It’s 1AM, I gaze down from atop my coffee table upon my best friend, curled up asleep on my sofa in the middle of my flat-warming party. Inevitably, we’re thinking we’re the next Destiny’s Child, singing at the top of our voices after too many Aperol Spritz: yet it appears she is none the wiser. I’m used to it from her, with the ability to sleep in any place at any time we’re no longer surprised when she requires a Disco nap before and during a party, my younger-self would never believe I’d be jealous of such a seemingly mundane skill.
Studies have shown that shift workers, and in particular night shift workers, have higher rates of type 2 diabetes, heart attacks and infertility, due to the effect they have on natural hormones and brain function. Seven and a half years in, and the only way it has effected me so far (that I’m aware of) is my ability to go days on end without any sleep at all. Though still healthcare professionals, my best friends work outside of ‘shift life’ so when opportunities arise to make plans, I see a day off as a day off, regardless of if I had spent the early hours of the morning bringing new life into the world – I’ll be damned if that would make me miss a brunch date.
I recall trying to tell a friend about a dream I’d had, when I realised I couldn’t recall when I had actually last been asleep – Was it the morning or the evening? What day of the week was it? When did I last have something to eat?? For days at a time my diet consists of toast and coffee, I cheerily exclaim “Good morning!” to colleagues as I stroll onto the ward at 7pm.
Let me talk you through the average night shift on a maternity-led unit. I turn up to work at 1915, the first thing I make a note of is how many doors on the unit are shut as I walk through the corridor, are any of my day shift colleagues in the corridor or at the nurses’ station, or are they all hidden away in rooms with labouring women? (Note; at this stage, I have already checked the online rota to see which 2 midwives and which maternity support worker I’ll be spending the next 12.5 hours *minimum* with) I get changed into my first pair of blue scrubs, take my seat at the plastic covered table in the staff room and wait…
If I’ve managed to find the big red ward book, I’ll have a peak, trying to get some glimpse of what’s to come – how many people are here in labour, how many had their babies through the day, are there still women waiting since this morning to go home? Has the tide turned and everyone’s waters started breaking? (The red book also informs us of staff sicknesses, gives us an idea of early labourers and tells us which piece of equipment has been broken and reported that day… or a week ago which still hasn’t been returned)
The clock hits 1930 and my shift officially starts.
Tired day shift staff emerge from their rooms, they haven’t eaten yet, they’ve still got their paperwork from the delivery at 11am to do, the clinic was double booked then they couldn’t leave the woman who’s just started pushing; they need relieving. We take handover; not too bad a start, room 6: in labour – a second time mum who’s cracking on, someone needs to go in and take over asap, room 2: a lady who’s baby was born last night, but baby has a heart murmur, we asked the paed to come 6 hours ago but they’ve been too busy, the couple are desperate to go home. Room 3: A first time mum who delivered yesterday afternoon, her baby’s not breastfeeding, she’ll need support tonight, “he’s a night feeder”. “Perfect” we think, one woman each.
Oh, and this woman’s waters broke this morning, the fluid was clear when she came for her check but her partner just called and said it’s turned green, they’re on their way in.
Oh, also, a third time mum has started contracting, they’re only 10 mins apart at the moment so she’s staying at home, but we told her to come when they get a bit closer together.
Postnatal ward are a midwife short and labour ward are full.
My two midwifery colleagues were on the night before; they know the two postnatal women so I allocate myself to the lady in labour, I gaze longingly at the coffee I made myself, as I leave it on the handover table and enter the steamy birth environment.
Two hours later, we’re pushing, head visible, call bell pulled, second midwife requested.
My second comes in just as the head is being delivered, she grabs the laptop to continue the documentation and we watch as the woman births her baby, into the pool then lifts onto her chest. The whole room stops while we all watch as the baby takes its first breath, and as they become a family. We work together to get them out of the pool, and continue the end of labour care, skin to skin, delayed cord clamping, third stage, suturing, breastfeeding, tea and toast.
I finish off in room 6 and for the first time since 1945 come out of the room and back onto the brightly lit ward. My maternity support worker heads in, an invaluable member of the team who will now assist moving the woman into a clean room and support her in breastfeeding while I finish the all important paperwork (Cue *eyeroll*)
While this has been happening, the lady with the green waters has come in, confirmed meconium and been transferred upstairs, labour ward were busy, so my colleague has had to stay up to look after her. The baby with the heart murmur became tachypnoeic and the paeds are here, considering IV antibiotics.
It’s now around 11pm, as my friends and family are all starting to head to bed, my night is just getting started.
I finish off my birth notes, register the birth on the computer system, print name labels, and registration stickers, make a hospital folder for the baby, fill out the birth book, the ward book, stick about 1208 stickers in the red health visitor’s book, start my postnatal documentation, sip on a cold coffee, eat a celebratory snickers, update the bed board, take a set of postnatal observations, check the bleeding, check the latch, eat another snickers (why don’t my colleagues like these ones?) and then the phone rings…
Fast forward to 5am; no one has had a break yet, the baby with the fast breathing was transferred to postnatal ward to receive the antibiotics it needed, the baby in room 3 has finally latched to the breast and is asleep. But 4 women have come in for assessment, their waters have broken, they’ve had bleeding, they’re concerned about the baby’s movements, it’s been a constant flow of phone calls, assessments, admissions and discharges. Another birth, and one more imminent. A transfer for fetal heart rate decelerations, one pool with cold water and 2 cans of Diet Coke. Our maternity support worker has gone to support elsewhere, and I’ve just gotten my own name wrong.
I take a seat on the sofa in the staff room, my head is banging; I have been awake since 7am when my boyfriend, and most normal people, got up for work. I spent the day doing uni work, shopping, watching Netflix, and it’s usually about this time every shift I regret not having a nap in the day.
6am. I can hear screaming, the faint sound of an emergency buzzer on another ward and call bells. Then I realise the screaming is getting closer, and then our door buzzer goes. It’s the third time mum, her labour suddenly sped up, she feels the urge to push and her partner is holding her up as they come through the door. As my colleague heads up the corridor to greet her, I duck into the closest birth room, grabbing one of our equipment tool boxes. One quick but beautiful birth later, the four of us (+ baby) are smiling and exclaiming “that was quick!” “home birth next time!” “looks like you came at the right time!” The paperwork will take longer than the labour care, but we’ve all done it so many times now that it’s become old hat.
Its 0715, I already know my shift is going to overrun as I finish off documentation and paperwork. I blink hard at the harsh computer screen which I’m trying to input data into about one of the births, I just about get the time of birth and gender correct and I hear a bright “good morning!” from behind me. Day staff.