Four Twelves

During the beginning of my residency I had heard some of the nurses discussing their schedules, and one of them mentioned that she was working four twelves.  Since I was new I had no idea what she was talking about.  Then she explained that “four twelves” means that you work four 12-hour shifts in a row.  Does that sound too horrible?  Probably not, unless you are a nurse (or some other profession which works a demanding job with long hours).  Thankfully we residents were either scheduled for 8-hour shifts or 12-hour shifts of only a couple days in a row.  The longest I had worked was three twelves, which is bad enough.

Then it happened.  My schedule for this past weekend showed that I was scheduled for the dreaded four twelves, with a bonus 8 hour class the following 5th day.

Since the days were over a weekend, I wasn’t working too many hours in a week, and so I could be scheduled for more days in a row.  And since there wasn’t really anything I could to about it, I decided to suck it up and deal with it.  Nurses did four twelves all the time, right?  I would survive… right?

Day 1:  Nothing too different than usual.  My primary preceptor wasn’t scheduled for that day, and so I worked with my secondary preceptor, a woman with whom I did not have much experience.  Busy day, lots to do.  Babies were sweet, but there were a lot of frustrating times as well.  Nothing I couldn’t handle with some help from the other nurses.

Day 2:  Getting a little tired, but still nothing I hadn’t done before.  Still with my secondary preceptor, still with the same three babies, so the daily routine was somewhat familiar.  One little peanut was a bit “naughty” throughout the day (“naughty” being the nursing term for her heart rate and oxygen levels dropping), and so I got more experience with quick-thinking nursing care to bring her back around.

Day 3: Back with my primary preceptor.  Rough start to the morning due to secondhand feedback from my secondary preceptor;  feedback that wasn’t at all constructive and in fact quite undermining to my already shaky confidence in my skills.  Fortunately my primary preceptor took what she heard with a grain of salt, and believed me when I said that there was more to the story that what was told to her and that it wasn’t entirely my fault.  The main part that bothered me was that this wasn’t told directly to me in the moment when I was working with this nurse.  So with confidence completely shaken I launched into a very difficult day, even by my preceptor’s standards.  Two different babies, each with fairly complex issues.  Got to help more experienced nurses and respiratory therapists intubate one little guy who could hardly breathe.  Great learning experience, but since I was his nurse I was thrown for a loop because I had no experience with intubated babies.  Cried in the locker room during my lunch break, cried in the car after work, and had a complete meltdown once I finally got home.  Bad day all around.

Day 4:  Uncharted waters… the fourth twelve-hour shift in a row.  After the previous day’s events I was tired both physically and emotionally.  My preceptor knew that I was still bothered by the previous day, and she was wise enough not to talk about it too much, just to move on with our day.  Same two babies as the day before.  My intubated baby was doing a little better, but our other little friend was worse.  Kind of like the two of them were taking turns.  Remembered some stuff from the previous few days, which helped a little bit.  Lots of new information, which got overwhelming after a while.  Very happy when the shift was through.

Day 5 (Class):  Thoroughly exhausted.  Sitting in one place for an extended period of time did nothing to keep me alert.  Good information in the classes, and I always feel bad when I catch myself nodding off in the middle of class.  We’ve explained to the various instructors that we mean no disrespect if they see us trying not to doze off, and we’ve all received permission to stand up and pace in the back of the room if we need to – anything to keep us awake.  When I got home I had planned on catching up on some homework, but ended up just sitting and relaxing.  Well deserved and hard earned rest.

So there you have it – the anatomy of a four twelves work schedule.  Now that I’ve survived a stretch like that, the rest should be easy… right?

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