The medical industry is beginning to take a look at the physical and mental toll that is taken on by physicians who work long and stressful hours.
STAT News highlights that long shifts start at the early stages of medical schooling. “During residency, medical school graduates are supervised while they learn to practice in a safe and professional manner. They gain real-world experience with a wide range of diseases, conditions, and procedures. They also learn about the complexities of medicine in outpatient settings, where most care is provided,” the article states.
Shifts, which last anywhere from 24 to 36 hours in order to follow patient’s illnesses and adjusting treatment over time, can leave physicians exhausted. Since a highly publicized case from 1984, which involved an 18 year old student’s death, was linked to resident work overload, studies have shown that fatigue among health care workers decreases patient safety by increasing the risk of error, injuries, and accidents.
As seen with the 1984 case, resident fatigue can be extremely harmful to the residents as well. Stat News writes that “Health care workers are more likely to experience accidental needle sticks or cuts when fatigued. A study showed that interns who worked 24-hour shifts were more than twice as likely to be in a car accident on the way home from work than those who worked 12-hour shifts.
In response to the growing evidence of safety risks linked to longer shifts, in 2011 the Accreditation Council for Graduate Medical Education (ACGME) established 80 hour per week limits for residents. Interns (first-year) are limited to 16-hour shifts, and residents beyond their first year can work 24 hours straight.
Since the implementation of the hours limit, there have been clear effects. One early consequence has been an increase in the number of “hand offs” which take place at the end of a shift. A resident must transfer the care of his or her patient to another resident. STAT reports that miscommunication has become a common problem which allows for errors and puts the patient’s health at risk.
The ACGME is currently reviewing the requirements for residency programs, and The National Patient Safety Foundation is urging the group to continue research on the impact of work hours on “safety, professionalism, joy and meaning in work, and burnout” among interns. Tejal Gandhi, President and CEO of the National Patient Safety Foundation writes that, “Let’s find ways to give residents the clinical experience they need while optimizing safety for both patients and residents, our next generation of the health care workforce.”
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