Lessons from Working a 24 Hour Shift

We love visiting Saskatoon in the summer.

I occasionally do locum work at different universities.  Locum is short for locum tenens, a Latin term describing temp work for doctors.  I assume they don’t call it “temp work” because doctors would rather be called “locums” rather than “temps”.  In any event, I am usually on call the entire time, and during my last locum position I got called in at 2:30 am for a horse with colic, worked the whole day, then did a back dog and a spay dehiscence after hours.  I learned and relearned some things and thought there were good lessons to share with you.

The colic case did reasonably well until they untwisted the colon torsion.  Then all hell broke loose- the blood pressure tanked and the heart rate rapidly climbed from 40 to 90.  The horse was resistant to all treatment and ultimately died. It was only the second horse I’ve had actually die under anesthesia in 20 years.  I was frustrated, sad, angry, ashamed, and felt powerless. I acknowledged those emotions, then talked with one of the other anesthesiologists and the new second-year resident about the case.

Then I had a little time to go home, get a shower, and get back for the day.  I had only gotten 3 hours of sleep the night before, so I was a little groggy, but I had cases for which I was responsible, so in I went.  The day progressed fine, then we had the first emergency around 6 pm. That case did fine until it recovered, when it started screaming. I was basically alone- there were no students, the techs were all busy with other cases, and the surgeon was getting ready for the next case.

I had a relatively brief but powerful anger wash over me.  What the hell is wrong with a system where I’m doing a case by myself and there’s not enough staff to help me get this patient comfortable?  I felt like screaming and swearing and cursing the ridiculous system. It may have made me feel a little better, but it would have upset everyone else and the situation was, frankly, beyond my circle of control.  What COULD I do? I asked one of the techs to get the surgeon and we were able to get the patient comfortable and settled.

Between that emergency and the next, I had time to get some water and a bathroom break.  It was about 10 pm by this time, I was working on four hours of sleep (I got a little nap in during my afternoon lunch break!), and I had been up for 20 hours.  I hit my second wind and thought, “This is hard, it’s not what I WANT to be doing, but yes I am having fun and feel pretty good.”

The last case finished around 2 am and I got home but was still on edge from the day so I got to sleep by 4 am.  In veterinary medicine, if you’re not doing 24-hour shifts at least once a year during your training, I would suggest that you’re probably not working hard enough.  I rarely do them now as I am a fairly senior faculty member, so it was an experience I haven’t had for a few years. I realize some jobs require shifts that last 48 hours or longer, so I’m not saying this was incredibly arduous or amazing.  But it was an experience I haven’t had recently. This experience reinforced some ideas and philosophies I want to share; lessons I would like to pass on.

  1. When you have a poor outcome or something bad happens, you have two options: ignore it and assume you did everything you could or contemplate it and talk to others to see if they have ideas you don’t have.  The resident had a couple of decent questions which helped me reflect on the case. Being able to seek outside help or input, and accepting that from anyone- even those who may know less than you- is about humility.  Everyone can work on improving their humility. I was reminded that you can learn something from anyone and humility is critical to success in life.
  2. You Do The Work.  Because you’re a god-damned professional.  I don’t care if you didn’t sleep well last night, or you’re feeling out of sorts, or you don’t wanna.  You do the job. I understand if you’re actually sick, or someone died, or you’re starving from not having eaten all day.  I also understand different people have different tolerances. But, at the end of the day, others are relying on you. If you can’t get the job done, arrange for someone else who can.  You can’t just not show up or show up and put in a poor effort. As a veterinary professional, you are expected to act professionally. I really didn’t want to go back in after that colic case, but I took care of myself as much as I could, took a deep breath, and went in because others were relying on me.  It reminded me of the difference between professionals and everyone else.
  3. There are three types of happy lives: the pleasurable life, the good life, and the meaningful life.  The good life includes flow and using your strengths in your life to enhance flow.  Even though I worked long hours during this shift, I was in a state of flow for much of it.  It was… fun. It made me feel satisfied and, ultimately, happy. The takeaway here is: make sure what you’re doing for work makes you happy.  There’s no need to be in a miserable position you hate. Life is too short.

I suppose you could say that I just found justification in a difficult experience for decisions I’d already made earlier in my life.  A narcissistic sociopath who has someone praise them may interpret it as validating their life decisions. Ah well, I think my life is terrific, I’m very happy, and I hope you can have a happy, satisfying life.  Above are some ideas I believe would be helpful in the pursuit of that, in your career.

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