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Uh um yeah, so I'm working in Grr right now, I'm working the Gastro ward. I've done one rotation in gen search one rotation rheumatology and now I'm in Gastro right now. So I'm just gonna have a quick talk about night shifts. It's not going to be a very long talk. It's mostly gonna be if anyone wants to ask any questions about it. Um So a typical night shift will be around 12 hours to 12 12.5 hour shift, including the handover that you come in at the start and the handover at the end as well. So you read in surgery, it starts at eight PM and this is mainly me speaking in the G R I just because that's where the only place I've worked in. Um, so it starts at eight PM and ends at 8 30. Again, this includes handover at the beginning and at the end, um for medicine, it starts slightly later at half eight and then it finishes at, um, well, half eight as well, but the handover usually last around 15 minutes. So finishes at 8 45 in the morning. Wait, Peruvian. Are you showing your presentation or are you showing us the screen with all your files on it? The presentation? Okay. I can, I can see the screen with the files on it. So, not the presentation. Is it still the files? Yeah, I saw you like, oh, uh, yep. There we go. Ok. Bye now, I'm not experiencing this. Yeah. So these are the, these are the shifts. Uh, no speaking, but it's not. So usually on the night shift, there'll be three grades of doctors starting with the most junior, which is the fy ones and then the S H O s and the Med Ridge, all the surgical rich as well. So, so these three grades will usually be at the hospital and they will always be an on call consultant as well, which is usually at home. And if the registrars have any questions, they'll be the one's contacting the consultants. So as an F Y one, you're the first point of contact for. Well, basically everything that goes wrong in the hospital, whether it be fluids or anyone becomes unwell. Well, usually the first point of contact and from then you escalate it to your S H O which could be anywhere between an F Y two or an optic and I M T two, I believe. And then from there onwards, it's the marriage that oversees the whole hospital event essentially. And in terms of night shifts, it comes, it comes in sets of threes or fours. So as you can see below that, um, some one set can be a Monday, Thursday, Monday, Tuesday, Wednesday, Thursday, and then another set will be the Friday, Saturday, Sunday. So that's the usual four and three. But like for the G R I in medicine, it goes first Tuesday, Wednesday, Thursday and then the four days of the Friday, Saturday, Sunday and Monday, which is a bit annoying because the Monday is just a bit, it's an extra unnecessary day, but that's how it works. So when you're on night shift can either be in the receiving wards or the downstream boards. And the receiving words, essentially when patient's coming through to a any or a, you, they come straight to the receiving wards to have like a proper assessment or proper evaluation to be clocked in by usually the S H O. Um So they will usually be around two S H O s for each receiving ward, I think. And they're the ones who clark in the patient's there. And as the fy one, you'll mostly be expected to do all the small jobs such as the Candelas blood's filling people's head. Hmas, um E C G S as well. So once you've done quite a few, quite a few night shifts and you gain more confidence or experience the F I once usually do the clerk Ing's as well just to help the S H O s. And what do you usually do is the clerk in the patient and then there is presented back to the S H O to make sure that uh whatever plan that if you put on is a proper one and it's actually a really good experience if you just keep doing it, uh sort of prepare you to become a better S H O. So, downstream, uh, nights is usually, can usually be a hit or miss. It can be either one of the best shifts you ever had or the worst one humanly possible. And I've usually had a horrible night shifts for most of my night shifts actually, especially in the G R I. When you're covering, when one fy one covers like 19 wards and the other F I one covers another 19 wards and that's only one S H O for each of those 19 wards overseeing you. So you will get paged for essentially everything, everything that the nurses think might be wrong with the patient or don't think might be wrong. So one of the jobs that you need to be is managing, managing acute problems with patient's and the most common presentations to see is patients become suddenly short of breath. Um So someone with someone is desaturated, become really short of breath and is usually an infection or someone's gonna Q T E or it just could be that someone is really breath or sometimes with COPD. So that's all, that's one of the most common presentations. Substances. Another one, someone spikes the temperature agitation, you'll see a lot, especially in Glasgow when delirious old people come in, um they usually get worse at night. Uh I clearly got hit with um I was thinking if I extinguisher once as well, so people who can, people can be really agitated, um contribution just quite normal and then chest pains. So you also get bleeped for other small issues, mallory issues like small jobs such as fluids and insulin prescriptions. So throughout the night, there will be nurses paging you or even putting on hospital at night on track cap for you to just do fluids, insulins and all that small little bits and Bobs. Uh Yeah. So hospital and I um it works across the whole of g, see where nurses will put in sort of small jobs, sort of like fluids or insulins or any other like Hamah, antibiotic prescriptions, uh just for you to check. So you don't get paged so often about everything. Um Just a side note, I think for most hospitals in Scotland, their healthcare support workers that come into blood scandalous and the cds and you should really use life them because nights can get really, really busy. And the last thing you want to do is struggle to get blood from someone. So these healthcare support workers are really good helping that. So I've really gone through the escalation process. So, um if I want me to get paid for stuff and then if they end up escalated. U S H O and the S H O is having doubt, escalated with marriage. Um, the one thing to note is never, probably never, like, try to be a hero if you don't know, something always ask because there can be a variety of problems that happened. And the last thing you want to do is just try to guess what you're doing. So I would say even if it's, especially when you're just starting fy one. Um If you're in doubt about anything, just believe you're S H O and always ask them because I think they would understand that. So they were in the same position as you guys as well. Um Just don't be afraid to ask them anything. So a lot of, a lot of you guys are probably wondering how to prepare for a night shift. So everyone has their own specific routine. Uh For me, I try to tire myself out as much as I can. So I usually sleep late the night before. Um, wake up really early, maybe like 77 30 AM straight and hit the gym straightaway. Go for a big cardio stash. Let me Jim or swim. I've been running just to tie myself as much as possible and then have an afternoon net. I think most of you will find that the first night shift, that net they have just before. That would be the worst one because you, you'll still be in your normal sleep routine. But usually that's my, my way of preparing for a night shift and it just gets, you get more and more used to it. The more night shifts you do again, different people have different routines. So the best thing you could just ask around and see which one works best for you. Um, so during the night shift itself, um, like I said, you arrived at half eight for medicine and eight o'clock for surgery and you call for hand over and just get handed over any of the small jobs or even unwell, okay, or even unwell patient's. Um, so small jobs can be, again, fluids, insulins, um, or gente mayes ing levels that need to be taken. But if any bloods need to be done, again, just try to use hospital at night if they're not legend. So again, regularly go through hospital and like to make sure all those small little tiny annoying jobs are done and try to help out the F I want to the S H A good visit because when you're visit, they're probably the only ones there to help. Um, also get when it's really quiet, which you can be, sometimes try to get some rest. Don't try to entire yourself by over doing a lot of things. Uh, get a nap. I've usually, I try to sleep at least 2 to 3 hours for each night shift. Obviously, you get bleeped in between. But, um, if you're really tired, I would say just get a nap, um, in the G R I as well. If you're in the doctor's mess, we usually just put a movie, um, when there's nothing much to do. So our last night shift we've binge watched the entire all six episodes of Star Wars are just amazing. So, yeah, try to relax when there's nothing much to do. So again, like I say, you will bleed for everything and when you first start night shifts as because you're still new to everything, you'll assume that everything is an emergency. So you'll just attend to all of whatever the nurses deep you for. But as time goes by, you'll get more and more used to it and you start to realize that most of it, most of these things you don't have to go to, you can literally just do it from the, from the computer, away from the actual world. So, or even like, you know, we need to go to see the patient because you don't think that's anything that needs to be done. So it just takes time and practice, keep getting beat for all these, don't know that most things you don't need to attend to. Again, I can't stress this enough. But when you're in doubt, always get help from the S H O s. Um same thing, I guess for the S H O s to get help from the marriage, they're not sure about anything. Um, Yeah. So see when you're during the day shift as an F Y one, you're basically, you're mainly just like award like a jobs monkey just doing ideals, bloods and stuff. But when you're night shift, you actually expected to become a doctor and actually like manage really unwell people. So it's a very, very good experience too to man to learn how to manage like a deteriorate indication. Um a very cool thing as well that you get to attend harry, arrest and arrest that happen overnight. All try to the hospital and you do see some really nasty stuff but also really, really good learning experience. Um, so almost done with the presentation actually. So after a night shift, it's best to get as good as a rest as you possibly can because you're changing the entire sleep schedule at that point, have a good meal as lame as it sounds like having a really nice hot meal after a night shift will really help with your rest process. Um, yeah, so after your sets of night shift try to readjust the normal sleep cycle. So what I usually do is I'll go to I'll go home, have a quick meal, have a short net with the curtains open as well because you don't want to oversleep, you just want to have um, a 2 to 3 hour nap, so you can go back to your normal sleep cycle and as late as it sounds like open the curtains actually help to make sure that, you know, there's light in the room and you're not just sleeping till 89 PM and that can really ruin you your sleep schedule. Um, again, what I do is I tire myself on the last night shift. So after the last night shift to make sure that I'm able to sleep at night. So, yeah, I would say try to ask around and see what people do before night shift and after a night shift to, to try to grab for what works best for you. So you can just keep trying until you find something that really works for you. Um So just a few points, it's definitely gonna be very, very scary, especially in your first night shift because you're gonna, you're gonna be managing a lot of patient's and I would say 98% of them, you don't even know who the patient's are or why they even came into hospital. So everyone's going to be a stranger. Um And always, always as help if need be, get into a suitable routine from what you think is the best. I think that's all. So there's any questions anyone wants to ask me. So it's a very short presentation, but it's nothing a lot to talk about. Nature's. Um If you guys have any questions you can put into the chat or um if you don't, then the feedback forms in the chat. So if you guys can just fill that out because it helps us for future sessions as well. And some of the things that you mentioned, like the steps is short of breath and stuff. We've done sessions on that like insulin, prescription fluids and stuff. So if you head over to a metal page, all the recordings are up there, so you want to refer to anything is all there. But yes, just fill the feedback form. And if you don't have any questions, I think that's us probably if you don't have anything else to say, they don't have any questions. Not. Thank you. Oh, okay. I'll send it again in case and people can't see it. Uh They're uh hop on there. It is again in the chat. Thank you. Thanks for the presentation. If you guys have felt the phone, that'd be great. Otherwise, thanks for your time and that's it. Ok, cool. See you guys.