Our Queens injury lawyers often warn of the dangers of getting behind the wheel while fatigued.
But what if you are responsible for prescribing powerful narcotics? Or preparing to exact a delicate incision? Or trying to to treat an influx of critically injured trauma patients in a fast-paced emergency room?
That’s the kind of scenario medical residents deal with on a weekly basis, where they are often allowed to work 28-hour shifts at a time.
Compare that to rules that the Federal Motor Carrier Safety Administration lays out for commercial drivers: No more than 10 straight hours in any single stretch.
Given that your daytime alertness can be decreased by more than a third just by cutting your nighttime sleep by just an our-and-a-half, a 28-hour shift is beyond unreasonable, especially when you’re talking about the kinds of intensive, demanding medical procedures and calls that physicians-in-training are expected to make. It creates an unnecessary situation rife for error and instances of medical malpractice.
Some in the medical field argue that it’s important for residents to go through a sort of trial-by-fire to learn what life is really like as a medical doctor. But the value of that experience seems to be far outweighed by the detrimental impact that a resident’s fatigue may have on his or her patients.
Dr. Steven Lockley, a neuroscientist specializing in sleep disorders as well as an associate professor at Harvard Medical School, wrote an editorial recently for the Wall Street Journal, asserting that more needs to be done to limit the insane work schedules of medical residents.
He states that numerous studies have been released indicating the harm that can be caused by a doctor worn down by fatigue as a result of grueling shifts and an emotional drain. In response to those, most medical programs have capped first-year medical residents to a shift of 16 straight hours.
That’s a start, to be sure, but 16 hours is still a very long time, constantly on your feet and making critical life-and-death decisions. It also doesn’t address medical residents who are further along in their education.
The Accreditation Council for Graduate Medical Education cuts off weekly work hours for medical residents at 80 hours (with another 8 hours tacked on for “education”) – but they can still work up to a marathon 28 hours in a single stretch.
Lockley’s own team recently researched this issue and found that when first-year residents working in intensive care settings were permitted to work a 24-to-30-hour shift, they made nearly 40 percent more SERIOUS medical errors than when they worked a 16-hour shift. Additionally, they were twice as likely to fall asleep on the job.
These residents were not just a danger to patients. They were a danger to themselves, Lockley’s team found, with those trudging through 24-hour-or-longer shifts sticking themselves with needles 60 percent more frequently and doubling their chances of getting into serious car accident on the way home, compared to those who worked fewer hours.
In reviewing nearly two dozen medical resident and shift length studies conducted in 2010, all but one found improvement in care when residents worked shorter shifts.
The Law Offices of Nicholas Rose, PLLC offers free consultations. Call 1-877-313-7673.
Should Medical Residents Be Required to Work Shorter Shifts? Feb. 18, 2013, Journal Report, The Wall Street Journal
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Elderly Injuries, Deaths, From Bed Rails Prompt Federal Inquiry, Jan. 31, 2013, Bronx Medical Malpractice Lawyer Blog