Fatigued interns

[Patrick]

Okay, this story finally brings to light one of the biggest problems in my profession. And I will begin to face this problem hee in a couple ofyears when I start my residency. Anyways, it's the issue of sleep deprivation. Fortunately, now under law, residents are limited to 80 hours per week. Strangely enough, it used to be common for a resident to work 120 hours a week....crazy! As you can imagine such fatigue leads to more errors......hmmmm, and higher malpractice rates.

I personally think physicians hours should be limited to 60 hours a week.
Anything over that is overkill. No wonder why doctors are so stressed.
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"Sleepy interns studied


By Janet McConnaughey
Associated Press Writer

From prescribing overdoses to sticking a tube in the wrong vein, doctors-in-training made one-third more serious mistakes during typically long shifts than they did during "short" 16-hour ones, a Harvard study found.
At the same time, those first-year interns were wired up with electrodes to measure how often their sleepy eyes rolled, and they ended up nodding off more than five times a night during long shifts.

Together, the findings suggest that recently imposed limits on how many hours new doctors may work do not go far enough, the researchers said.

The studies were the first to measure the real-life toll that sleep deprivation takes on interns' medical judgment. The results were reported today in the New England Journal of Medicine.

"There are currently more than 100,000 physicians-in-training in the United States, most of whom work these kinds of 30-hour shifts on a regular basis," said Dr. Christopher P. Landrigan, who led the study on medical errors.

Work hours limited
Since July 2003, interns at U.S. hospitals have been limited to a four-week average of 80 hours a week. Also, they may not work with patients for more than 24 hours straight, though six hours can be tacked on at the end for paperwork and classes.

"These long shifts are perhaps more hazardous than the number of hours in the work week," Landrigan said.

The two studies involved 20 interns and were conducted in the cardiac and medical intensive care units at Harvard-affiliated Brigham and Women's Hospital in the year before the new limits took effect.

Each intern spent three weeks in one unit, working at least 24 hours on every other shift, and three weeks in the other unit, with no more than 16 hours per shift. Doctors were hired from the outside to watch them work and note any mistakes.

During the longer shifts, the interns made five times as many diagnostic errors, such as missing the bull's-eye rash that showed that Lyme disease was causing a patient's heart problem. They made 36 percent more significant medical errors of all kinds.

There was no difference in the number of patient deaths and the average length of hospital stays, largely because other staffers often found and corrected the mistakes, the researchers said. "

[Midtowner]

Maybe the next time I'm sick and an intern sees me, I should ask how many hours they've worked this week... If hours > 60, maybe I should request someone fresher?

[floater]

Intern positions have always been panned as slave (and cheap) labor, but you guys take it to the extreme!!

[Keith]

I don’t think I would want an intern that has been up for more than 24 hours, to be taking care of me. I wonder how many of these interns take some type of drug to keep them awake?

I realize TV is not real life, however, after watching ER for several years, I remember seeing the new interns working two straight shifts (almost 36 hours) with no sleep. If they did sleep, it was a little nap that they would catch in between emergency calls.

The question is, when they wake from their little nap, are they coherent enough to do their job ?

[Patrick]

Guys, although ER does stretch medical reality to some extent, that show is right on the number of hours interns have to work. 48 hours straight is not uncommon. Remember though that the interns are allowed some cat naps when work is light, but they are at the hospital that long....they might get to sleep 2 hours at a time and then have to wake up to be sent on a call. I guess I'll get to experience this here in a few years. In July I'll start my 3rd year which starts thd clinical portion of medical school (I'm currently off to help my fiancee plan our wedding). Although 3rd and 4th year students don't put in as amny hours as interns and residents, it's not uncommon for medical students to put in 24 hours at a time.

I find it quite strange that the medical community works interns and residents this many hours. Seems like if we're promoting good health, we should live up to what we preach by getting enough sleep at night and limiting stress. Unfortunately, that's just not the case.