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15 August 2011 @ 07:00 am
Overworked America  
There are blue collar workers included in this story at Mother Jones, but this was interesting to me because I had thought that reducing the hours residents could work would make patients safer. But those hours just got passed on to the attendings. We're making medicine a pretty unattractive field to go into, aren't we? Not to mention endangering patients. Sleep deprivation can't possibly lead to the best level of care.

David: Surgeon, Michigan

Residents cannot work more than 80 hours a week. When I was training years ago, there was no such law. Sometimes that meant not sleeping, literally, for days on end. So it wasn't unusual for me when I was in my late 20s and early 30s to be working 110, 112 hours a week. It was regarded like a badge of courage, and if you wanted to succeed, you just had to do it. You had to look forward to the time when, as an attending surgeon, you wouldn't have to work that hard, because you'd have the new residents do all of the extra work.

Well, that didn't last very long, because I had been an attending surgeon for only a very short while when these laws started to become real. Now the residents have to leave the premises and go home, and if they don't, then the accreditation body could close down that whole residency. It became obvious after a while that the people who were catching up on the slack were us, the attendings. That means a guy like me—I'm 67 and still working full-time. Guys like me now have to work just like we did when we were residents. When the residents have to go home and something needs to be written up or the patient needs to be seen in the middle of the night, the person who has to do that is me.

I work four days in a row, 24/7. By the time 96 hours is over, there isn't a lot of energy left for anything. That doesn't mean that I can stop taking care of patients. That means if I get called because somebody needs a prescription, or somebody has a complication from an operation I've done a few days previously, then I can't say, "Oh, let's get the resident."

I'm stretched so thin that I can't really give all of my attention to places that I really want to, because I'm too tired, because I've got too many patients to see. That's not just me. This is happening all over the place.

See also:


Christinekisekileia on August 15th, 2011 10:02 pm (UTC)
Sounds like they need to lower doctor:patient ratios.
Tapatitapati on August 16th, 2011 07:00 pm (UTC)
yeah but dream on...the nurse/patient ratios also suck because we have a nursing shortage.

It's becoming so expensive to become a doctor here that less people are going into medicine.

The article also had some scary accounts by an air traffic controller about how dangerous it is for them to be short-staffed and short on sleep, and someone who works in a mental health facility about the dangers of not having enough personnel to safely subdue a violent patient.