Hospital at Night

I AM: eating breakfast before going to bed

I have learnt some valuable things over the last few nights. Like: body clocks are very easily messed with. And: the second night is tougher than the first, but by the third you've got the hang of it. There is a very wide variation in the calibre and usefulness of ward nurses. Having to carry a walkie talkie on your belt all night is intensely annoying, particularly when your trousers are too big in the first place. 4am is not a great time for an impromptu teaching session. It really is okay to call your registrar and tell him you don't know what to do, even if it seems ridiculous because the best explanation you can offer is "her obs are stable, she seems okay, but something isn't right and I can't work out why" - because we're trained to spot sick people, not just sick blood results.

3am is not a bad time to have a crisis of confidence and want to cry - because there's no one in the corridors, so there's space to pull yourself together. It's pretty embarrassing when, assessing a confused patient, you ask what day it is - then realise you don't know yourself. Hospital at Night (HAN) nurses and coordinators look after their team really well, and when you finally roll into their office for your break at 6am, they'll let you stay there for an hour to recover and tell the wards to wait. People do not take kindly to having needles stuck into them in the middle of the night, however many times you warn them you're about to do it. They're not keen to chat, either. Some are worryingly hard to wake up.

It's really difficult to make decisions about a patient's management when their case is complex, you don't know them, and the team who've been looking after them for three weeks have failed to make a plan. If you don't drink anything between 9pm and 5am, you will get dizzy and have a tummyache. The BNF is your bible, and will save your stupid ass (and your dignity) regularly. Saturday night is a prime time for staff being generous with yummy foodstuffs throughout the hospital. You can even get in on Chinese takeout if you're in ward 9 at the right time.

Finally, and most importantly - I can do this. There have been many points this weekend when I thought I couldn't, and there will undoubtedly be many more. However, thanks to some wise colleagues letting me get on with it but making sure I know they're there if I need them, I've finished this morning feeling very optimistic about it. To all those people who've asked me if I'm loving being doctor - it's taken a few weeks to get here, but today the answer is a resounding yes.