Looking after yourself on night shifts

Clinically reviewed by Dr Nick McIntosh, Emergency Medicine Senior Registrar (ACEM) · November 2026

The short answer

  • Double-check high-risk tasks around 04:00.
  • Eat, drink, and take a break.
  • Plan your trip home before your first night.
  • Talk to someone after a hard night.
On this page
  1. Fatigue is a safety issue
  2. The basics
  3. Getting home
  4. After a hard night

You can’t look after patients well if you don’t look after yourself. Nights are hard on everyone, and a few simple habits make them safer for you and your patients.

Fatigue is a safety issue

Being tired impairs your performance as much as, or more than, being over the legal alcohol limit for driving. Most people hit a low point around 04:00. Double-check anything high risk at that time, especially prescriptions.

The basics

  • Eat and drink on every night, even when it’s busy.
  • Take a break. A short nap on your break, of no more than 20 minutes, helps if your hospital allows it.
  • Use caffeine early in the shift rather than late, so you can sleep when you get home.

Getting home

Plan how you’ll get home before your first night. Doctors driving after very long shifts have more crashes and near-misses. If you’re too tired to drive, rest first, or take a taxi or public transport.

After a hard night

A death, a mistake or a rude phone call can stay with you. Talk to someone: another junior, your registrar, your supervisor or a friend. If something is still bothering you after a few days, get help.

  • If you’re in danger now: call 999.
  • Samaritans: 116 123, 24 hours a day.
  • BMA counselling and peer support: 0330 123 1245, 24 hours a day, for all doctors.
  • NHS Practitioner Health: text NHSPH to 85258 for 24-hour crisis text support.

General education for doctors, not advice about a particular patient. Your hospital’s policies and your seniors always come first.

Sources (9)
  1. Fatigue, alcohol and performance impairmentNature 388(6639):235. Dawson D, Reid K
  2. Anticipating and managing fatigue associated with doctors’ working patternsBritish Medical Association (BMA)
  3. Extended work shifts and the risk of motor vehicle crashes among internsN Engl J Med 352(2):125-34. Barger LK, Cade BE, Ayas NT, et al; Czeisler CA
  4. Fatigue and sleep deprivationBritish Medical Association (BMA)
  5. Moral distress and moral injury: Recognising and tackling it for UK doctorsBritish Medical Association (BMA)
  6. When to use 111NHS (nhs.uk)
  7. Contact a SamaritanSamaritans
  8. Counselling and peer support servicesBritish Medical Association
  9. Shout and PH crisis support text serviceNHS Practitioner Health

Adapted from First Night On Call, chapter 5: Looking after yourself overnight, version 2026.1, UK Edition.

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