The Intern’s Guide to Sleepless Hospital Shifts

The Intern’s Guide to Surviving a 24-Hour Shift: Coffee, Chaos, and Catnaps

1. Welcome to the Jungle (Ward)
Your white coat might be crisp, but by hour 18, you’ll feel like it’s stitched from despair and leftover adrenaline. The 24-hour shift is the rite of passage every intern stumbles through. You’ll walk in with energy and leave with eye twitches and three pens that aren’t yours. Just remember: everyone has survived it before—barely.

2. Coffee: Nectar of the Overworked
Coffee isn’t just a beverage; it’s the unofficial currency of the intern floor. But here’s the key: strategic caffeine consumption. Too early and you peak at hour six; too late and you’ll be awake at 11 a.m. post-call, hallucinating your stethoscope is whispering to you.

Coffee Strategy Tips:

• First dose: After rounds begin. That’s when sleep inertia starts strangling your brain.
• Second dose: Just before post-lunch slump (usually 2 p.m.).
• Final dose: Only if there’s a code or a crash—because you’ll need the heart rate of a hummingbird.

3. Hydrate Strategically (but not too much)
Water keeps you alive and functioning. But if you chug it like a gym rat on creatine, expect to know every bathroom on every floor. Balance is key: sip regularly, not gallons at once. Bonus: dehydration makes your headache worse, and after reading 12 progress notes written in hieroglyphics, you’ll already have one.

4. Avoid Sitting Down – You Might Never Get Back Up
The number one mistake of new interns: sitting for “just a minute.” That’s how your attending finds you drooling on the keyboard of the ICU computer at 3 a.m., your EMR still open to a normal ECG you stared at 2 hours ago.

The Rule:

• If you sit, it must be intentional.
• Never sit without setting an alarm on your phone.
• Sitting = sleeping. Sleeping = possible disciplinary email.

5. Make Friends with the Night Nurse
The night nurse is your lifeline. They know where the veins are, which patients throw bedpans, and which consultant answers the phone after midnight without cursing. Respect them, help them when you can, and never say, “Are you sure it’s urgent?” You’ll regret it.

6. Eat Like You’re Planning for War
Your metabolism will betray you. What feels like a harmless croissant at 7 a.m. might come back as gastric regret by hour 22. Pack your own food if you can, ideally something with protein, fiber, and hope.

Snack Survival Tips:

• Protein bars > sugar bars.
• Avoid hospital cafeteria spaghetti—unless you want to fall asleep during CPR.
• Midnight meals should be light. Heavy = nap coma.

7. Learn the Sacred Art of the Catnap
A 15-minute nap at 3 a.m. can feel like a full spa retreat. Don’t wait until you're hallucinating your patient’s EKG is Morse code. Power naps save lives—yours.

Intern Nap Locations (Classified):

• Radiology dark room: excellent white noise, but beware of the radiologist.
• Empty call room (if you can find one before the anesthesiology resident does).
• The quiet corner of the staff library—just don’t drool on the anatomy atlas.

8. Beware the Pager Phantom
After hour 16, you’ll start hearing your pager even when it's silent. This phenomenon is real. It’s called “phantom paging” and it lives rent-free in your soul. Sometimes your thigh vibrates, and nothing’s there. Welcome to the club.

Pro Tip:

• Set different tones for different services.
• Know which ones you can delay 3 minutes to finish your banana.

9. Document or Die (Figuratively)
If it’s not documented, it didn’t happen. No one will remember you gave morphine at 2 a.m. or caught a brewing sepsis case without proper notes. Chart like your license depends on it—because one day, it might.

10. Don’t Try to Be a Hero at 4 a.m.
At some point, you’ll feel like proving yourself: doing procedures solo, admitting 3 chest pains at once, or interpreting troponins on 1% brain power. Don’t. Ask for help. No one expects you to be McDreamy your first month. Just don’t be McDangerous.

11. Laugh or You’ll Cry (or Both)
Sleep deprivation turns emotions into wildcards. You may cry over a missed lunch tray or laugh at a code blue joke. Let it out. Vent with your colleagues. Share memes. Laugh about how you just introduced yourself as “the nurse.”

12. Carry the Essentials
Your survival pouch should include:

• Two pens (you’ll lose both)
• One granola bar
• Alcohol pads (not for patients—for cleaning your stethoscope and dignity)
• Deodorant
• Mini mouthwash
• Hand sanitizer (life is sticky)
• Power bank (you don’t want to beg radiology for a charger)

13. Know When You’re Too Tired to Be Safe
Fatigue doesn’t just make you slow—it makes you dangerous. If your eyes are closing during charting or you’ve rechecked the potassium level 5 times because your brain can’t trust itself—ask for help. This isn’t weakness. It’s professionalism.

14. Embrace the Weird Moments
Midnight conversations about the universe with the psych resident. The patient who swears the ECG machine is reading their aura. The surgical registrar who walks in at 3 a.m. smelling like espresso and despair. These moments are yours. They’ll get funnier with time.

15. Post-Call Recovery is Not Optional
Going home after a 24-hour shift? Do not pass Go. Do not clean your house. Do not "just check Instagram." Go straight to bed. Block calls. Text your mom later. Your neurons need silence and sleep, not endless scrolling or existential crises.

16. Reflection (Once You Wake Up)
You’ll make mistakes. You’ll forget to check a lab. You’ll misplace your badge. That’s all normal. The goal isn’t perfection—it’s progress. Every shift is a step toward becoming the kind of doctor you looked up to.

17. Final Thought: You’re Not Alone
Thousands of interns are right now googling “how to survive 24-hour shift without collapsing.” You’re not broken. You’re just learning. This is hard. It’s meant to be. But so are you.