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Tuesday, December 02, 2008

Young doctors still too tired for safety

It is unfortunate that this same evaluation process is not undertaken in the group of professional nurses, because in many specialties this pressure of long hours and inadequate sleep plagues them as well.

It is also worth considering that the constitution of young people is lessening when compared to those completing residency in the 40s, 50s, 60s and 70s.

It is also a concern when you consider that some patients may require extensive surgeries taking eight or more hours.

Maybe the next time you are in hospital you'd best remember to ask the doctor what hour it is in his work schedule. If it is hour 29, then perhaps you need a replacement.

And if you are a young doctor dealing with fatigue, ADVENTURX just might help you along with a healthier approach to nutrition and some supplement support.
WASHINGTON – Doctors-in-training are still too exhausted, says a new report that calls on hospitals to let them have a nap. Regulations that capped the working hours of bleary-eyed young doctors came just five years ago, limiting them to about 80 hours a week.

Tuesday, the prestigious Institute of Medicine recommended easing the workload a bit more: Anyone working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours.

At issue is how to balance patient safety with the education of roughly 100,000 medical residents, doctors fresh out of medical school who spend the next three to seven years in on-the-job training for their specialty. The long hours are in some ways a badge of the profession; doctors can't simply clock out if a patient is in danger.

But sleep deprivation fogs the brain, a problem that can lead to serious medical mistakes. So in 2003, the Accreditation Council for Graduate Medical Education issued the first caps. Before then, residents in some specialties could average 110 hours a week.

The government asked the IOM to study the current caps. Violations of current limits are common and residents seldom complain, the committee found. While quality of life has improved, there's still a lot of burnout.

And despite one study that found residents made more errors while working longer shifts, patient safety depends on so many factors that it's impossible to tell yet if the caps helped that problem, the report said.

So it also recommends:

_Experienced physicians should more closely supervise residents.

_Better overlap of schedules during shift changes to reduce chances for error as one doctor hands patients' care over to the next.

_Increase mandatory days off each month, and extend hours off between shifts depending on how long the resident worked, during day or night.

The accreditation council didn't immediately say if it would follow the recommendations.

- from the Associated Press


Anna's Spot said...

Yes it is scary. My husband use to be on call every other night and worked till 3am alot of morning and that wasn't as a resident. He has a much nicer call schedule only working one in fifteen days now. I was an OR nurse for 13 years till our kids came into our life and some of my call days were 20 hours with return to work in 6 wow that was tough. It gets harder when you are in your 40's. They didn't really help the nurses with the call one day work the next. I wish they would look after the nurses too.
Great report.

Unknown said...

Something that might be helpful is to use pure essential oil of peppermint, put a drop or two on a tissue and breathe in. It is stimulating and refreshing. I use it when I am driving over long distances.