Nightshift

It is 3:45 pm and the sun has been setting already an hour ago….what better thing to do now, than starting another nightshift in the North?….

A brief glimpse at the car park of the clinic while finishing an evening run had informed me already that it will be busy tonight….

Following a shower and a quick change into scrubbs, I am arming myself with the first coffee of the night and head straight for the inpatient area.

Here I not only find out who will be on my team tonight (each team has its own chemistry….), but I also discover what patients I will be responsible for over the next 16 hours.

There are first of all the freshly operated patients that are not stable enough to go home that night. In addition to this there is usually a fair number of patients with various internal medical conditions that are connected to a range of infusions pumps and syringe drivers to keep them comfortable and most importantly hydrated. Some might also be cathederised or have been fitted with feeding tubes. This is when you appreciate having an experienced nursing team by your side that is keeping an overview…..

Finally don’t forget the patients in the various insulation wards that might for one or the other reason be infectious.

Thus “warmed up” and with most of my coffee drained already, my next stop is the team that is still admitting acute patients, initially to give a helping hand and then to take over whatever is left in the waiting room or what is on its way to the clinic (which can take a while in this part of the world…..).

Not surprisingly time is flying, especially at the start of a shift….

Nightshifts are a bit like Marmite……you either love them or you hate them….

If you – like me – join a veterinary team just on a temporary basis, it makes more sense that you see more acute than established patients with long and complex clinical histories which will take a fair amount of time to read up on and with clients that would prefer more continuity of care.

Because of that, I am quite enjoying nightshifts : most of my patients are clinical “white sheets” with short or with no clinical histories, where I can make a fresh start.

In addition to this I have always enjoyed working at nights (even more so here in the North where at the moment the hours of darkness are making up more than 3/4s of the whole day….). In addition to this working with a smaller, but dedicated team is giving you a greater opportunity to learn more about your co-workers while spending time together at the operating table or over a cup of midnight coffee in the otherwise abandoned cafeteria.

One of my first patients tonight is a Jämthund, a member of the canine family that at first sight doesn’t look much different from a wolf, but usually with a far more amicable personality. Following the successful destruction of a whole carpet followed by a three hour journey through half of Sweden, this dog doesn’t look happy at all and a control X-Ray of its abdomen shows so many abnormalities, that we are progressing without delay to the operating theatre.

As it turns out not a moment too early as the carpet fibres have already started to string up the whole small intestine while cutting off part of its blood supply. The fast intervention – the removal of the foreign body material – allows the full recovery of the gut. A couple of hours of further delay would probably have required the removal of a large section of the intestine combined with a much higher risk for postoperative infection.

Once the Jämthund is recovering in his cage, I have to return to the theatre as an obese cat is already waiting there for me, unable to urinate due to a small bladder stone. This poor boy has to be cathederised and will then also enjoy our hospitality for the rest of the night.

The next patient is then straight forward – its a Golden Retriever puppy where the owner is reporting that a rubber ball went missing just an hour ago. While the puppy is actually looking pretty innocent, the immediate application of an emetic gives a rather impressive result

and both owner and dog are sent home again 1/2 hour later.

The next patient has also traveled more than 200 km to us – a cat with a “loose screw”…..to be precise one that has unmistakably lodged itself in the stomach and here an emetic is not having the desired effect.

At least it is a very rewarding surgical case and half an hour later there is the unmistakable plinging of a metal object being dropped into a kidney dish. Another half an hour later and the cat is sitting upright in its cage asking for food and the screw has been washed and returned to the owner in pristine condition for the next DIY project.

Time for a midnight snack of household cheese and polar bread and for once not a coffee…..

Now there is also time to check again on the inpatients and to give the canine patients their regular toilet break.

This is an undertaking you need to be prepared for with slip resistant footwear for all team members

and with the necessary arctic weather clothing as by now the outside temperature has dropped to -12 C.

Thankfully our feline patients – like this 9kg HUGE Maine Coon – do not require this service.

They are happy to stay in their warm cages, where regular meals, their medication usually administered via established catheders and the occasional cuddles (sorry – can’t resist it…..) is all they need.

Another patient arrives – a dog that sustained a jaw fracture after chasing a moose (not a mouse….). Here another anaesthesia and thick cerclage wire is needed to both stabilise the fracture and hopefully safe the canine tooth. Luckily the root was undamaged.

Although it is by now already early in the morning, the nurses still find the time to comfort the severely ill patients

or to wash and groom a patient that is ready to go home in a few hours.

It is still dark outside when we are handing our patients over to the morning team and I am arriving back home for a “good day’s sleep” – or may be for another coffee ?!…..