How old are you?
Any experience doing 24 hour shifts?
What’s the nursing culture there?
I went into fire/EMS at age 18, so I had a lot of experience working 24/48’s. I started as an ER doc at almost exactly age 30. Now at 35, i still do 24 hour shifts occasionally, but even with a slow night, I don’t bounce back as easily as I did at age 20 in the fire service. Usually sleep for 4 hours “post call” even if I got 6-8 hours of sleep at the hospital because it’s just not good quality sleep. We have a stable group, oldest full time docs (two of them) are i. Their late 50s and only do 24’s. I fill in so while I prefer the 24’s, I sometimes work 12s. I had a lot of experience in my late teens and 20’s with 24’s so they don't bother me that much.
My 24 hour sites average 16-18 per shift. Very heavily skewed towards pre-work/school (6-9 AM) and after work/school (4-10 pm). Record for me was 45 patients, still was in bed by 1am, slept until my alarm went off at 0745. Would prefer that to two CP or Abd Pain pts who roll in at 1 am and 3am. Never batted zero, though some if my partners have. Slowest day for me was 6. First patient at 3pm, last patient around 8 or 9 i think.
Experienced nurses are key. Some of these ladies are old enough to be my grandmother. They come from the days when they worked up the patient with protocol orders, and called the patient’s PCP “Hi Dr. Smith. Your patient, Mr Jones is here, with chest pain. Labs are xxx, first trop us negative, and we faxed the EKG to dr. Cards and he said it looked fine. Should we admit him for you to see in the morning?”
Unfortunately, more and more of them are retiring. CP is a bad example, we dont have cards to read our EKG’s anymore so they actually have to wake me for CP to look at the EKG, but then after examining the patient, I can go back to sleep until the delta trop results (unless there is a critical result, when they call me). Abd Pain might be a better example, they technically cant order CT imaging, but know me well enough that I don’t care, and will just call me after labs, imaging, etc are done and I can see the patient then. They are very good at telling sick/not sick, and if they even suspect something is amiss, i get paged to see the patient before they do their thing. If they call me during triage, my spidey senses go up. They are usually right. The most egregious example of them protecting physician sleep was a guy who cane in early in the AM because he needed a covid test. They knew i usually get up at 730 when i sleep all night so they told him the test would take a while and then didnt page me until 0730 only saying “guy came in a few hours ago wanting a covid test, it came back negative, vitals are good, cxr was negative. We just need a discharge after you get your coffee. Have a good day!” (Night nurses work from 1900-0730).
I recently worked a 24 with a traveller (covering FMLA for one of our older nurses) and a relatively new grad. It’s made me decide I will retire from 24’s once all the seasoned nurses retire. I had to order my own ankle XR at 2am *gasps*!
