When you are on-call you are expected to be available outside of your normal working hours to work as and when required, the number of hours will have been previously established within your contract. Your location during your on-call shift will also have been stated in your contract. Typically, junior doctors remain on-site and then consultants off-site to allow flexibility of work.
In this post, we provide you with some fundamental tips on how to successfully work an NHS on-call shift and some advice from an SHO General Medicine working within the NHS.
Weekend day on-calls
Weekend night on-calls
There are also different forms of on-call shifts. This can include on-take shifts, where you will perform examinations or history-taking. You could also cover ward-rounds, which is crucial for reviewing and planning patients care. Please note, the type of shift you will be undertaking will be determined by the specialty you work in.
Before you start your first NHS on-call, you will need to prepare in order to have a successful shift. The first task is to bring food with you. Often, when doctors first start working on-call they decide to order pizza and drink cans of coke to increase their energy levels. However, fast-food will only make you crash later on in your shift and will also result in weight gain.
Secondly, it would also be useful for you to organise your personal life prior to working on-call. This could include doing a food shop, paying bills, organising childcare etc. This will reduce stress and worry when you are working on-call, allowing you to focus on your job.
Thirdly, when on shift, you should carry a list of common medications with their dose to save time. This will help you speed up routine tasks.
By eating well and regularly exercising this will reduce the negative effects of working nights, such as fatigue, performance levels and your mental well-being.
1. Eat and drink properly as this will help you maintain your energy levels.
2. If you are unsure of the appropriate action – ask for help. Your responses will not be as reliable as they are during the day and nothing beats a second opinion.
3. Try and take naps when you have the opportunity
Once you have finished your on-call shift and you are making your way home, try and stay vigilant. Whether you are driving or taking public transport, your responses will be low so take extra caution to help you stay safe. Once you reach home and you get into bed, reduce all possibilities of waking you up to ensure you get a good-quality sleep and you wake up feeling rest. This includes, earplugs, blackout blinds and put your phone on aeroplane mode.
“Although everything will be taught and demonstrated within your induction, there is such an influx of information that some of it is often forgotten. In addition, as an IMG you will be used to practicing within a different system with different processes. Therefore, requesting a blood test or an x-ray can often lead to you feeling slightly confused or overwhelmed. However, it is important to remember to ask for help. This includes nurses, pharmacists and therapists as well as doctors– they would have previously been in the same position and so everyone will be happy to help you. And over time you will feel a lot more confident.”
Medicalprotection.org. (2018). Surviving on call. [online] Available at: https://www.medicalprotection.org/ireland/new-doctor/volume-2-issue-1/surviving-on-call [Accessed 16 Nov. 2018].