Residents Physicians May Need More Sleep. But,is that really the issue with medicine today?
Submitted by Dr. Gwenn Is In
Once again the issue of residency hours and patient safety is in the news. This has been a hotly debated issue for a very long time, which is surprising because it’s common sense and public knowledge that all people function with optimally rested bodies, minds and souls, especially people in high stress situations.
The new recommendations on residency work load aim to give residents more rest during the long shifts and increase supervision. Both are much needed, and were much needed when my colleagues and I were in the throws of our training. But, what our training gave us was patient experience and patient hours. Those hours and the hands on time were invaluable to getting us the experience and ability to think on our feet quickly that have served many of us so well when we were finally on our own. As much as I truly despised many aspects of my residency, I’m certain I wouldn’t be the doctor I am today without those experiences. If residency hours are cut, residency length needs to be expanded. There really isn’t any other way to slice that pie.
The issue of sleep deprivation in medicine isn’t just an issue for residents, though. This is an issue hard wired in the medical system even for attending physicians. Regardless of the field, attending physicians work long hours without breaks for meals, often going 6, 8, 12 or more hours before sitting down to take a moment to refuel. Doctors are not unionized as nurses are so we don’t have a way to demand or enforce the breaks. We don’t even have a way to insist another doctor fills in for us for a few minutes if we feel we need a few minutes to take a break. For a profession whose goal it is to care for others, we don’t do a great job care for ourselves or each other. It’s no wonder burnout is so high and many of us get health issues over time. I’m convinced my herniated disc was the result of all those 12 hour shifts with no break. It’s the only extreme wear and tear I’ve had over the last decade and the only time I recall extreme back pain.
So, while we attempt to fix what’s broken in our residency programs, we have to look at the entire medical system and experiences for attending physicians in all fields. Quality of work life is important so we can take care of patients to our best of abilities. Medicine is stressful and we deserve to have a supportive work environment that has built into the infrastructure whatever is needed for us to do our jobs well without putting our health at risk. As part of the overhaul of the system, better balance between home and work life should be a given. We care for people with families so our work lives should include reasonable limits to get home to our own families - while they are still awake!
For a field whose motto is “do no harm” and is in the business of healing, it’s time we turned our own philosophies on each other and our own field.
