Surviving Night Duty
30 Nov 2018
The most miserable time in my career was a term of nights as a Resident Medical Officer working on the oncology wards.
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
My Career Journey with Dr Nick Coatsworth
Dr Nick Coatsworth is an expert in health policy, public administration and a practising infectious diseases physician. He held a national role in the Australian response to COVID-19 as Deputy Chief Medical Officer of Australia, becoming one of the most recognised medical spokespeople during the pandemic. Nick engaged the Australian community through a variety of media platforms most notably as the spearhead of the national COVID-19 vaccination campaign. Dr Micheal Gannon, Obstetrician & Gynaecologist, sits down with Dr Nick Coatsworth to discuss Nick's medical career journey, and what insights and advice he has for junior doctors. MDA National would like to acknowledge the contributions of MDA National staff, Members, friends and colleagues in the production of the podcast and note that this work is copyright. Apart from any use permitted under applicable copyright law, you may not reproduce the content of this podcast without the permission of MDA National. This podcast contains generic information only, is intended to stimulate thought and discussion, and doesn’t account for requirements of any particular individual. The content may contain opinions which are not necessarily those of MDA National. We recommend that you always contact your indemnity provider when you require specific advice in relation to your insurance policy or medico-legal matters. MDA National Members need to contact us for specific medico-legal advice on freecall 1800 011 255 or email advice@mdanational.com.au. We may also refer you to other professional services.
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