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inkysphinx

Hey, I'm not even in med school yet, but I have a difficult time working the night shift in ICU (I'm a tech). How am I ever gonna stay AWAKE when it matters?? I swear, working the night shift makes me SO irritable and I'm hardly alert. . .how do you 3rd and 4th years do it? How did your body get used to it???

Thanx!
 

Renovar

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Just you wait til your 3rd year, your first post call day on general surgery.

:)

Lots of people in my class takes SSRI's, and a lot more are literally addicted to caffein (some even take pills)... I personally find that going to bed early whenever and whichever day you can helps on call nights. Imagine if you have only 4 or 5 hours of sleep the night before your call night how you will feel on the post-call day... Sleep when you can, eat when you can.

Hey... med school isn't for the weak of heart - we all know that from the start...
 

CANES2006

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Dude, I have to figure out how to stay awake during biochemistry lectures first.:D
 
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Vader

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Caffeine helps.

In all honesty, I think a lot of it comes down to:
1) On rotations, you feel a certain sense of responsibility for your patients and their health.
2) You are required to know a lot about your patients and to read up on what you don't know. Presentations are a big part of third year.
3) You are continually trying to impress your medical team to receive stellar evaluations. Falling asleep on the job just doesn't look good.

And finally, there's caffeine. :D
 

Ponyboy

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it's pretty easy staying awake. You simply don't have a choice. There are nights where I've been down in Emerg all night admitting patients. You simply can't fall asleep because there are at least four more patients waiting to be admitted. The next day, you stay awake because you have to see all of your patients and get all the scut done. Coffee helps but it's the never ending pile of work that keeps you moving.
 

Whisker Barrel Cortex

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I agree with Ponyboy. There is usually so much work piling up when on call that you have no choice but to stay awake. The other night I got 4 admits to internal medicine within 3 hours, finished the first one, got the second one and was in the process of doing a paracentesis on that one (took an hour b/c we had to take off a lot of fluid) when 2 others came in. This was all happening at around midnight. I finished all my work around 4:30 AM and really didn't feel too tired.

As for tips. Caffeine is good! Eating whenever you can also keeps you alert. I make sure to eat dinner and snack several times during the night to keep my energy up.
 

Winged Scapula

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You do it because you have to. As long as I'm moving, I have relatively little difficulty in staying awake. I don't drink coffee but consume a number of caffeinated sodas during the day and night - no problem falling asleep when I need to.

Fortunately, dependent on service, generally the only thing that keeps me up at night are Traumas. Most nights, most of our patients are pretty stable and I've got a good plan at sign-out with the Chief/Fellow. Our SICU nurses are fantastic and keep patients going with little trouble or need for me many times.

So, sleep when you can, eat when you can and stay moving when you are fighting off the urge to sleep and there's more work to be done.
 

surge

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Originally posted by Renovar
Just you wait til your 3rd year, your first post call day on general surgery.

:)

Lots of people in my class takes SSRI's, and a lot more are literally addicted to caffein (some even take pills)... I personally find that going to bed early whenever and whichever day you can helps on call nights. Imagine if you have only 4 or 5 hours of sleep the night before your call night how you will feel on the post-call day... Sleep when you can, eat when you can.

Hey... med school isn't for the weak of heart - we all know that from the start...

SSRI's?:confused:
I thought those were Rx only.... I guess you can always borrow some Prozac from someone :D

Anyway, I sometimes use caffeine, but I'm so beyond the coffee/soda stage (no way I could ever intake the volume needed) that I use NoDose (or something similar). Also, there's Ephedrine (GNC), which I personally like the best (doesn't give you the jitters AND helps you lose weight :D ) Oh, yeah.... has been known to cause arrhytmias and other fun sideffects ;) But maybe I'll get rich some day when class-action lawsuits get under way :clap:
 

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you can do it w/o drugs! Its totally possible-the human body is amazingly flexible. You don't always need 6-7 hrs a night. 4 solid hours can be enough w/practice and concentration. And besides, the side effects of drugs could trump the intended alertness.

best,
biffer
 

ckent

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I am post-call, my very first night of overnight call, and it is pretty damn difficult. My night was especially difficult because I didn't even get to eat dinner then night before, my dinner consisted or 3 cookies I found at a nurse's station. I agree with all of the posters who say that it is easy to stay awake when there is a lot to do, but then all of the sudden at ~4:30 things just about died and my intern had to go around rounding and writing notes on everybody while I just had to watch (Med students' notes don't count for anything except for our practice in this hospital, it's a private affiliated hospital). Well, I was falling asleep just standing up watching her write those notes. And then when it cam time to do sign out rounds, (where med students don't talk, they just listen), I was having so much trouble keeping my eyes open. Next time I'm definitely going to ask to be excused for dinner because I think that's what did me in at the end.
 

drdaizy

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I've just finished my first rotation, which was Peds, and every single call night that I had with the exception of ONE was horrible. But I did manage to make it with very little caffeine consumption by sleeping well the night before, trying to catch a short nap when I had a few minutes, and by eating a little bit at a time throughout the night. Post-call days can be very rough; depending on your resident and attending you might get to go home an hour or two early, and on Peds they were always very understanding if they knew that your call night had been bad. Not so in other rotations...I guess it sort of helps that I worked a crazy schedule before med school (night shifts, had to get up the next day after 3 hours of sleep and work in a free clinic all afternoon a couple of times a week + marriage, studying, etc) and my body just got used to it over time. I'm getting used to it again, and of course my next 2 rotations have no overnight call!
 

MD2b06

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Actually, this problem worries me more than most I bet. I don't think I've ever stayed awake for 24 consecutive hours, let alone the 36 that many residency programs make you work. I've never really had a reason to stay up though. All these people that pull all nighters studying for exams amaze me. Sleep is much too precious for me. I need at least 7 hours every night or else I'm tired. Plus, I sleep like a baby. My parents tell me I slept through Hurricane Andrew. :eek: If that didn't wake me up, I don't think any pager will do the trick. So........dermatology residency anyone? ;)
 
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inkysphinx

Thanks for the reply guys! It's so cool to know that what it comes down to is that you stay awake because you HAVE to. But I'm not there yet! So I'll continue to avoid the night shift for as long as I can ;)

Good luck to ALL!
 

tussy

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It is amazing what your body is capable of when you push it to it's limits. When you're busy on call staying up for 36 hours isn't a problem. Endogenous adrenalin is the only drug you should be taking. Most residents do not take uppers (apart from caffeine, and even that not in excess). The tricks are to eat lots of healthy snacks on call (granola bars, fruit, those dried fruit bars, etc.), and never skip meals. Unless the patient is literall coding, they can wait 10 minutes while you eat a quick meal. SKipping meals just makes you even less efficient and you end up accomplishing less.

Most nights on call you do get some sleep (although it may be only 15- 20 minutes at a time). It all adds up, so you have to take advantages if you have a few free minutes. Occasionally though you may have nights where you are crazy busy the whole night long. THe other night i had a wild night of call in the ICU where i literaly never stopped running all night long, and managed several unstable/coding patients simultaneously, running from one end of the ICU to the other. By morning i was a mess, completely manic. You get a little high from the adrenalin and stress. It's quite fun if you're an adrenalin junkie. A few calls in a row like that wears you down though.

Everyone that goes thru residency survives call, so you all will too. Don't worry about it so early in your career.
 
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