How To Survive 28-Hour Residency Call Shifts

In my internal medicine residency program we work 28-hour shifts while rotating through the medical and cardiac ICU every 4 days. You show up at 7am and work your usual shift and then cover all of the patients in the intensive care unit when everyone else goes home. You see new evaluations on the floors and in the emergency department and help run any codes that happen throughout the hospital. The following morning you get to leave at 11am if all the work is done and do it all over again 3 days later.

Thankfully the CCU and MICU rotations usually are only 3 week stretches at a time but it is still mentally and physically exhausting. Here are my tips to getting you and your patients through your overnight shifts alive.



Sleep (duh)

Never stand when you can sit, never sit when you can lay down, and never lay down when you can sleep. At some point you will be able to find some down time so take advantage of it when you can. I’ve found that if I can get 4 hours of sleep overnight I can somewhat function well enough the next day. 3 hours and everything takes me a little bit longer than usual. Anything less than that and I’m a zombie. Bonus points to whoever can manage to have a nap during the day before your evening call shift starts.



Pack an overnight bag

I have the same routine during every overnight shift. I claim my favorite call room with the best AC, steal an extra pillow from an unused call room, and snag two towels from the linen cart. Usually sometime around midnight or whenever there is a lull in the action I wash my face, brush my teeth, and throw on some new socks and underwear. If nothing else it makes me feel a little more refreshed and clean after being in the hospital for close to 18 hours. Of course, this plan goes sideways if I forget to bring my overnight bag. My overnight supplies consists of the following:

  • Toothbrush and toothpaste
  • Face wash
  • Contacts/glasses
  • Fresh socks
  • Fresh underwear
  • Advil



Meal Prep

My usual goal is to bring at least one full meal with me for my overnight shift. Sometimes that consists of a Trader Joe’s burrito or home made mac ‘n cheese while other times its simply some yogurt and a coffee K-cup. It takes minimal effort but makes a big difference when you’re tired and hungry. This way you can just be tired! Not to mention that ordering take out gets old and expensive pretty quickly.



Go home and sleep afterwards..but set an alarm

The best overnight shifts, and rarest, are ones where you get enough sleep during the night that you can just go home, take a quick nap, and have the rest of your day off to enjoy. Typically what happens is I get home by 11:15am, eat something small, and pass out. When I first started working overnight shifts as a junior resident (PGY-2) I would sleep as much as I wanted. The problem I encountered is that I would wake up at 7pm and not be able to fall back asleep until 3am. Which would be fine if I didn’t have to be back in the ICU by 7am the next morning. To avoid this sleep schedule nightmare I always set an alarm for somewhere around 3-4pm. This way I would get enough sleep to be able to function for the rest of the afternoon and also still be tired enough to have an early night. Or catch happy hour depending on the day.


How do you survive your 28-hour overnight shifts? Don’t forget to subscribe so you don’t miss my next blog post!

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