More Exhausted Residents = More Dead Patients?


Think you work long hours? Medical residents, those who have graduated medical school and are working in hospitals to get hands-on experience, can currently work up to 16 hours a shift. The private group overseeing physician training in the country is proposing that it be increased to 28 hours, reports the Los Angeles Times. That may mean exhausted residents treating patients in New Jersey hospitals in the future.

Have you ever been awake for more than 24 hours? If so, how well did you function? Do you think you would be able to make life-and-death decisions after being awake that long or perform a medical procedure without making mistakes?

The 16-hour limit was a reduction in 2011 from 24 hours, after evidence showed exhausted residents were endangering both their patients and themselves.

  • Studies show the longer residents work, the more likely they are to make potentially deadly errors when caring for patients.
  • Nearly 20% of residents at the University of California Los Angeles stated in a 2007 survey that they had fallen asleep while driving, because of work-related fatigue.

Doctors who want the increase claim that current shift limits may endanger patients by forcing residents to leave at critical times and that the grueling hours are preparation for the future, when they will be unsupervised. This training is compared to getting ready for a marathon. “With enough experience comes resilience and the ability to perform under expected, sometimes challenging conditions,” Thomas Nasca, chief executive of the Accreditation Council for Graduate Medical Education, stated when announcing the proposed change.

The proposal is rightly coming under criticism from both physicians and consumer groups. One medical school professor stated that it’s “very well established” that being awake for 24 hours “severely degrades performance.” In one trial it was found that first-year residents working in an intensive care unit for 24 or more hours made 36% more serious medical errors than those working shorter shifts. At times, researchers found residents asleep while standing up.

Under the proposal residents could work for more than 28 straight hours in cases where they are needed for patient care, and there would be no requirement of at least an eight-hour break after shifts shorter than 24 hours. The overall number of hours a resident could work would be a mere 80 per week, averaged over four weeks.

Residents facing these kinds of hours may rightly fear for their sanity. Instead of making hours more reasonable to avoid mental health problems, the proposal provides that hospitals must provide 24-hour access to affordable mental health treatment for residents.

The Council proposed increasing the hours after a study concluded there was no difference for surgery patients’ safety when hospital residents worked longer than the 16-hour limit. The year-long study involved 117 residency programs. About 9% of patients died or had serious complications after surgery, whether or not the hospitals followed the shift limit.

“These were trials run by physicians who wanted to see the rules overturned,” Sammy Almashat at Public Citizen’s Health Research Group was quoted as saying. “We don’t let pilots stay awake for 28-hour shifts…because we know the consequences.”

Physicians make mistakes and commit medical malpractice for many reasons, including mental and physical mistakes due to fatigue. If you believe that you or a family member has been injured because of negligence by a medical professional in New Jersey, schedule a free consultation with our office by calling us at (973) 358-6134 or by using our online quick connect form. Contact us so you can learn about your legal rights and take action to protect your ability to seek compensation.

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