monday night was my first call night. i had started to feel fairly comfortable with the wards by the second or third day of work, and the fourth day was my first call. i've been on call plenty of times in med school, and i've routinely worked all night on busy services without getting any sleep, without much trouble. i do fine without the sleep, i just make it up later. but monday night was different. i got paged a lot about important things that i had to take care of. and there were usually at least four or five things happening at the same time that i had to be on top of. i felt like a waiter at a busy restaurant--while i was in the middle of doing one thing, i got paged to do three others, some of which trumped what i was doing priority-wise. this patient is in respiratory distress; this one needs to be discharged; this one is asking to see his doctor about the results of his CT scan. and there were admissions just pouring into the ER all night, so i had to go downstairs regularly to evaluate and admit them. we ran out of beds on the wards, so we'd have to see the patients, admit them, and manage them while they were sitting in the ER waiting for room to open up on the floors. i didn't even know where my call room was let alone think about using it for a nap that first night. after rounds finally started in the morning at 7:30am, i caught myself falling asleep while standing up three times between 9-9:30am. that's never happened to me.
so i was tired. but it went ok. it certainly put my expectations in a good place for subsequent call nights. even getting an hour of sleep on call now will seem like a bonus, so i'm glad it started that way. and by all accounts, it doesn't get any busier than it did that first night, so that's a good way to get started.
my second call on friday night was more manageable. the admissions were more spread out and i only was called a few times for minor events during the night. i even slept an hour and a half, which felt like a long time and helped me avoid the narcoleptics of tuesday morning. some call nights are better than others, and i suspect they'll even out over time. i have many call nights ahead of me left, but there are now at least two down.
