It’s hard to find a lot of love in my heart for out-of-hours work.
Maybe, as many of my colleagues are finding, it’s a perfectly acceptable and rewarding job all by itself, but being on call on top of working a normal day job isn’t a barrel of laughs – it’s not even a barrel of polite smiles.
It’s exhausting trying to work a fully-booked morning surgery, having been up all night with a gastric dilatation-volvulus; it’s difficult and potentially dangerous. However, my biggest problem with OOH work has been, and will probably always be, the stress and fear of the unknown.
On the alert
I have known, in my career, a few lucky individuals who didn’t seem to mind being on call – that is, they could pop out to the pub, appearing perfectly relaxed, and not (as I am) constantly checking their mobile phone to make sure it still has a signal, or that they haven’t missed five urgent telephone calls in the 20 seconds since they last checked it.
“Popping out to the pub” is not something I want to do when I’m on call. I don’t want to start any job I can’t finish quickly if interrupted by a telephone call.
In fact, I don’t honestly want to do anything at all except sit in a darkened room and wait for the phone to ring – but I may have a strangely perverse personality about these things.
Anticipatory anxiety
I have realised, over many years – as with so many things in life – the fear of getting called out is almost always worse than the actual telephone call itself.
Similarly, listening to someone else describe his or her experiences of the night always leaves me thinking “I have no idea how I would have made it through that,” when the actual experience of living through it wasn’t all that bad – largely because my mind was far too occupied with stopping things from bleeding and taking things out of – and/or putting things back inside – people’s pets to have any spare capacity for worrying.
This is something I know for a fact, as I sit here happily typing my blog with a nice latte beside me; but, sadly, the knowledge doesn’t reduce my stress levels at all when duty calls once more.
Work-life challenges
Unfortunately, because of my “darkened room” personality, I find the normal vicissitudes of family life challenging when I’m on call. Cooking tea, changing a nappy or talking to the neighbour all feel incredibly difficult because that phone could ring any moment – it could ring right now; right now while you’re boiling the pasta!
Consequently, in an effort to reduce the on-call worry to more manageable levels, I find myself spending most of my OOH time away from home, either sitting in the car reading, pointlessly wandering supermarkets or staying in the practice.
Staying in the practice helps because, if the phone rings, I have everything right there – all my reference books, drugs and the inpatients – ready to hand, all of which takes the edge off of the largely irrational fear that pervades my soul when I’m working OOH.
Enjoying the silence
Spending time in the practice OOH is also, occasionally, a slightly surreal experience, oddly calming for a peculiar and introverted person like myself.
Sometimes, sitting on the table in the prep room, reading through a textbook and surrounded by silence (the occasional meow or bark from the various wards notwithstanding), I imagine how the place looks during normal working hours – phones ringing constantly; vets, nurses and support staff hurrying backwards and forwards; and a whiteboard filled with operations and notations.
I find a strange peace in the contrast between the barely organised chaos of the day and the quiet of the off hours.
I start to feel in control of the practice, in a way that is impossible in a working day – even when I’m on call, the phone is ringing, procedures are on the board, the chaos is all mine and no one else’s is going to intrude on it. It’s a weird and powerful feeling – one I suspect I’m not expressing very well, but it’s one of the few positives I find in working OOH.
Bursting the bubble
Sometimes, the only time I realise I’ve been under the influence of this odd serenity is the sense of annoyance I feel when the OOH is over, the phone starts to ring with people asking for appointments, reception is manned again and the chaos starts to creep back.
“Hey,” I think – irrationally resentful as people come in talking about their weekend or night, hanging their coats up and turning on lights – “What are you doing? This is my place!”
It’s a strange thing to admit, but that feeling of peace and serenity is so alien to everything else in modern life (or at least in mine) that it almost makes being on call worth it…
Almost.
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