EXPLORING THE LIVED EXPERIENCES OF MEDICAL REGISTRARS DURING NIGHT SHIFTS IN A TERTIARY HOSPITAL: A QUALITATIVE THEMATIC STUDY

Abstract

Background:
Night-shift work is an unavoidable component of hospital-based medical practice and postgraduate training, it is associated with significant physical, cognitive and emotional strain. Long working hours, unpredictable caseloads and limited recovery time contribute to fatigue, burnout and reduced clinical performance. Medical registrars, positioned at the intersection of training and service delivery, face compounded pressures from patient care responsibilities, decision-making autonomy and institutional demands.

Objectives:
The aim of this study was to explore the lived experiences of medical registrars during night shifts in a tertiary hospital, focusing on the interplay between workload, learning, teamwork, emotional well-being and institutional support.

Methods:
A qualitative exploratory design was used to capture in-depth insights. Eight registrars representing internal medicine, surgery, obstetrics, pediatrics, anaesthesia, psychiatry, emergency medicine and radiology participated in semi-structured interviews. Data were analyzed inductively following Braun and Clarke’s six-phase thematic analysis, complemented by framework analysis for cross-case comparison.

Results:
Analysis revealed eight interconnected themes: workload and fatigue, learning through autonomy, teamwork and communication, emotional burden, institutional gaps, patient safety risks, coping and resilience and professional identity. Registrars described night shifts as transformative draining experiences that simultaneously fostered independence and exposed them to exhaustion, emotional distress and systemic inefficiencies. Participants emphasized the duality of growth and vulnerability inherent in their night duties, linking fatigue and institutional shortcomings to potential safety risks.

Conclusion:
Night shifts cultivate clinical maturity but at the cost of personal well-being. Institutional reforms, including structured rest, psychological support and mentorship, are critical to balancing education, performance and health.