Doing night shift at this ward is equally challenging. Although generally there will not be no admissions during the night time as most of the patients are on scheduled admissions for chemotherapy but it depends on luck as always.

Before I start my night shift every time, I would pray and hope that all patients would be stable and there would be no admissions for the night. Of course, the least bloods to draw from the patients, the better.

Once I reached the ward at eight at night, the first thing that I did was to get the list of bloods that I have to take from my extended shift colleagues. Then I would enquire on the patients that I had to watch out for throughout the night as they might be unstable or critically ill.

Then I would call the operator to ask for the name and mobile number of the medical officer (MO) in charge for the night. Alright, the MO on call was the one I worked before. There should not be a problem. Fine.

There are two waves working in haematology wards, which happen to be at 12 midnight and 4 in the morning. During these times, the nurses will check patients' vital signs and inform me if there is any temperature spike. That being said, these are the key events to determine whether I will have a peaceful night or vice versa.

Call from one of the wards (I took care of 3 wards alone), "Doctor, Eve has temperature spike and coughing out some blood." Come on, this was my first night here, please treat me better than that. Alright calm down and go assess the patient instantly.

"Hey Eve, are you alright? I got to know from the nurse that you have a fever and coughing out some blood (haemoptysis)." I asked her. Eve replied," No doctor, I feel chilly and slight cough with whitish sputum mixed with blood since eight just now." 

"Okay, let me just go through your documents and I will contact my MO to come over to look at you." While I was flipping through the documents, I saw the platelet count was 2 . Shit. I needed to order platelets transfusion for the patient. She could have suffered from haemorrhage since her bloods would not clot with such low level of platelet.

I called and updated the MO and there was no standing orders for the Eve, she came down stat to look at her. Started her on stronger antibiotics since she was already on two antibiotics. I managed to request for 1 lot of platelets from the blood bank MO on call who happened to be grumpy most of the time.

Despite ongoing transfusion, her haemoptysis became worse and she started to have difficulty of breathing. No worries, MO on call was there with me. We frantically referred Eve to the anaesthesia team as a precaution in the event we might need to intubate her since her oxygen level was not picking up with the non re-breathe mask.

Another lot of platelet was requested and transfused to the Eve and she felt better and her haemoptysis was getting less. Alright at least she was stable and her oxygen level was picking up. "Eve, do let the nurses or me know if you are feeling unwell or coughing out more blood. Otherwise have some rest."

Once Eve was stable, I was told by another nurse that Patient B, Adam was having temperature spike 38.5. To be honest, the nurses' calls sent shivers up and down my spine each time they called me. There was always something bad that happened.

I went through Adam's documents and luckily there was a standing order that action should be taken in the event his temperature was above 39. Thank god. I told the nurse the monitor his vital signs closely after assessing the patient. 

Then I checked the time and it was 4 in the morning. Gosh time passed by real fast. I needed to start drawing bloods from the patients and make sure the results were back before the morning round started. 

Mustering all my already depleted energy level, I went to all three wards to draw the bloods, sent them to the labs myself, traced the results, and did reviews for the patients at the cubicle that I was assigned for after my night shift.

By the time everything was done it was already 11 in the morning. I was so exhausted and sleepy by the time I came back home. I survived another night call.