Begin chest compressions! Push one ampule of — Oh, nevermind, it’s time to clock out!

Exhausted DocFrom MSNBC:

Doctors-in-training are still too exhausted, says a new U.S. report that calls on hospitals to let them have a nap.

Regulations that capped the working hours of bleary-eyed young doctors came just five years ago, limiting them to about 80 hours a week.

Tuesday, a panel of the prestigious Institute of Medicine recommended easing the workload a bit more: Anyone working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours.

When the 80 hour work week limit went into effect a few years ago, I was a big supporter of it.  When I read about attending physicians complaining about the rule, I thought what was good for the goose was good for the gander.  Let them burn the midnight oil for a change instead of enjoying long hours of uninterrupted sleep at home while the residents did the grunt work.

Seeing the work ethic, or lack thereof, of some residents I’ve since encountered, I’ve started to question whether my attitude toward the 80 hour work week for residents was motivated by a thoughtful concern for the profession or simply a feeling of sympathy for and allegiance with bleary-eyed residents over well-rested attendings.

Another couple of quotes from the article:

These junior doctors frequently are the front-line medical staff on duty around the clock in teaching hospitals. The long hours are in some ways a badge of the profession; doctors cannot simply clock out if a patient is in danger.

Violations of current limits are common and residents seldom complain, the committee found.

I wonder if there is a growing sentiment among the residents themselves that being a physician means that one cannot clock in and clock out like a factory worker?  I recall the extreme fatigue I felt after a number of horrendously busy call nights on Internal Medicine during residency being partially offset by a sense of pride in the large number of patients I had admitted and cared for.

Patient safety always comes first, of course.  But turning some bright young man or woman into a doctor is hard work.  I hope we don’t try to lighten the burden residents must carry too much.  Physical and mental endurance, as well as a strong work ethic, are important skills that physicians in training need to master.


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