Your first night on call as an intern

Your first night on call is a rite of passage, and almost everyone finds it daunting. A little preparation turns it from frightening into manageable.

How cover works overnight

Overnight, you’ll cover several wards and many patients you’ve never met. Your registrar covers the same patients, but with bigger responsibilities: they may be admitting new patients, or in theatre if you’re covering surgical wards. The rapid response team sits behind you both. You’re never the only doctor in the hospital, even when it feels like it.

Most Australian hospitals have an after-hours team, sometimes called ward call, though the name and structure vary. Calls may come straight to you or through a coordinator.

What to bring

• Food and water for the whole night, and something extra. Snacks to share with the nurses and the rest of the night team do wonders for morale.
• A phone charger.
• Logins you’ve tested on every system you’ll need.
• The key numbers saved in your phone: your registrar, the rapid response team and switchboard.
• A pen, and a copy of the handover.

The handover you need

Before the day team leaves, make sure you know:

• which patients are sick or worrying, and what would make the team more worried
• the jobs they’re handing over, each with a time and a trigger
• the resuscitation decisions for the patients who are unwell
• the patients they’d like you to review.

If a patient sounds unstable, ask for a bedside handover.

Before your first night: checklist

• Test your logins on every system
• Save the key numbers: registrar, rapid response team, switchboard
• Find out which wards you cover, and who coordinates calls
• Pack food, water and a phone charger
• Plan how you’ll get home
• Go to the evening handover, and use the formal handover tool
• Ask about the sick patients and their resuscitation decisions

Once the calls start

The rest of the night comes down to a few skills: deciding how fast to go to each call, knowing when to call your registrar, looking after yourself and handing over well in the morning. The free guide also works through the ten calls you’re most likely to get.