MD & DO Physician Burnout, Long Shifts, Sleep Deprivation

[947830]

Hello All,

I'm a podcaster who writes/posts about premedical and medical education. Recently, I witnessed several of my med student friends and roommates go through 30-hour shifts for their surgical rotation. Some got through it fine, but some were quite worn down, some took leaves of absence because of it, and I'm just wondering what are your opinions on the issue of long shifts. I realize on one hand it's training, but on the other hand, it also seems to be an inefficient way to train people. Am I weird for thinking that 30-hour is a long time?

I would appreciate any comments on the issue. Thank you all so much!

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[Psai]

If you want something easy, there are np schools throughout the country.

 

[0ncogene]

We do 36-hr shifts as a PGY2 Q3d at my program. It sucked. I can do 24hr shifts, but 36hr is too long. I didn't learn anything the last 12 hrs; I was just dragging myself to get through the day then went home and slept.

edit: any shift over 12 hrs is too long in my opinion

 

[947830]

We do 36-hr shifts as a PGY2 Q3d at my program. It sucked. I can do 24hr shifts, but 36hr is too long. I didn't learn anything the last 12 hrs; I was just dragging myself to get through the day then went home and slept.

Thank you so much for your reply!

 

[947830]

If you want something easy, there are np schools throughout the country.

Thank you for your reply! Do you believe that 30+ hour shifts are not unreasonable? What is your take on long shifts?

 

[Tenk]

If you want something easy, there are np schools throughout the country.

And the internet.

 

[Instatewaiter]

Hello All,

I'm a podcaster who writes/posts about premedical and medical education. Recently, I witnessed several of my med student friends and roommates go through 30-hour shifts for their surgical rotation. Some got through it fine, but some were quite worn down, some took leaves of absence because of it, and I'm just wondering what are your opinions on the issue of long shifts. I realize on one hand it's training, but on the other hand, it also seems to be an inefficient way to train people. Am I weird for thinking that 30-hour is a long time?

I would appreciate any comments on the issue. Thank you all so much!

Leaves of absence bc of call?! Must be that no one gave them a trigger warning first.

...Millennials

 

[pawprint]

Absolutely any shift over 15 hours is too long to be on. The mentality of "that's the way it has been, therefore that's the way it should be" is a poor one. After my 24+4 hour shifts, I make frequent math errors and do not think straight. I should not be making patient decisions. And I am not alone in that, everyone I work with functions the same way post-call. Its dangerous and not safe for patient care. I would never want a post-call resident making medical decisions for me or any of my family members. Unfortunately, attending physicians do not have work hour restrictions so the reality is that the attending could be in the same boat without anybody supervising them. Its not just a resident issue, its a staffing issue across the board. and more turnover = more mistakes. I've already seen more things missed just from incomplete signout than I have from tired residents making mistakes. It doesn't make it right, but it just shows that there isn't a good fix to the system

 

[mvenus929]

I think it depends more on the nature of the work, than the length of the shift itself.

I worked 24 hour shifts in the nursery and NICU as a resident. There was typically a lull between midnight and 4 am that I could catch some sleep.

I worked 24 hour shifts in the nursery as an attending. There was typically a lull between 10pm and 6am that I could catch some sleep (occasionally, I'd get woken up for a 3am C-section).

I'm on home call overnight 3 times per week now from 5pm til 7am--generally, I"m expected to work a full day before and a full day after, unless it's the weekend. Most nights are fine and I'm able to get adequate sleep. Of the 10 or so calls I've had in the last month, there was only one night where I wasn't able to get decent sleep, secondary to them calling me every hour or less between 5pm and 4am, then having to get up at 6:30 to check on the rest of the patients.

Our interns and second years work 24 hour shifts on the floors. The seniors generally took care of admissions overnight, so it was relatively rare that you were actually up for the full 24 hours (a crazy night during the winter when you had to check on everyone's respiratory status, maybe). But generally, as long as you checked in with the nurses around 10-11pm, they would hold on paging for non-critical things for a few hours so you could get some sleep.

On my surgery rotation in med school, they had us do a 24 hour shift where we worked with our assigned team during the day, and then the on-call team covering all the services and trauma call overnight. We were moving all night, and I didn't get the chance to sit, let alone sleep, until about 5am, while the residents were working on their notes. It was exhausting and I can't imagine doing it every 3rd night.

 

[947830]

Absolutely any shift over 15 hours is too long to be on. The mentality of "that's the way it has been, therefore that's the way it should be" is a poor one. After my 24+4 hour shifts, I make frequent math errors and do not think straight. I should not be making patient decisions. And I am not alone in that, everyone I work with functions the same way post-call. Its dangerous and not safe for patient care. I would never want a post-call resident making medical decisions for me or any of my family members. Unfortunately, attending physicians do not have work hour restrictions so the reality is that the attending could be in the same boat without anybody supervising them. Its not just a resident issue, its a staffing issue across the board. and more turnover = more mistakes. I've already seen more things missed just from incomplete signout than I have from tired residents making mistakes. It doesn't make it right, but it just shows that there isn't a good fix to the system

Thank you so much for your response!

 

[947830]

I think it depends more on the nature of the work, than the length of the shift itself.

I worked 24 hour shifts in the nursery and NICU as a resident. There was typically a lull between midnight and 4 am that I could catch some sleep.

I worked 24 hour shifts in the nursery as an attending. There was typically a lull between 10pm and 6am that I could catch some sleep (occasionally, I'd get woken up for a 3am C-section).

I'm on home call overnight 3 times per week now from 5pm til 7am--generally, I"m expected to work a full day before and a full day after, unless it's the weekend. Most nights are fine and I'm able to get adequate sleep. Of the 10 or so calls I've had in the last month, there was only one night where I wasn't able to get decent sleep, secondary to them calling me every hour or less between 5pm and 4am, then having to get up at 6:30 to check on the rest of the patients.

Our interns and second years work 24 hour shifts on the floors. The seniors generally took care of admissions overnight, so it was relatively rare that you were actually up for the full 24 hours (a crazy night during the winter when you had to check on everyone's respiratory status, maybe). But generally, as long as you checked in with the nurses around 10-11pm, they would hold on paging for non-critical things for a few hours so you could get some sleep.

On my surgery rotation in med school, they had us do a 24 hour shift where we worked with our assigned team during the day, and then the on-call team covering all the services and trauma call overnight. We were moving all night, and I didn't get the chance to sit, let alone sleep, until about 5am, while the residents were working on their notes. It was exhausting and I can't imagine doing it every 3rd night.

Thank you so much for your response!

 

[OrthoTraumaMD]

If you want something easy, there are np schools throughout the country.

Hahaha... i suspect you’re secretly a surgeon


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[Psai]

Hahaha... i suspect you’re secretly a surgeon


Sent from my iPhone using SDN mobile

I considered it very closely.

 

[Angus Avagadro]

Long shifts are hard. People get sick/injured 24/7/365. Transplants happen round the clock. Someone has to be there. You can't scrub out or hand off patients every 8 hours. That IMO is worse than working tired. I believe more patients are harmed with poor hand offs than from sleep deprived doctors.Saw this with my Father. I understand if your body reacts poorly to lack of sleep, just go into a specialty with a better lifestyle. Certain specialties, Ortho, Gen Surg,Neurosurg,OB, IR,Anesthesia, all require long shifts. So yes I believe long shifts are an important part of the training, it's where you learn to work tired.

 

[mistafab]

The way you set up the question is biased.

...Too long? Shoot, any amount of hours can be too long. 5 minutes of something stupid is too long.
...Necessary? May differ based on who is asked (freshly minted M3 vs Intern vs cheif vs attending)
...Worthy experience? I think this is a fairer question.

 

[GenSurgONLY]

Leaves of absence bc of call?! Must be that no one gave them a trigger warning first.

...Millennials

I hate to say but many in my generation have no idea of what it’s like to have grind a little. maybe I sound mean because I am a older Millennial who lived on her own since HS, but being a mother, I am always going on about 4-5 hours of sleep(due to work, cleaning, studying), so I think I am accustomed to sleep deprivation.

My husband said his coworker called out because her baby kept her up. I laughed. Guess I was raised old school: which was shut up and suck it up and keep moving. Thanks mom!