Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

No Doctor Should Work 30 Hours Straight with No Sleep

theatlantic.com

Post reply on HN
Print view View original

51–60 of 208 posts

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#51

Post by minimuffins »

Learning about new ways that our medical industry is totally dysfunctional is baffling and infuriating. It seems to be an inexhaustible well of misery for workers and patients alike. These conditions are like something out of a 19th century factory town. One more way the US healthcare system is a ridiculous anachronism.

My first questions are

1) Is sleep deprivation and the generally toxic work culture for doctors and healthcare workers a uniquely American thing? Like does a doctor in Denmark or the UK or Mexico have such a brutal work regime?

2) What's the solution to this? I'm inclined to think healthcare workers have to organize themselves to oppose it and demand new policies because who else will? It seems no one in hospital administrations, regulatory bodies or government has any incentive to push for change here, in fact they're doing the opposite by expanding allowed hours worked.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#53

Post by finid »

linkregister wrote: post #38
finid wrote: post #22

Earlier quoted context omitted.

But nurses are no different. We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.

I know of no nurses that work this schedule, even voluntarily (overtime, swaps). Nursing in many states is challenged by unsafely high patient:staff ratios, excessive documentation requirements (on extremely slow user interfaces), and the need to vigorously double-check physician's orders (dangerous drug interactions, over-dosages, etc).

A friend of mine had to become his wife's driver, because after working double shifts across two hospitals, she could barely keep her eyes open.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#54

Post by finid »

gech wrote: post #49
finid wrote: post #22

Earlier quoted context omitted.

But nurses are no different. We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.

No, we should direct all the hate at lawyers asking for more than 250k for malpractice

So lawyers demanding 250k for malpractice is what's causing malpractice? OK...

Next you're going to be blaming the patients.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#55

Post by [deleted] »

pdxandi wrote: post #34
jseliger wrote: post #11

The culture of medicine, at least at the physician level, is completely insane; it's so insane that describing its insanity is part of the reason I wrote "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" ( https://jakeseliger.com/2012/10/20/why-you-should-become-a-n... ). Residents in particular have no power, and even physicians themselves frequently…

My wife's a second-year resident and it's pretty unbelievable how hard and how much they work. She's on her 18th straight day of working long days during the week and long nights during the weekend. Legally there's an 80-hour per week cap, but no resident would ever complain. They do 24 hour shifts, but never 30 hour ones, though other programs at her hospital do. I felt upset about her hours all through medical scho…

[deleted]

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#56

Post by j-pb »

dnautics wrote: post #4

Didn't they do a study and find that decreasing doctor hours caused an increase in patient mortality because of handoff errors? And that digitizing records didn't help because of a combination of inaccurate measurement by the staff and because of factors that can't be measured (intuitive observation, etc).

Proposal: Have doctors always work in pairs like we do when pair programming. The shifts of each partner consists of 8 hours but are shifted by half a phase. This way the maximum time of sleep deprivation is 4 hours and the handoff is also a process that takes 4 hours giving maximum information transfer and always a fresh mind to catch errors.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#57

Post by matrix »

pdxandi wrote: post #34
jseliger wrote: post #11

The culture of medicine, at least at the physician level, is completely insane; it's so insane that describing its insanity is part of the reason I wrote "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" ( https://jakeseliger.com/2012/10/20/why-you-should-become-a-n... ). Residents in particular have no power, and even physicians themselves frequently…

My wife's a second-year resident and it's pretty unbelievable how hard and how much they work. She's on her 18th straight day of working long days during the week and long nights during the weekend. Legally there's an 80-hour per week cap, but no resident would ever complain. They do 24 hour shifts, but never 30 hour ones, though other programs at her hospital do. I felt upset about her hours all through medical scho…

If she is pursuing a demanding specialty, consider having your kids while she's a resident; I've known a few people that did it and while it's hard, it can be the lesser of evils. Fellowship is just as hard - maybe even harder - than residency, and when you're practicing she likely won't be eligible for maternity leave initially and can face pressure from the group to keep on working (otherwise someone else might end up having those brutal all-weekend calls back-to-back... not a good way for the new person to make themselves popular with their group).

Of course, it's a different story if she will be in a more sane line of work, such as hospitalist, ER doc, etc.

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#59

Post by azsromej »

pdxandi wrote: post #34
jseliger wrote: post #11

The culture of medicine, at least at the physician level, is completely insane; it's so insane that describing its insanity is part of the reason I wrote "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" ( https://jakeseliger.com/2012/10/20/why-you-should-become-a-n... ). Residents in particular have no power, and even physicians themselves frequently…

My wife's a second-year resident and it's pretty unbelievable how hard and how much they work. She's on her 18th straight day of working long days during the week and long nights during the weekend. Legally there's an 80-hour per week cap, but no resident would ever complain. They do 24 hour shifts, but never 30 hour ones, though other programs at her hospital do. I felt upset about her hours all through medical scho…

My wife's in her final year of residency, so I know what you mean. I work from home in part to be around when she's off, but the demands of the lifestyle are especially clear when you see neighbors pulling into driveways at 5:30pm, friends enjoying a full weekend, vacations, and having several days off around the holidays.

Residency, by not granting you those things that people normally take for granted, helps you appreciate them!

Re: No Doctor Should Work 30 Hours Straight with No Sleep

#60

Post by themantalope »

pavel_lishin wrote: post #47

Doesn't this level of overwork originate with one medical instructor, who was a habitual cocaine user and thought nothing of going without sleep? I remember reading this somewhere, but can't remember where.

I'm a medical student. According to legend, yes, William Osler (one of the founding physicians at Johns Hopkins Hospital) used cocaine to increase his energy and focus while working.

https://en.wikipedia.org/wiki/William_Osler

Post reply on HN