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Study: Long hospital shifts, sleep deprivation can kill

We in the healing arts have waited a long time for a headline like this. It seems that someone has finally acknowledged what we knew all along: working long hours is dangerous to the health and life of young doctors-in-training. Hurrah for research! Let's celebrate by knocking off early, before we get hurt.

A study from the U.S. of doctors in their first postgraduate year (interns) has showed that working extended shifts is associated with increased reporting by the doctors of medical errors, adverse patient events and attentional failures.

Hmm...disturbing news, to say the least, especially if I were roaming the halls in a windswept gown, trying to dodge one of these "adverse events." But what about these poor doctors who are forced to risk their lives on only 10 winks of sleep?

In months in which residents worked even one long shift-of 24 hours or more -they were three times more likely to report a fatigue-related significant medical error compared with months in which they worked no extended hours. The rate increased to more than -seven-fold higher in months in which more than five extended shifts were worked.

Wait a second - is this yet another exposé of sleepy doctors committing medical errors? Isn't this common knowledge by now? Didn't we fix this problem by creating a tranquil, respectful work environment for interns and residents? What happened? And do I win a prize by asking five questions in one paragraph?

These errors apparently translated into adverse patient events; even in the months in which residents worked one extended shift they were seven times more likely to report an adverse patient event compared with months when no extended shift was worked. In addition, doctors working more than five extended duration shifts per month reported more attentional failures, (i.e., dozing off) during lectures, during ward rounds and during clinical activities, including surgery, and reported 300 percent more fatigue-related preventable adverse events resulting in the death of the patient.

Not to change the subject but using the term "attentional failure" to describe the act of nodding off during a lecture, even on a topic of vital importance to mankind, is like calling the words released from the human mouth after squarely hitting the human thumb with a hammer "indelicate locution." Let's stick with terms we can instantly comprehend, like "fallling asleep in class."

Speaking of sleep-deprivation, let the word go forth to the far corners of the Earth that I am all in favor of hand-cuffing interns to cozy down-filled cots and forcing them to snore like a lumberjack felling a sequoia. Sleep is not only important for keeping the minds of doctors sharp, so that they don't fail to prevent a preventable failure, but it also has at least one other value.

It is good for the sleeper's health, too.


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You know, attentional failure and indelicate locution remind me very much of wardrobe malfunction. How very PC.

I regularly fall asleep during lectures at meetings, and I'm doing it on a full nights sleep. Could that be attributed to failure to present?

Yup. We can quit anytime. Why?
6 years ago shingles left me with seizures and vertigo-drop attacks. I can't drink 'cause I take 3200mg of Neurontin to control it. Then 2 years ago my wife was diagnosed with C2 Chordoma (go look it up). The Surgeons took the 2nd vertebra out of her neck (transmandibular approach) but the stroke they caused paralyzed her left side. I'll spend the rest of what's left of her life here at our home, while attendants and nurses have turned it into a hospital. Check to learn more about her struggle.

The only crutch I've got left is smoking cigs. So why quit? The world is filled with random nasty stuff that'll try and kill ya' anyway, so enjoy the time you've got.

Don't dare to assume till you've walked in these shoes.

I meant to post that to 'Hand me my crutches... I'm going outside for a smoke'.

I'm excited to hear your response to the report that there were fewer breast ca diagnoses in 2003.

The quote I particularly was confused by was this: "Because breast cancer takes years to form, experts think the hormones mostly caused small tumors that had been growing to stop or shrink, making them no longer detectable on mammograms." But earlier in the article, weren't they saying that the hormones were making breast cancer worse?