Call nights are a hit and miss. On bad ones you might only see your bed at 3 am. On good ones you had an uninterrupted 7 hours sleep. The problem is there are usually no signs to indicate how your night would go, so we always plan for the worse and hope for the best. There are several comfort measures that I practice during call nights in order to minimize distress.
- Secure your dinner well ahead of call hours - nurses usually call for takeouts, and will ask you if you would like to join them. In our hospital, the night shift nurses start work at 4, so they will complete the last call by 4.30 pm or so. Make sure you pay them before the food arrives, otherwise they'll nag nonstop until bedtime.
- Eat while you can - on bad nights, calls will come nonstop. So whenever you find yourself enjoying a 10-second break, quickly gobble down some food to sustain your battle for the night.
- Shower during passovers - your calls are usually from nurses. Severity varies from the patient spurting fresh blood from his mouth to a forgotten medication. The former we have to attend to immediately, while the latter...it can wait. Now, when will nurses stop pestering you? When they're doing passovers. In our hospital it's around 4 pm (night shift) and 12 am (red eye shift). This is the safest time to shower as they're too busy handing down unfinished tasks and go home than to call you for more trouble.
- Dedicate time for petty tasks - there will be petty tasks that you have to attend to during call nights, like refreshing the order sheet, interpreting X-rays and ECGs, ordering (forgotten) medications, catheterizing a patient etc. Instead of letting nurses call and manipulate you around, tell them specifically when you intend to do all of these and ask them to list all the errands for you by a specific time. Efficiency.
- Program your nurses - some nurses are smart enough to know what's trivial and what's dangerous, and hence must be reported. Others just call at 3 am and tell you his temperature is 37.2^C and asks what would you like to do? (jab a needle into your head!) To minimize silly calls like this, program them. Tell them "call me only if the temperature goes above 38.5^C," or "do not give him insulin if his blood sugar is below 140 mg/dL." Think of them as computers. There's no point getting mad at computers.
- Tell your patients what you can and cannot do - most attendings and their residents would complete all the necessary procedures and plans before they leave for the night. However, thanks to easily accessible medical care, patients love recalling their other problems when in hospital. If you chance upon a patient that happens to suddenly remember a 5-year chronic joint pain that she forgot to tell the daytime physician and wishes you could work it up for her (can I have an MRI, perhaps?), tell her you're not her main physician and that to do what's not stipulated in her attending's plan would cause a lot of confusion in the morning. Since it's not a life-threatening problem, politely ask her to wait till the morning. Problem solved.
- Finally, if you really can't take it anymore, call for help - we have very friendly residents who wouldn't mind patching up and taking your call for a few hours. At least in Internal Medicine. Nobody can do all the work in medicine, and it's not your fault that you're human.