Forcing Hospital Residents to Work 30+ Hour Shifts Is a Bad Idea

January 5, 2016 | Crandall & Pera Law
Forcing Hospital Residents to Work 30+ Hour Shifts Is a Bad Idea

If you watch hospital procedurals on television, you are already familiar with the concept of the bleary-eyed doctor being forced to operate after little to no sleep in the last 24 hours. We have looked into the effects of sleep deprivation in nurses, and it stands to reason that they are not the only group of medical professionals who could hurt you or themselves is too fatigued to work.

Because of this, a study was done in 2011 by the Accreditation Council for Graduate Medical Education which limited the number of hours a resident could work, and hospitals around the country followed suit by adopting those restrictions. Now, a new study is testing whether or not patient care improves if the same doctor stays with the patient from the beginning – and that means some young doctors might be working shifts that last for 30 hours or more.

The details of the study

The impetus for the study revolves round the idea that patients who are handed off from doctor to doctor in the initial hours of their visit are in more danger of being hurt, harmed or neglected in some way, or that it is more likely that mistakes can be made when a patient does not have one constant doctor monitoring his or her recovery. The research is funded in part by the National Institutes of Health, and is being run by the University of Pennsylvania.

The Washington Post reports that:

“6,000 internal medicine trainees at 63 programs across the country [fusion_builder_container hundred_percent="yes" overflow="visible"][fusion_builder_row][fusion_builder_column type="1_1" background_position="left top" background_color="" border_size="" border_color="" border_style="solid" spacing="yes" background_image="" background_repeat="no-repeat" padding="" margin_top="0px" margin_bottom="0px" class="" id="" animation_type="" animation_speed="0.3" animation_direction="left" hide_on_mobile="no" center_content="no" min_height="none"][are participating in the study]. About 2,400 are first-year physicians…. 31 programs will stick to current rules on resident work hours. Along with the 16-hour limit for first-year trainees, second- and third-year doctors are restricted to 24 consecutive hours of work. Residents may not work more than 80 hours a week, must have one day off every seven days and may not work overnight more often than every three days — all averaged over one month.”

The remaining 32 programs leave scheduling up to the director’s discretion. If the director wishes to put residents on for 30-hour long shifts, he or she can.

Why this might prove to be a terrible idea

Aside from the obvious dangers of being treated by a sleep-deprived doctor – or a doctor who feels obligated to take OTC caffeine pills in order to stay awake – patients will be seen by new, young medical students. First, second and even third year residents may not have the adequate knowledge to respond to a crisis appropriately even when they are fully rested, let alone when they are exhausted. Yes, there must come a time when they are pushed from the nest, so to speak – but adding the burden of sleep deprivation right at the beginning could lead to disastrous results.

Furthermore, this study began less than half a year ago, in July. We were unable to locate any information regarding which programs were participating in the study, with the exception of any listed in the Post article and any programs in New York, which are by law unable to participate. The ethics panel at U Penn “deemed the study’s risk to patients and new doctors minimal, and said hospitals did not have to inform either” (emphasis ours) about their participation in the study, which means it is entirely possible that your recent trip to the hospital put you in the care of a second-year resident who had not slept in the last 24 hours – and no one was required to tell you.

Even if the study proves that longer shifts can improve patient safety, the lack of transparency – the inability of a consumer to obtain crucial information about his or her health provider, to make an informed decision about how he or she wishes to be treated – seems dishonest and wrong. You should be allowed to know how long your doctor will work in each shift, and to decide whether or not you feel comfortable sticking with one healthcare provider or being seen by more than one.

At Crandall & Pera Law, we believe that healthcare providers and facilities owe you a duty of care that extends to pertinent information such as how long your doctor might be on-shift. If you are injured because a sleep-deprived doctor was incapable of making the right decision to protect you, you may have a claim for medical negligence. Please contact us to speak with an experienced medical malpractice attorney in our Ohio or Kentucky office locations.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]