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Health/Fitness
Young docs prefer 30-hour shifts to taking naps
June 6, 2006 BY JIM RITTER Health Reporter
During their training, resident doctors regularly work grueling overnight shifts that last as long as 30 hours. To reduce their fatigue, University of Chicago Hospital allows residents to take naps uninterrupted by calls. After midnight, residents who have finished with their patients are encouraged to forward pager calls to another resident. But residents did so only 22 percent of the time, according to a study of the program published in the Annals of Internal Medicine. "I thought it would have been higher," said U. of C. lead author Dr. Vineet Arora.
 "It's really hard at first," Dr. Emily Mawdsley said of usually sleeping only two to four hours during her overnight shifts. "But over time, you get used to it." (JOHN H. WHITE/SUN-TIMES)
WHY THE LONG HOURS?
Make more mistakes
Young doctors, Arora and colleagues wrote, "are choosing to care for their patients over their own immediate welfare." The study included 38 first-year residents, also known as interns. Dr. Emily Mawdsley, who participated in the study, said she never turned off her pager. "You know your patients better than anyone else," she said. "You want to keep track of them a little more closely." After medical school, a doctor works long hours during a residency that lasts three to seven years. Some studies have found these sleep-deprived doctors make more mistakes. Under work rules passed in 2003 by an accrediting organization, residents are not supposed to average more than 80 hours a week or work more than 30 hours in a row. They're also supposed to get one day off per week and at least 10 hours off between shifts. But these work rules "may not completely guard against the negative effect of sleep loss on cognitive and clinical performance," researchers reported last year in the journal Sleep. At the U. of C., interns typically work overnight shifts every fourth night, beginning at 8 a.m. and working until 2 p.m. the following day. When possible, they sleep in "call rooms," two residents per room. The study found that while most residents on the nap schedule kept their pagers on for their own patients, they declined to take calls for patients not under their direct care. Nap schedule
Residents on the nap schedule slept an average of three hours, five minutes a night. That's 41 minutes longer than residents on a standard schedule. Nap schedule residents also slept more soundly and reported less fatigue. However, the study was too small to determine whether the nap schedule improved patient care, researchers said. Mawdsley, who is finishing up her residency in internal medicine, said she typically slept two to four hours during her overnight shifts. "It's really hard at first. You feel really tired," she said. "But over time, you get used to it."
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