Surviving Night Duty

Much of my time was spent seeing patients whom we thought were going to die during the shift – because we were under the (mistaken) belief that a death certificate could not be written by a doctor unless they had personally seen the patient when they were alive. I also failed to have any strategies for managing the disruption of working during the night.

All doctors in training have to face the challenge of night shifts, and there’s good evidence that working at night can impair doctors’ work performance and their health.

The following sleep strategies can improve your ability to successfully and safely manage your next set of night shifts:

Day of first night shift

• Sleep until you wake naturally (don't set an alarm).
• Avoid a morning coffee.
• Have a 90-minute nap between 2.00pm and 6.00pm.
• Have a coffee after your nap.

During night shift

• Maintain exposure to bright light.
• If possible, take a nap of 10-20 minutes during the early part of the shift.
• Have caffeine before napping.

When to eat

• Eat your main meal immediately before the night shift.
• During the night shift, eat lightly to remain comfortable (ideally high-protein, low-carbohydrate food).

Last few hours and on your way home

• Avoid caffeine and nicotine.
• Try to avoid exposure to bright light (e.g. wear sunglasses even on a cloudy day).
• Consider public transport rather than driving.

Days between night shifts

• Try to get to sleep as early as possible.
• Avoid bright lights or screens.
• Sleep in a dark, quiet and cool room.
• Create a routine for bed (e.g. bath or reading).
• Maximise your sleep time and remember that any sleep is better than none, even fragmented or shortened sleep episodes.
• Avoid sleeping tablets – see your GP if you think you need medication. Do not self-prescribe.

Resetting after night shift

• Attempt a nap (90 or 180 minutes) immediately following the shift.
• Go outside after waking.
• Aim to go to bed as near as your usual time as possible.

Watch MDA National’s short video on surviving night shift.

Dr Sara Bird
Executive Manager, Professional Services