Overview
Handover was completed at 4:30 p.m. yesterday, went to bed at 11 p.m., woke up at 4 a.m., left at 8:30 a.m. today. Along with a second-line senior colleague and the on-duty teacher, we admitted 9 patients, actually participated in managing 5 patients, wrote medical records 0.5X3, resuscitation record 0.1X1, blood glucose tests 20+, blood gas analyses 2, and so on.
I am very grateful to the senior for taking the lead and shouldering most of the pressure (at least 80%) 
The Joy of Building a Knowledge System
It is well known that only by engaging in clinical practice can one develop real skills. This entire night, I gained a very deep understanding of respiratory failure. The reason is simple—I encountered too many cases of respiratory failure, watched how the teachers handled them, and looked up tutorials in the moment, and roughly understood it.
I had listened to related lectures several times before but remained confused mainly because I wasn’t paying attention during class, and the main reason for not paying attention was that it seemed uninteresting. This time, wow, with several respiratory failure cases right in front of me and some decent lectures, it was quite interesting because it directly connected with pathology. This is the true meaning of learning in the clinic—most efficient 
.
Unfortunately, I was too nervous when presenting this knowledge point during the morning handover, and I didn’t catch anything from the director’s talk. Next time, I should be thicker-skinned during handover and listen more to what the director says.
The Joy of Mastering Brand-New Skills
Last night I took blood glucose for the first time. Before, I had closely observed how the nurse did it, but when I tried myself, I couldn’t properly insert the test strip, didn’t know which side faced the machine or up. I got awkward in front of the caregiver, then quickly switched gears, pretended to be calm, and did it in a snap.
I just didn’t manage to get it right 
In the end, I completed it with the caregiver’s help, and after that I became much more skilled and measured over twenty blood glucose levels with a bang bang bang.
I also learned how to do blood gas analysis. Drawing the blood gas is not my job, the nurse does that, I only deliver it to the machine. On the way, I saw the serum separate for the first time, and was worried if the tube was spoiled, but the machine’s designer had already thought that through—the blood gets mixed once aspirated into the machine. The blood gas test is quick, results come out in 1 minute; including transport time, from blood draw to result, 5 minutes are enough.
Also observed cardiac injury tests; this machine is more advanced, it even uses the Android system (my focus is oddly specific). The cardiac injury test takes 11 minutes; with transport time, from blood draw to result, it takes about 15 minutes.
These two procedures dispelled my previous misconceptions about the clinical laboratory. I used to think these tests were troublesome, but it turns out they are fully automated!
The Joy of Encountering Rare Cases
First time seeing a food poisoning patient: a middle-aged man who after drinking mineral water had tongue numbness and difficulty speaking (maybe poisoned?), with excessive salivation. Our hospital cannot manage this, so he was quickly transferred to Chaoyang Hospital—this case was in and out in under 3 minutes; I was lucky to see it and learned how food poisoning presents.
First time seeing a drowning patient: a young woman with sudden hypothermia (kept warm using aluminum foil), lungs filled with water (I guess she will develop severe pneumonia later, but she looks young and hopefully can pull through), awake and answering fluently but experiencing schizophrenia? (talking to herself all night).
First time seeing a right chest pain patient: elderly woman, woke up from sleep one and a half hours ago with sudden right chest pain, worse when breathing. ECG and CT showed no issues, nothing conclusive—usually chest pain is on the left, this was the first right chest pain case; after excluding cardiac causes and aortic dissection, it might be related to the lungs?
First time participating in respiratory failure resuscitation: elderly woman, I didn’t record medical history. When attending rounds, saw she was confused and unresponsive. I shone a flashlight, pupils equal and round but sluggish reflexes. The teacher quickly told me to call the nurse to start resuscitation. I was confused, the nurse was initially confused too but was experienced and started the process rapidly—I mainly moved the patient and ran errands (the first blood gas test mentioned above was for her). When I finished running, the ventilator and medication were already set up (emergency resuscitation often uses dopamine, norepinephrine, etc.; I will share drug experience later).
First time seeing terminal-stage metastatic ovarian cancer: middle-aged woman, had ovarian cancer surgery one year ago but did not undergo regular follow-up. Large amount of ascites, taut abdominal skin, CT showed large subcutaneous metastases. In the afternoon when I first saw her, she was vomiting yellow thin fluid (probably bile, also a first to see). Next time I saw her, she had severe distention pain and was given painkillers. Later we planned to drain the ascites, but her heart rate was too high and blood pressure not high enough so we didn’t. When I came back after a nap at 3 p.m., blood pressure was unmeasurable, heart rate 160, she had already undergone defibrillation and intubated for ventilation. Very pitiful, she was crying and in pain all night but we had no good solution. Her elderly mother accompanied her to the hospital, with a blank look as if she had lost hope.
And so on.
Other Joys
The joy of hearing gossip: after recent rotations, I’ve heard a lot of gossip in the wards. I am not much interested in gossip, but I have always been curious where people get their gossip from; turns out wards are an important source.
Encountering strange family members: a patient was critical two days ago, family members rushed from Xi’an to Beijing yesterday morning, cried for a while in the afternoon, then disappeared with the nanny at night—beyond my understanding. The teacher said this is just an act; maybe so.
Pain
We often say “pain and joy coexist.” Initially I wanted to write how exhausting this night shift was and then what I gained, but on second thought, everyone already knows night shifts are tiring, so why emphasize it?
Better to focus on what can be gained from night shifts. If any student reads this and when facing their first night shift in the future feels not fear or anxiety, but anticipation and calmness, then this writing has served its purpose!