Pit stop!

We both remember nights like this all too well! Alex is over-worked and under-rested but his bleep is firing on all cylinders! Every racing driver needs regular pit stops. Both car and driver benefit in the long-run. In the race that is a medical on call, a brief time-out can improve a doctor's performance, so benefiting everyone.[1] Even the Great Healer took his team away to eat and rest when things got too hectic.[2] So, Alex could lock himself in the toilet for five minutes! NHS loos are well-recognised safety valves: bang your head on the door, count slowly to ten or even have a good cry. Bleeps can usually go unanswered for five minutes.

Resuscitation

Even the prophet Elijah snapped! Tired, stressed and hungry, he wanted to die. God provided food, time out and rest…before sending him on to his next assignment.[3] Once Alex has regained emotional control, he should attend to his physical and spiritual survival. What about some of the following?.. Shoot arrow prayers: 'Lord God help me!'[4] Read a pocket Bible or Doctor's Life Support to regain perspective.[5] Recall a timely verse: '…neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God…'[6] A quick wash and drink are excellent pick-me-ups. Alex's next destination should probably be the nearest vending machine.

A cunning plan

Munching on a Mars Bar (if there's nothing healthier on offer), Alex could make a cunning plan.

1. Damage limitation is the smart option

No-one likes being snapped at but most nurses are amazingly forgiving. A&E nurses are particularly flexible and helpful. A sincere telephoned apology could do wonders for the rest of Alex's night in A&E! He could even ask her to apologise on his behalf to his waiting patient.

2. Prioritisation is worth learning

Try listing bleeped requests as 'urgent', 'this shift' or 'next shift'. Let people know where they stand, for example: 'Thanks for letting me know about this. I'll get onto it by the end of the shift'. There is nothing non-Christian about reminding others that you only have one pair of hands and legs! If people argue with your prioritising, turn to…

3. Negotiation, the art of making everyone happy

Alex could have given that ward nurse three options: accept a non-opioid verbal, do nothing until he could leave his higher-priority patient, or send an HCA down with the drug chart. This last option would have satisfied him, the nurse and the patient!

4. Delegation is wonderful… in theory at least

Alex's team should be brought in to help, and jobs reallocated where possible. Be clear about which team member you're asking to do what and that (s)he is proficient in the necessary skills.

'But I'm a Christian…'

Irritable sleep-deprived Christian medics often feel guilty. [7] Yet our bodies are not meant to function without sleep or nourishment. An irritable remark certainly isn't a positive witness, but a sincere apology from a tired medic is a rare thing and people do sit up and notice. If you're usually irritable when sleep-deprived, it may be worth apologising in advance.

Spare time?

Alex should look at his time off. Sleep, sensible meals and time with God are absolute musts.[8] A plethora of Christian meetings (however worthy) is unlikely to refresh, but a relationship with God should take priority. This does not necessarily mean a regular quiet time or weekly church attendance.[9] Regular chats with a 'soul friend' may be better than dozing through Bible study groups![10] Calling into the hospital chapel can be helpful. CMF have a mentoring system and regional juniors groups.[11]

Looking to the future

The memory of 1:2 on calls without protected sleep may be dimming for most of us but the NHS still works its on call doctors hard! The Hospital at Night policy, rolling out across the NHS, should help further.[12] Alex may find such awful nights becoming rarer as he gains experience. Still, even seasoned juniors have the occasional nightmare shift. If his problems continue, Alex should confide in his tutor. He could also contact the Doctors' Support Network, and see his GP;[13] he may be at risk of burnout and depression.

Be thou my vision, oh Lord of my heart… be Thou my best thought in the day and the night, both waking and sleeping, Thy presence my light. (Ancient Irish Hymn)