Nights

I think it goes without saying that most people hate nights. I quite like nights because there's no-one else interfering, and there's normally a great "survivor" attitude. You can't faff around arranging CTs and contacting GPs - because they don't do that overnight. And nor should we - a 24/7 healthcare service isn't viable at the moment. Yes, if it's an emergency - we'll sort your CT. But if it doesn't change your overnight management, and won't impact on your life - why should we? What I don't like about nights is not being able to do your job. I'm on nights this week, and they're looming up on me like a big dark cloud. I'm terrified - I don't know who my juniors will be, whether the Nurses will be helpful (most likely they will be, I know one or two of them), but most importantly, will I have the resources to do my job? Or will there be five hour corridor waits overnight? Will there be a three hour queue for radiology in the morning? Will the Consultant arrive in the morning and disagree with every decision I have ever made? Will I need to argue with the surgical SpR about something I believe is right? If I do- will my Consultants support me? Topped with that there's always the question of "should I ring the Consultant"? And moving from hospital to hospital affects that - here, if a trauma comes in either I deal with it, or they go to the MTC. In other hospitals, as soon as that trauma alert goes out, the Consultant is rung. And, in the heat of the night when you're tired, sub-optimal and trying to do everything - remembering where you are and what you do here isn't always easy. The news is always full one week about how shift work and night work is bad for your health - and then the next week it demands longer GP opening hours and a 24-7 Consultant lead health service. Well, I've got news for you. Doctors are people too - and they don't like working nights any more than you do, and the pressure has to stop somewhere. So When I'm a Consultant...I'll encourage my SpR to ring me, when ever they need to. If they think "shall I call the boss"...then they should. I'm sure that'll change after a few sleepless nights leading to sleepless day shifts. And of course, that's if they aren't non residential calls. As a specialty we wonder why people move to anaesthesia...I was always encouraged to call my Consultant, what ever time of day, when they needed to they came straight to the hospital, and never ever made me feel like I'd made the wrong decision. Is that the pressure of EM demonstrating itself, or just the personalities of EM consultants? I don't know - but I know what I'd rather.