The Care and Feeding of Your Nocturnist: A Field Guide for Diurnals
By Someone Who Regrets Writing This at 3:12 a.m.
It is a curious feature of modern medical ecosystems that diurnal creatures—those brisk, tie-wearing types or business casual disciples of daylight—persist in misunderstanding the elusive nocturnist. We dwell where owls roost and fluorescent hallway lights flicker. Our circadian rhythms, along with being sleep-deprived, are like jazz: unpredictable and oddly poetic.
To care for your nocturnist properly, begin by acknowledging our natural habitat. Contrary to myth, we do not burst into flame at sunrise—though we may smolder mildly. Nor are we merely residents or providers who forgot to leave at the end of training and got comfortable near the food offerings at the nurses’ station.
We slumber when others grocery-shop and “do lunch.” Attempting to contact us between 10:00 a.m. and 4:00 p.m. is like shouting into a canyon—only with less echo. If you must page us during daylight hours, provide apologies and food when we arrive that evening.
Texting a nocturnist at noon about a patient seen at 2 a.m. is akin to reading your grocery list to a houseplant—it’s useless and no more effective than trying to get weekend coverage.
We survive on coffee, protein bars, cold pizza, and existential dread. Optimal feeding involves warm meals not labeled “infused,” “artisan,” or “shrub-forward.” Styrofoam is preferred, and if it fits in a cup, even better. It conveys a tactile reminder of simpler times—before EMRs and committee emails.
Mid-shift snacks should be simple. Hand us a cookie, not a TED Talk.
Nocturnists are mentally acute, philosophically nimble, and chronically underappreciated. We diagnose esoteric syndromes beneath flickering bulbs and parse ambiguous handoffs like cryptographers.
Please enrich us with:
- Praise—preferably written with a Sharpie and provide eye contact, at least once.
- Try not to blame us for the 6:45 a.m. code blue when the patient “looked fine at 5 p.m. the day before.”
- Don’t leave us with handoffs titled “FYI: Might be septic?”
- Don’t page at 6:58 a.m. unless there’s actual fire or a donut emergency.
- Don’t ask us to “check in with the family overnight.” We aren’t psychic emissaries.
- We prefer Post-it notes, EMR messages, or interpretive dance. Keep messages concise.
- We can write three pages at 4 a.m., but we cannot decipher your 17-line emotional arc in the handoff section.
Why Keep Us Happy?
Because we are the last line. The safety net. The stewards of chaos. When the septic patient rolls in with 25 drug allergies, many of which are antibiotics, acetaminophen, and ibuprofen, a misunderstood code status, and a feral sibling named “Boom-Boom,” we don’t panic—we document. Thoroughly. So, cherish your nocturnist. Feed us, respect our sunlight aversion, and don’t call unless it’s necessary or you have queso.
We’re here. We’re alert-ish. And we’re silently judging your handoff etiquette.
Mr. Facklam is an adult hospital medicine nurse practitioner and nocturnist with Apogee Physicians at South Georgia Medical Center in Valdosta, Ga., and a member of SHM’s NP/PA advisory council.