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Why Do Hospitals Hate Sleep So Much?

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Re: Why Do Hospitals Hate Sleep So Much?

#291

Post by cstross »

ineedasername wrote: post #240
IB885588 wrote: post #230

Earlier quoted context omitted.

Peter Attia (MD) had a podcast episode where he talked about being a resident and how it almost killed him (asleep while driving) and was bad for patient. Also explained that the guy who created the residency program was a cocaine addict who rarely slept, and since then all doctors have to try to follow his crazy schedule for no good reason..

Yeah. I mean, I get that hospitals are 24-hour operations that need doctors & nurses available at all times. So some people are going to get the crap end of that stick and have to do night shifts. But is it really necessary for them to work 80+ hours while they're at it? It seems like there's enough people trying to be doctors that you could cut that down to a healthier 40 hours+ 15 hours on call if it's really neces…

Here in the UK, the way I heard it from a friend who was doing their pre-med, is that there was a built-in cost incentive: hospitals paid doctors who were on-call at one third of their regular hourly rate for out-of-hours on-call coverage. (That's not regular hourly rate plus a third; that's one third of normal wages for hours after the first 40.) So the hospital administration had a solid reason to work their interns and house officers into the ground rather than hiring extra junior doctors.

The original rationale was that the "on call" hours were not supposed to be busy and the duty doctors could spend most of them sleeping in a bunk or studying: but by the late 1980s (when I heard about things) they were working more or less constantly through their shifts.

The EU Working Hours Directive was supposed to fix this by banning workers from putting in more than about 50 hours a week without very specific protections being enforced, but one of the first things the UK's Conservative government did in 2010 was to stop enforcing this.

Re: Why Do Hospitals Hate Sleep So Much?

#292

Post by majewsky »

dahfizz wrote: post #281
pc86 wrote: post #239

Earlier quoted context omitted.

Most companies (not startups) don't have their employees work much more than 40 hours. Lack of sleep is very rarely an issue with your employer.

Even with an 8 hour day plus a long commute, there are at least 14-15 hours a day left for you. If you aren't finding time in there to sleep, that's on you.

Good thing that work is literally my only responsibility as an adult. /s

Re: Why Do Hospitals Hate Sleep So Much?

#293

Post by billfruit »

random878 wrote: post #288

As someone on HN who is medical, not tech, this thread is as frustrating to read as it would be for many of you to read doctor's opinions on how best to run a software engineering firm. "I'm not a software engineer, but here's my full breakdown on where you are all going wrong based on using a BBC Micro for a week back in 1993"

But in your experience is there a problem with hospitals not understanding that patients need proper sleep?

Re: Why Do Hospitals Hate Sleep So Much?

#295

Post by pc86 »

antidesitter wrote: post #272
pc86 wrote: post #260

Earlier quoted context omitted.

You would likely have to extend residency based on everything that you need to learn for a given specialty. Med school graduates have an average of over $180k in student loan debt - from med school alone - and resident salaries in the 2-4 year programs are mid five figures. Given the choice, I'm not sure someone whose 4-year earning potential is capped at $60k with $200k in student loans would want to extend that to…

I believe the GP is talking about increasing the number of doctors, not their years in residency.

You learn how to do your entire specialty during residency. If you cut the number of hours, you have the same amount to learn in less time.

Re: Why Do Hospitals Hate Sleep So Much?

#296

Post by bpyne »

DisruptiveDave wrote: post #218
cstross wrote: post #182

Earlier quoted context omitted.

You were dealing with doctors and nurses, right? One group runs a gauntlet of fire by sleep deprivation during pre-med training: with on-call work hours up to 120 hours a week. And the other group are typically on shift rotas so their sleep patterns are permanently disrupted. I'm going to call it for them being oblivious to the sleep requirements of ordinary human beings, because these professions are self-selecting…

To be clear, you're saying that people whose job is to - quite literally - understand, diagnose, and treat hundreds (thousands?) of medical issues that they personally haven't experienced, don't have the capacity to understand that not everyone is on their same sleep schedule?

The mind does funny things. They also understand that exercise and good nutrition are fundamental to health. When I worked in a hospital I normally ate in the cafeteria. The physicians had horrible diets, including the cardiologists.

Let's not even get started on how many nurses smoke.

Re: Why Do Hospitals Hate Sleep So Much?

#297

Post by conanbatt »

ineedasername wrote: post #240
IB885588 wrote: post #230

Earlier quoted context omitted.

Peter Attia (MD) had a podcast episode where he talked about being a resident and how it almost killed him (asleep while driving) and was bad for patient. Also explained that the guy who created the residency program was a cocaine addict who rarely slept, and since then all doctors have to try to follow his crazy schedule for no good reason..

Yeah. I mean, I get that hospitals are 24-hour operations that need doctors & nurses available at all times. So some people are going to get the crap end of that stick and have to do night shifts. But is it really necessary for them to work 80+ hours while they're at it? It seems like there's enough people trying to be doctors that you could cut that down to a healthier 40 hours+ 15 hours on call if it's really neces…

> It seems like there's enough people trying to be doctors

Not in the US. The doctor per pop count is very low.

https://www.nationmaster.com/country-info/stats/Health/Physi...

Re: Why Do Hospitals Hate Sleep So Much?

#299

Post by jac241 »

gerbilly wrote: post #282
jac241 wrote: post #278

Earlier quoted context omitted.

In medical school, 120 hour weeks really only exist for 4th year med students who are on sub-internships in surgical specialties like neurosurgery, orthopedic surgery, general surgery, etc. Students in those fields do 3 or so month long sub-i's at hospitals they want to do residency at. They basically function as month long interviews for those programs, and are also used to get letters of recommendation from promine…

So they are being taken advantage of then. Sounds like they should just legislate away the "Residency match system."

Ironically, congress passed a law in 2004 to give the NRMP, the organization that runs the match, immunity from antitrust legislation. https://en.wikipedia.org/wiki/National_Resident_Matching_Pro...

Re: Why Do Hospitals Hate Sleep So Much?

#300

Post by serguzest »

shados wrote: post #228

I'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, a…

Because civilizations are built and ruled by Type A people, who usually sleep less and get up super early, they are known to die younger though.

And %3.3 people have DSPS, who are just simply labelled as sleazy.

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