Many of us have, at some time or another, felt the effects of a night with too little sleep. We may have come to work drowsy, we might be a little slow, or just not motivated to attack problems that day. Several studies have been done linking fatigue to an increased likelihood for accidents in industrial settings. Fatigue can decrease productivity, increase risky behavior, and even be a factor in auto accidents while the employee drives to and from work.
Medical residents work some of the longest shifts in the workplace. Some doctors-to-be can work 100 hours a week with as many as 36 hours at one time without sleep. Residents have long argued that this puts their own health, and the health of their patients at risk. Supporters of these long shifts claim they are necessary to complete medical training in a timely fashion, are a traditional ‘right of passage’ and that changing the rules could cost hospitals millions of dollars in additional staff.
One study reports that staying awake for 24 hours straight can impair performance as much as a .10 percent blood-alcohol level. ABC News reported that forty-one percent of doctors polled cited fatigue as the cause of their most serious medical mistakes. In one third of medical mistakes, a patient died as a result of the error.
New rules proposed by the Accreditation Council for Graduate Medical Education would limit the total hours medical residents can be on duty to 80 hours per week. Under the new rules, residents would get at least 10 hours of rest between shifts and would not be allowed to work more than 24 hours straight. The new rules would take effect in July 2003.
The council would be able to punish teaching hospitals by withdrawing its accreditation, which could cost the hospital millions of dollars in federal funding.
The Association of American Medical Colleges endorses the new rules and said it would urge hospitals to comply. The American Medical Association is scheduled to release its own rules after its annual meeting held this week.