Picture this: Everyone in your home, except you, has been sick since yesterday. Coughing, vomiting, you have (literally) had no sleep in the past 24+ hours. All you've done is tend to one, then tend to the next, responding to tears, moans and groans, anger, frustration.... And you aren't really sure whether you are even giving them the right care. Maybe that cold medicine isn't the right kind. Maybe that queasy stomach elixer is making things worse?
You're exhausted. The last time you had any sleep was the night before last. Now, on top of your exhaustion, you are expected to get behind the wheel of your car, maybe to drive to the drugstore. Maybe to pick up medicine....
Should you get behind the wheel of that car? Further, should you be making decisions about how to treat those family members in your care, knowing how little sleep you've had? What if you make them sicker? What if they die, because you haven't had enough sleep?
Now multiply this by several days each week, week in and week out - for years.
[Seriously. Close your eyes for a moment and think about it.....]
If you are hospitalized, the chances are excellent that one of your "doctors" -- you know, the ones in white coats with IDs on them that say "doctor" -- is just as exhausted as you would be with no sleep.
Why? Because resident doctors -- who are still, formally students (meaning, they have a basic understanding of how to help you, more or less depending on how many years they have been a resident) -- can and do (by law) routinely work 24-30 hour shifts, several days a week, for years, during their training.
And if you are admitted to a teaching hospital (which most hospitals are), they will be treating and taking care of you. Exhausted, having had no sleep, with thirty or forty other patients on their minds -- they will be the people deciding how to treat you.
These residents are found in every care-providing area of the hospital. In emergency rooms, in surgery, working directly with patients. Working with YOU and your loved ones.
Scientific evidence shows exactly how dangerous this is. In 2008, the Institute of Medicine published findings on this topic, recommending that residents' hours be reduced as a safety measure. Yet, today, more than one year later -- few hospitals (if any) have paid any attention.
There are some rules in place. Yes - residents hours have already been limited -- the limit is those 30 hours at one shift! Residents are also limited to an average of 80 hours per week -- but that average might mean they work ONLY 60 hours this week -- meaning they can work 120 hours next week!
Could you work those kinds of hours week in, and week out, for years? Then turn around and make life and death decisions, over and over again, for hundreds of people in your charge?
I know I certainly could not.
So what are we patients to do about this very frightening problem? There are actually two things we can do:
1. Be aware of the problem. If you or a loved one is hospitalized, and a resident (which should be noted on his/her hospital ID) arrives to treat you -- ask when they last slept. That simple. If if seems they've been on the job for more than 10-12 hours? Then ask that someone else make recommendations for you. (It's worth a try anyway.)
2. A grassroots movement to force changes to this overwork and too-little-sleep policy has begun, and you can sign a petition asking for more recognition, and steps to change it. Called "Wake Up Doctor" - it will take you only a minute to sign.
Have you been directly harmed by an exhausted resident doctor? If so, then Wake Up Doctor asks you to share your story, too.
There are so few aspects of the big picture of medicine that we patients can improve. This may be one of them. I hope you'll spend a few moments learning more about the problem (awareness) and signing this petition today.
I'll keep you posted on progress.
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Trish, how can you tell a resident or med student by their ID tag? One day out of medical school, they’re allowed to have MD behind their name. I think there are some initials on the tag that indicate what year resident or student they may be, but can’t find a reference to it anywhere on the web. Thanks for any info.
p.s. half of the ID tags on nurses and docs at my hospital are flipped over or tucked in a pocket. When I asked a nurse if this was deliberate, she said it was for privacy and safety because they get deal with some nutter patients.
Emily, It’s a great question. You used to be able to tell by the length of their coats, but so many wear scrubs now. And I’ve heard that some hospitals are considering having their doctors remove their white coats and their ties because of the chances of infections being passed.
The only answer is to ask each person as they come along. That privacy and security answer about tags is ridiculous, but I don’t know how you could ever go about changing it.