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Nobody is a strong statement unless you mean just within tech. During residency I would pretty regularly work 10 hour days with 3 24+ call shifts that week on t

by zeagle 3y ago

Nobody is a strong statement unless you mean just within tech. During residency I would pretty regularly work 10 hour days with 3 24+ call shifts that week on the ward. Like Monday 7am till Tuesday noon, sleep, regular Wed Thu, Friday Sunday call. Next week similar but Saturday call. Was brutal.

throwaway5959 3y ago
That seems dangerous for both you and patients.
- n8henrie 3y ago
  It has been studied, and (surprisingly) restricting resident work hours to "only" 80 hours did not improve patient care / outcomes. One of the reasons is suspected to be increased number / frequency of "hand-offs," a high-risk time for information to be lost. Plenty has been written on the topic.
- zeagle 3y ago
  n8henrie summarized it well. Its a basically a bandwidth issue. You might sign over 25 patients in 30 minutes... things get lost or miscommunicated which cascades to errors vs. being sleep deprived. Sick/new admissions get more time but still can only say so much. There is decent literature on signover tools to guide this process too. I used to joke second and third Mondays of working in a row should have a different name like SecondMonday and 3rdFnMonday. Thankfully never did a 3rd weekend in a row on call like that.
- ein0p 3y ago
  That _is_ dangerous for their patients. Quarter of a million deaths per year in the US are attributed to medical mistakes. Why they keep doing this IDK.
  - zeagle 3y ago
    The are a lot of sources of error in the system other than long duty hours for residents and alternatives e.g. shorter duty hours introduce error at other points and individuals in healthcare. Should something be done? Sure, reducing error is obviously good but its simplistic to attribute it to this or think alternatives aren't worse. I personally also think the trend shorter duty hours in medical school and residency when you have that support is it's own problem of not learning enough to be as competent (and at the expense of career longevity for practicing physicians as inevitably all that gets dumped on the attending).
n8henrie 3y ago
This was my first thought also: "Well somebody didn't do a residency..."

by zeagle 3y ago

throwaway5959 3y ago

That seems dangerous for both you and patients.

n8henrie 3y ago
It has been studied, and (surprisingly) restricting resident work hours to "only" 80 hours did not improve patient care / outcomes. One of the reasons is suspected to be increased number / frequency of "hand-offs," a high-risk time for information to be lost. Plenty has been written on the topic.
zeagle 3y ago
n8henrie summarized it well. Its a basically a bandwidth issue. You might sign over 25 patients in 30 minutes... things get lost or miscommunicated which cascades to errors vs. being sleep deprived. Sick/new admissions get more time but still can only say so much. There is decent literature on signover tools to guide this process too. I used to joke second and third Mondays of working in a row should have a different name like SecondMonday and 3rdFnMonday. Thankfully never did a 3rd weekend in a row on call like that.
ein0p 3y ago
That _is_ dangerous for their patients. Quarter of a million deaths per year in the US are attributed to medical mistakes. Why they keep doing this IDK.
- zeagle 3y ago
  The are a lot of sources of error in the system other than long duty hours for residents and alternatives e.g. shorter duty hours introduce error at other points and individuals in healthcare. Should something be done? Sure, reducing error is obviously good but its simplistic to attribute it to this or think alternatives aren't worse. I personally also think the trend shorter duty hours in medical school and residency when you have that support is it's own problem of not learning enough to be as competent (and at the expense of career longevity for practicing physicians as inevitably all that gets dumped on the attending).

n8henrie 3y ago

This was my first thought also: "Well somebody didn't do a residency..."