Out of Hours Survival Guide

Updated: Aug 7

Out of hours survival guide

By Anisha Mangtani

Whether you are a clinical year medical student or a foundation trainee, nights and on-call shifts can seem daunting. While they can undoubtedly be tough there are a few things that can help keep you sane throughout the shift.



  • Take breaks. Some of the most helpful advice I received during foundation training was that the vast majority of things can wait for you to have a sandwich, some water, or go to the loo. Be strict with taking them, and you’ll be more productive as a result. Identify some quiet places in the hospital on the slim chance you get a lie-down on nights – empty clinic rooms, for example.

  • Ask for help. If you’re new to a job or a shift type, let your senior know, and ideally the nurses too. Don’t be afraid to escalate, they will be expecting it and will be able to support you. Other avenues for help include trust guidelines, apps, other trainees and the wider MDT.

  • A big part of the job is just being organised so keeping a good jobs list with key bleeps/numbers and knowing where spare pens and batteries are kept really helps.

  • Learn how to (politely) say no. This comes with practice but not every job you will be asked to do necessarily needs to be done out of hours.

  • Invest in blackout curtains, or a good eye mask, and ear plugs. Sleep makes a huge difference to your wellbeing and working capacity. “Too tired to drive” rooms should also be available at every trust - escalate to your JDF if needed, and make use of it if available.

  • Plan some downtime and self care for either side of the shifts, whatever that looks like for you - exercise, fresh air, yoga or meditation, seeing friends, binge watching Netflix… all helpful.

  • Some people meal prep, others survive on huel and pot noodles. Experiment and find out what works for you. I find having meals that I’m really looking forward to eating makes the shifts more bearable, and making some attempt at getting my 5 a day helps me feel less gremlin-like.

  • If your mental health is dipping as a result of on-calls or nights (we’ve all been there at some point), speak to an approachable ES/CS, and/or your GP. It’s a well-worn cliche but you can’t pour from an empty cup.

It’s worth remembering however that they’re not all bad; some out-of-hours shifts have been great learning experiences and opportunities for procedures, discussions and working more closely with the smaller team present, and the zero days either side can easily be combined with annual leave to get a longer break.


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