New rules limit doctors' residency to 80 hours a week

[American]

El Globe-O del Peoples' Monde Republika au Bostone (http://www.boston.com/dailyglobe2/181/metro/Doctors_ordered_Work_less+.shtml)


Good? Bad?

I say 80 hours is about right. Everyone should go through something like that, no matter what your profession. It's good to be tested. No? I could be wrong. I'm not sure.

[a_unique_person]

It's crazy. I have worked shift work, and agree with research that has said that being tired after a very long shift at night is just as dangerous as being over 0.05 alcohol, (the australian safe driving limit).

If you want doctors to work safely and learn properly, they shouldn't even be working more than 60 hours.

[iankaplan]

Some friends of mine are residents, and they told me about the new rule limiting weekly hours to 80, and consecutive hours to... THIRTY (!).

I replied that it sounded harsh, but they said it was better than 110-120 hours a week, so they were pretty happy about it.

Its kind of funny, though, that these people work in HEALTHCARE, and the system they work in CARES so little about their HEALTH.

[American]

I know it's tough, but I bet they play it up for glory. They do get to take naps and stuff. It's not a 3-year hell week or nothing.

I did 70 hours myself for awhile! But that was cashiering/food service/temporary jobs. I ain't had people's lives under me. Still, you forget to super-size a meal, you're gonna hear about it Charlie!

[Dr. Imago]

Coming from someone who this will soon affect, I must say, in answer to your question, this is a very, VERY good thing. In fact, I was one of the thousands of medical students and residents who, through the American Medical Student Association (AMSA) of which I'm a member, sent emails to my local congresswoman here in Houston lobbying to get this bill passed. But, I fear that it work hours will still get abused... trust me, this will be hard to enforce (what young gunner-resident is going to want to blow the whistle on his boss?).

Nonetheless, here's why it's a good thing:

- Over-worked students and residents = potential for trouble + poor learning experience. After 24 hours of wakefulness, cognitive function deteriorates to a level equivalent to having a 0.1% blood alcohol level. These doctors would be considered too unsafe to drive, yet could still treat patients for 12 more hours. (Nature, 1997; 388: 235) And, forty-one percent of resident physicians attribute their most serious mistake in the previous year to exhaustion. (JAMA, 1991; 265: 2089-94)

- Hospitals complain that they will suffer because they will have work hours imposed on their employees - doctors they rely on to provide care to their patients. Well, teaching hospitals do not pay for residents. The Graduate Medical Education bill does. The federal government thus pays residents, so their working conditions can also be outlined in federal funding terms.

- Having an "outside of the hospital" life is equally important to training doctors for both emotional and physical reasons. One study found that 49% of residents reported falling asleep at the wheel during their residency - much higher than the percentage of attendings. (Sleep 1996;19:763-766) In an examination of depression among residents (a prevalent condition to begin with), investigators found that depressed responses were most frequently received on those rotations that routinely required over 80 hours per week. (Arch Int Med 1985; 145:286-288)

These are just some of the reasons. Personally, I wouldn't want to be seen by a doctor who's been in the hospital for the past three days, perhaps "napping" (as someone above said) here and there, without having had a real break.

-TT

[Crossbow]

Originally posted by American
El Globe-O del Peoples' Monde Republika au Bostone (http://www.boston.com/dailyglobe2/181/metro/Doctors_ordered_Work_less+.shtml)


Good? Bad?

I say 80 hours is about right. Everyone should go through something like that, no matter what your profession. It's good to be tested. No? I could be wrong. I'm not sure.

This move is long overdue and I welcome it.

For some reason people going through residency are often worked over 100 hours per week and the reason why is "Well I had to do that when I wanted to be a doctor, so they should too!".

I have never have heard of a good reason, but vindictive reasons abound.

[Dragonrock]

I've always considered the high work hours to be a form of hazing. Since I detest hazing I've always been against it. My wife is a nurse and she takes great pleasure in torturing interns and residents, but her attacks are limited to berating them about silly orders, and the orders always get sillier when the residents have been up for several days.

[Dr. Imago]

Originally posted by Dragonrock
I've always considered the high work hours to be a form of hazing. Since I detest hazing I've always been against it. My wife is a nurse and she takes great pleasure in torturing interns and residents, but her attacks are limited to berating them about silly orders, and the orders always get sillier when the residents have been up for several days.

Dragonrock-

I am dead serious about this request: Please ask your wife, as representative of the nursing profession that routinely interacts with students and residents, what she would first like to hear out of a new student/resident's mouth that would dissuade her from feeling the need or taking delight "torturing interns". Is it an attitude issue with specific interns/residents/student? I'm assuming that she only picks on the narcissistic, know-it-all types that I (unfortunately) also already see emerging in my ranks.

Please advise. I'm very curious.

-TT

[Dragonrock]

Originally posted by ThirdTwin


Dragonrock-

I am dead serious about this request: Please ask your wife, as representative of the nursing profession that routinely interacts with students and residents, what she would first like to hear out of a new student/resident's mouth that would dissuade her from feeling the need or taking delight "torturing interns". Is it an attitude issue with specific interns/residents/student? I'm assuming that she only picks on the narcissistic, know-it-all types that I (unfortunately) also already see emerging in my ranks.

Please advise. I'm very curious.

-TT

I can answer that one, cause out of curiosity I've asked it myself. It's the god wannabes that she can't stand. As for what you can say to keep from being tortured, it's simple: discuss your orders with them. Don't just say "500 miligrams of drestrapictaline" and run out the door, cause you might not have noticed after working 80 hours that the patient is allergic to drestrapictaline and now she has to chase you through the halls. Before you look at the patient, make sure you ask the nurse if there's anything you might need to know. However, the most important thing is simple, if a nurse says "are you sure?" then stop what you're doing and if necessary ask.

Please note: This only applies to ER and ICU nurses, outside the field of critical care nurses are a bit more easy going.

[Paul C. Anagnostopoulos]

Uh, why should residents work more than 40 hours a week with a few hours overtime? Well, okay, perhaps it's a start-up hospital, in which case maybe 50 hours.

~~ Paul

[sorgoth]

Well, around here, there simply isn't enough doctors, so they work ridiculous hours. And, since people see doctors working these hours, nobody wants to be a doctor. Vicious cycle.

[Boo]

It's about time they did this. I worked in the ER of several teaching hospitals as a tech over a period of 10 years and calling up a resident at 2 am was like kicking puppies. Many of them told me they liked doing ER rotation because they actually had a semblance of a life for that month.

Third Twin,

One other piece of advice, always say please and thank you. This small courtesy will pay off.




Boo

[American]

They should replace the whole system with some kind of initiation. Like you have to make out with an ugly nurse or something like that.

[American]

Did I just kill my own thread?