Practical advice for safe and effective on-call shifts.
Before the shift
- • Eat, hydrate, nap if possible
- • Check rota, bleep, hospital map
- • Review handover sheet
During the shift
- • Prioritise: sick patient > sick bleep > admin
- • Use SBAR for every escalation
- • Document everything as you go
- • Eat at 2 am, take a 15-min break
- • Ask for help early — never alone for a sick patient
Common night calls
- • Hypotension: A→E, fluid challenge, sepsis screen
- • Falls: A→E + CT head if anticoag/head injury
- • Pain: WHO ladder + reassess
- • Death verification: stable, document, inform family + bereavement office
- • Cannula / catheter: senior nurse first, then F1
Morning handover
- • Sick patients first
- • Outstanding jobs and pending results
- • Anticipated deteriorations
- • Family conversations needed
