the pain temporarily but recurred and then maybe EVAC was initiated or they tried to get her into the car…. …. what the hell time did this incident start and how long has she been in pain now ? – are going to be the first among many questions to me from an attending & is it true or atypical chest pain? in other words which system is really the problem? And the pt & family think I’m completely incompetent & not listening now because I need to know what time did you start having THIS pain after that story has been recounted to me and I feel like screaming No YOU are Not Listening. (For those who don’t know – when this happens during the day it often comes with times and relative times are in terms of lunch hour and ‘a little after 3’ much more tangible times.
When you don’t “live” on the night shift – in other words when it’s not your usual for long periods of time – your life is on 2 opposite time tables and the balls you juggle require you to be present for both. Especially in professional school where you’re working hard and things take longer than practitioners do them and then OH Yeah! School stuff too! Since this is an impossibility you end up just doing poorly with both. All of the balls you juggle all the time and the expectations of your peers/family/colleagues/professors for you to continue or maintain those juggling manuevers of course fail. Your basic needs aren’t even being satisfied so you’re always running sub-par and wondering if you’ve done X yet or not, what day it is and when was this or that event.
Imagine if I was the type of person who doesn’t like the night-shift?! Lol.