An ER doctor who works 24-hour shifts shares his best tips to keep your energy up, no matter how tired you are

sudip bose 4Dr. Sudip Bose.Courtesy of Dr. Sudip Bose

  • Dr. Sudip Bose is a clinical professor in the Department of Family and Community Medicine at Texas Tech University Health Sciences Center.
  • Whether he's working a 24-hour shift in the ER or pulling long hours at his startup, he has a few simple tricks to get his energy up.
  • He makes sure to keep moving, seeks out the light instead of the dark, and focuses exclusively on the task at hand.

When I'm working a 24-hour shift in the ER, I naturally become tired. I've learned a few things to fight through the fatigue and continue to perform at a high level.

Keep the adrenaline flowing

Whether it's at the start or toward the end of my shift, anytime severely injured patients arrive from a car accident, I get a surge of adrenaline. The energy burst enables me to focus better, work faster, and perform at my absolute best.

Of course, even in an ER, not every situation is critical and not every moment is energizing. When I feel my energy waning, I concentrate hard on what I have to do and manufacture an internal sense of urgency. The more important you make a task, the more energy your body will produce to get it done.

Outside of the ER, I do the same thing when I feel tired. I ask myself what exactly do I want to accomplish? Maybe it's as simple as reading one more chapter in book or answering some important emails. I'll play a little game and tell myself that I have to complete the task in a set amount of time - say, 30 minutes. This gives me an objective and a motivation.

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When you're tired, it's very easy get distracted and start doing things that are unproductive and unhealthy, such as wasting time on the Internet or eating a sugary snack. Having a clear goal and a set time for its completion forces you to focus and generates energy.

Keep moving

If I feel myself getting tired in the ER, I make an effort to be more physically active. I'll stretch, walk briskly, or do a few push ups. I want to get my pulse rate up and my blood moving.

Occasionally, I'll have an opportunity for a short nap. I'll aim for between 10 and 20 minutes. Any longer and I'll likely to fall into a deep sleep and wake up feeling groggy and out of sorts. Once my nap is over, I get moving and keep moving.

Seek out bright lights

Our biological clock is controlled by Suprachiasmatic Nucleus (SCN), which is a group of cells in our brain that responds to light or darkness by making us feel more awake or more sleepy.

In the morning, in response to light, the SCN sends signals to other parts of the brain to raise body temperature and produce hormones like cortisol. At night, the SCN sends signals the brain to produce melatonin, which promotes sleep.

When I'm feeling tired in the ER, I'll deliberately look into lights in effort to stimulate the SCN to help keep my body in an awake state.

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Be healthy

Staying well-hydrated and eating small nutritious meals and snacks is the best way for me to keep my energy levels fairly constant through my 24-hour shifts. I avoid vending machine snacks, soft drinks, and limit my caffeine intake.

Focus

There's no question that sleep deprivation and exhaustion can cause mistakes and bad decisions - in medicine or any other field. For me, the key to maintaining a high-level of performance through a 24-hour shift is a to focus relentlessly on the patients and the tasks at hand. The better I focus, the more energy I have.

Dr. Sudip Bose was accepted into medical school directly out of high school through the Honors Program in Medical Education at Northwestern University, getting his MD at 25. At 28, he was named an assistant clinical professor of emergency medicine at Texas A&M, making him one of the youngest medical-school professors in the country. Later, while serving on the faculty at the University of Illinois at Chicago as an associate clinical professor, Bose cofounded several leading medical-education companies.

He is currently a clinical professor in the Department of Family and Community Medicine at Texas Tech University Health Sciences Center. Follow him on Twitter @docbose.

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