I’m happy to welcome multi-published Canadian author Dr. Melissa Yi. Today, Melissa shares an entertaining post about night shifts and her new release, Graveyard Shift.
Graveyard Shift, the name of my new Hope Sze thriller, is slang for the night shift.
Love ‘em or hate ‘em, night shifts are powerful beasts that you must know how to control as an emergency doctor. So it seems like an appropriate subject for the Power of 10.
Here are five reasons to hate ‘em mixed with five to love ‘em.
Hate #5: Fewer tests
At my tiny rural hospital, I don’t have access to extended labs or any X-rays after hours, let alone ultrasound technicians, CT scans, or MRI’s.
This is scary. Sure, we have a portable ultrasound and our stethoscopes and our training, but anything could go wrong.
Love #5: Bragging rights
No one admits this, but if I’m doing a night shift, the whole world has to know about my extreme dedication. I post signs on my door saying, “DO NOT DISTURB! NIGHT SHIFT!” I warn new friends that I don’t answer my cell in the ER, and I turn everything off before a night shift. Because I’m doing a NIGHT SHIFT. Are you doing a NIGHT SHIFT? No? Then you are not as wild as me. Sorry
Hate #4: Skeletal Staff
We only had one nurse in my rural ER overnight a few years ago. Now I have two, but the volumes have gone up, meaning that we can have many people, some of them on cardiac monitors, including patients who have been admitted but don’t have a bed on the floor, or who’ve had a heart attack and are waiting to be transferred to the heart institute. We can only juggle so many patients before our brains and beds overload.
Love #4: Chill patients
Some night shift patients are a different breed. They’re not the high-strung 40-year-olds who’ve been hanging out with Dr. Google and getting themselves revved up for the past six hours. They’re the teenagers wandering in at 3 a.m. because their toe looks funny. Tell them their toe is fine, and instead of saying, “But don’t you think I need a C-reactive protein? I read that a CRP can be extremely helpful in situations like this,” they say “Okay” and go home.
Hate #3: Drunk or wasted patients
Okay, not everyone. But many people! More than you’d think. The ones roll in regularly (“Is that Sam again?” “Of course it is.”). And the ones who think a company Christmas party is a good reason to do shot after shot after bottle after bottle.
Love #3: “If I work nights, I can be home with my kids during the day.”
This is the #1 reason nurses give for working night shifts. Personally, I would deteriorate into a seething mess if I worked all night and then spent all day with my knee-high offspring, but I admire the people who do this.
Hate #2: I am alone for a long time
I work in a single coverage emergency room. That means I’m the only MD guaranteed in house. Family doctors have clinics during weekdays and some evenings, but after 7 p.m. and every weekend, I am the only physician. The buck stops with me. Every code, every lawsuit, has my name on it.
Yes, I can call specialists at other hospitals for help. It doesn’t mean they’ll be instantly available.
And night shifts last from 6 p.m. until 8 or 9 a.m.—if you leave on time. Many times, we stay late to see a patient through or chart.
Love #2: I’m alone with good people
The nurses focus on me. When I first started at one of my hospitals, we used to have a single nurse dedicated to the doctor, so that every time a wrote an order, he or she was on it. Now, when up to six doctors are work, the nurses are sometimes like, “Aaaagh! Too many orders! Take a break.”
I miss those dedicated days. But on the night shift, I’ve got it back.
And the nurses are some of my favourite people. We make jokes. We laugh. One super doctor (not me) makes fancy desserts before her night shifts, so it’s kind of a party.
Hate #1: I’m tired and more prone to mistakes
Some people may love all-nighters. Not me, and certainly not multiple ones in a row. Studies have documented more medical errors at night, when staff is tired and overworked. I try to counterbalance this by double-checking doses and by telling nurses to please let me know if they spot anything amiss. Two or three heads are better than one, and we need all brains on deck at 3 a.m.
Love #1. I get all the cool cases
No other doctor siphons off the shoulder dislocation or the pre-arrest. I’m it. And that is the #1 reason to do emergency medicine—because you love the thrills, the bizarre, the extremes of humanity.
So there you have it. Love it or hate it, night shifts aren’t going away.
And if you want to read about the world’s worst night shift, I wrote my next thriller about it: Graveyard Shift! Thanks so much to Joanne for having me.
Kobo is kindly offering a promo code, GRAVEYARD100, so you can grab a free copy here.
Some of the proceeds will prevent violence against women. Part of them will go to a scholarship in honour of Dr. Elana Fric, and some will go to the Akwesasne Family Wellness Program.
Melissa Yi wields a stethoscope and a scalpel as an emergency physician. She also pens the Hope Sze medical thrillers, which have been named one of the best Canadian suspense books by the Globe and Mail, CBC Books, and The Next Chapter. Yi was a finalist for the Arthur Ellis Award for best crime story in Canada and shortlisted for the Derringer Award for the best short mystery fiction in the English language. Her novels will debut in audio as Kobo Originals on November 5th. Sometimes, she sleeps.
Sgt. Coulter will attend this evening’s Facebook Launch Party for Graveyard Shift. All are welcome. Find out more here.