Nighttime in our community hospital was something to be dreaded when I was a resident. It meant I was on overnight call, following a regular day’s work. The hospital emptied of the day staff and visitors, leaving limited lab and imaging services, fewer nurses, a couple of physicians and emergency room staff–tag, you’re “it”. When the pager went off, if it were the emergency room, that wasn’t good—most likely a new admission, possibly unstable, requiring at least an hour for a thorough assessment, plan and documentation. Multiple admissions were “hits”. It could be a nurse calling for any patient in the hospital, likely unfamiliar to me, for something aggravatingly simple (you woke me for that?), or something quite dire. Did I need to get out of bed to attend to the issue, or manage by phone? Did I need to call for backup from another resident or attending, which involved waking them up and risking their ire? If there were a woman in labor, it usually spelled long hours and the anxiety of two lives at risk if we missed a problem. Was there any chance I could get enough sleep to be able to function the next day? My mind played games as I tried to sleep in the hospital’s converted nun’s cells; I would physically jump, my heart pounding, with each pager call.
Trudging through the darkened halls it was a struggle to overcome my own grumpy fatigue mixed with mild terror. It was clear that I was not a night person. Then there was a gradual change as the O-dark-hundred hours waned and the day staff reappeared. My circadian rhythm kicked in, allowing me to join the morning rounds, report on the night before, and find a way to finish the rest of the day ahead.
Most of the hospital work was done in rooms without a view but coming down from the nun cells/call rooms on the top floor, it was possible to look out a window to the east. Sometimes I would stop there in the early morning turning of the earth, captivated by the line of the Cascade mountains and the reddening sky before the sun appeared. In that quiet and beautiful alone moment I could breathe, wonder, and find space to carry on.
Khati Hendry
“Breathe, wonder, and find space to carry on.” The new day brought you a sense of renewal and that’s what dawn is all about, Khati; a sense of refreshing oneself. Your photo is breath-taking.
Dawn does seem to have that special quality of a fresh start. If you are awake to see it, it can be a special reward. The picture is indeed dawn over the mountains—but outside my current house in Canada—and I get to see it going to make coffee in early hours.
Oh Khati, my son’s a nurse who sadly works more shifts than he should. Your story led me to visualize the night shift and all the unexpected things that could occur. Must be a long and anxious waiting game. Your vision of sunrise summoned thankfulness and sustaining assurance, hope my son shares this moment on his way home. I must ask him.
The night shift in a hospital plays by different rules and can be stressful—or quiet. Many nurses work really long shifts or double shifts with short staffing and it would be interesting to see your son’s experience.
Thanx Khati for sharing another example in your long, extremely dedicated medical career.
Had you not been a physician you could have been a writer, this story like your others, is seamless. And thanx for letting us join you at that east-facing window!
Thanks Dana! That view to the Cascades was always a joy, but never more so than at dawn.
The last line is a thing of beauty.
Medical shifts are not. They are insane. I often wonder how many serious errors are made under the influence of sleep deprivation. Airline pilots and truck drivers have strictly regulated hours, but doctors and nurses can be worked until they are walking around in a daze, yet expected to make life-and-death decisions.
Crazy.
Thanks, Dave. And amen on the night shifts. I know many programs have improved hours after a lawsuit over a death in Massachusetts some years back, but not enough. I had a week of every-other-night call on one rotation and refused to do it again (36 hours on, 12 off, rinse, repeat). Insane. I took many steps to mitigate the effects of night call over the years, and never regretted it.
This sounds so familiar, Khati. My husband described his overnight calls in a similar manner. Back then, when the pager went off, he knew sleep was gone. He hated those nights and welcomed the dawn of a “regular” day.
Yes, certainly not an experience unique to me. You understand.
What a unique framing of dawn, and one that most of us have not experienced or thought about, Khati. Thank you for sharing this insight of dawn at a hospital, as seen and felt by the medical staff.
Glad to share. One of the things I like about Retrospect is the opportunity to get a glimpse of others’ experiences.