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Abstract
Background: Night shifts work is unavoidable component of hospital based medical practice and are integral to emergency medicine training but associated with unique emotional, cognitive, physical and professional challenges. Understanding residents lived experiences can guide institutional strategies to improve training, supervision, learning, and well-being.
Methods: A qualitative exploratory study was conducted in the Emergency Department of MTI Lady Reading Hospital, Peshawar, from 1st to 28th September 2025. Twelve emergency medicine residents (2nd–5th year) participated in in-person, audio-recorded interviews averaging 45 minutes. Data were transcribed verbatim and analyzed using Braun and Clarke’s six-phase thematic analysis framework. Trustworthiness was ensured through triangulation, reflexivity, and member checking.
Results: Analysis revealed five overarching themes: (1) System-level constraints at night, (2) Emotional toll and cognitive fatigue, (3) Autonomy under pressure—learning versus risk, (4) Coping repertoires—short-term relief, limited restoration, and (5) Ethics of triage and fairness under scarcity. Residents described resource shortages, emotional fatigue, moral distress, and forced independence that shaped both professional growth and burnout.
Conclusion: Night shifts provide crucial experiential learning but at the expense of well-being and structured learning. Improvements in staffing, supervision, equipment reliability, and structured recovery support are needed to balance autonomy with sustainability.