When my brother was in the hospital, I really appreciated it when he had the same nurse 2 or even 3 days in a row {he/we had his/our favorites}, so when I read this article talking about letting medical interns extend their shifts from the current 16 hours in a row to 28 hours in a row, it made some sense to me. I felt a little more of a bond grow the longer they were caring for him, but that 28 hour thing got to me. Seemed like such a long shift!
But I guess they’ve done a bunch of studies on it and found that the relaxed rule wouldn’t increase risks for patients. In fact, the longer work hours {like a 28 hour shift!} could make patient care safer and would also improve medical training by giving young doctors more realistic experience. They’d actually be prone to make LESS mistakes in regards to patient care.
I don’t sleep a ton, but there’s no way I could survive 28 hours shifts as the norm. People probably wouldn’t survive their hospital visits if I was their doctor! But I guess people do it all the time, and maybe you grow accustomed to the long hours and train your body to handle it?
What’s the longest you’ve ever worked? How many hours do you routinely work straight through?
I’m tired just thinking about it!
~Mavis
Amy says
OH, I don’t think they typically are awake the entire 28 hours… I know my OB doc had a cot/ couch in his office at the hospital and would take nap breaks during not-busy times… of course there were days when he didn’t even have time to break for a cup of coffee, but on the typical day, pulling a 24 or longer shift, he did take rest breaks – but was always on premises/ on call should he be needed…
Just some further food for your thought 🙂
Karin Carson says
I am a Care Aid/Nursing Assistant and we as well as the nurses in the hospital and extended care facility regularly work 16/18/24 hrs shifts , it sucks but it is what it is, right now we have facilities and hospital wings/units closed to new patients as we have a GI out break ( gastrointestinal ) , oh the joys of health care… But I wouldn’t work in any other occupantion , I love my job .
Tracy T says
I am a Paramedic and I used to work 24 hour shifts on the ambulance. If you have a busy shift and you are up the entire time – I can tell you that you are dangerous after hour 19-20. It is not safe for you or the patient. 12-14 hours should be the maximum unless there is some downtime for sleep/nap somewhere.
Lindsey says
Agreed. Husband is a paramedic and they are allowed up to 36 hrs straight and this is in a major metropolitan where they never sleep. It’s just flat out dangerous. A medical student may be a bit safer because at least they aren’t driving an emergency vehicle but still, people need sleep!
Blair says
As a Registered Nurse, I used to work in an OR where we pulled 24 hour shifts and let me tell you, it was dangerous. There were times when I would catch myself dozing off against the wall during surgeries! There is just no way this is safe!!!!
Tricia says
I am also a registered nurse. I worked 16 hours straight in a newborn nursery. It was non-stop babies. By the end of it –I was spent– it took 2 days to recover. I love nursing but 16 hours was my limit.
Maxine says
Accountant, so not life threatening role, but 12-14 hour days are normal, some 80 hour weeks during tax season, but more mistakes happen the more long days not to mention grumpiness. Too many and people are afraid to be near you. Don’t think I’d have much bedside manner.
Nurses doing dialysis for my step-dad are being pushed to do more hours at a time but never 40 total for a week I would guess to avoid giving benefits so they try to find another job to supplement but shifts change. Very hard. Small town
Linda Sand says
I would not like to be a patient there. I did like having the same nurse every day but not for more than one shift. I remember being able to stay up long hours when young but I could also tell my brain was not working as well as those hours passed. I would no like having someone caring for my life have that foggy brain.
Allison says
My son had a few interns at childrens. These were oncology transplant interns. They had a room set up on the floor for them to sleep, eat, shower etc. But if we needed them, they were on the floor. I agree with the feeling of comfort with the same ones, he would freak out a little if his favorite was off for 24 hrs. I also agree with the care aspect. I know his situation after transplant changed sometimes hourly, having the same dr there helped greatly. On occasion the new intern would call the last one for questions and directions , not having been there. I wonder if they worked 28 hrs of they would then be off 28 hrs? That could pose issues too.
Kathy says
I’ve worked 16 hour days in medical field before I burned out on direct patient care (30+ years of it!). It can be taxing. Still in healthcare but behind the scenes, and only 8-10 hr day. I’ve known doctors when, as interns, that pulled 36 hour shifts but had a sleep room at the hospital for them to try and rest after 18 hours. (Most of them have retired by 55-60 yrs old now) To me, it isn’t right working longer than a double (16 hrs), but some people thrive on it.
kmkat says
My son is finishing his residency in family medicine this year. His opinion, which he has shared with me in the past, is that any shift that goes longer than about 18 hours is dangerous. As an accountant myself, I routinely worked 12-14 shifts during the busiest times of the year (which are NOT just the run-up to the April 15 deadline for individuals), and I know that I personally would hit the wall sometime in the 12-14 hour timeframe. Happily, I could drop the pencil, turn off the computer, and go home to sleep. Doctors, residents, and interns have a room where they can sack out during the down times, but how well do they sleep? How often are they awakened? Do they even get down time in a given shift? Their breaks are in no way equivalent to actually getting a decent night’s sleep in one’s own bed.
Personally, I would not like to be under the care of someone who has been working for 27 hours. And I would really, REALLY like to see who funded this research you mention. If it was any group having to do with hospitals or the AMA or who might have a vested interest in saving money by having interns or other staff work longer shifts, I seriously doubt the validity of said research.
Carole says
I pulled a 14 hour day before. You do get foggy brained and I am not sure how I got home, auto pilot I guess but I would not like it as a continuing thing. Definitely not if someone’s life depended on it.
Happyplace says
I worked many years in an ICU in a large teaching hospital where interns and students thrive. These hours are a breeding ground for mistakes that can be fatal. I have seen it many times. I have even went to their rooms to physically wake them and many times they make no sense.
Heather H says
My newborn son lived at a Children’s hospital for 8 1/2 months straight. I will say that it was very stressful to my husband and I when we’d have a different nurse everyday…they’d have to practically be introduced to our son’s rare heart issue. We loved it if we could have a nurse even 2 days in a row. These nurses had 12-hour shifts.
I’d talk to every nurse and most would tell me that the night shift was the hardest trying to stay awake.
I’d say whatever is the best for the nurses so they can focus and give their 100% to their patients.
Emily E. says
I’ve been an RN for 20 yrs and worked up to 20 hrs in one shift. It’s not safe. I don’t care what the studies are saying, nobody is going to be as sharp at hour 16 or 19 as they were in the first few hours. This is from a nurse’s perspective however. Interns are supposed to have a room to rest throughout those day or longer shifts. While I do think it’s realistic prep for real life on call, it’s still not the safest practice. We are only human and good intentions will only get you so far. Medical personnel make mistakes during 8 hour shifts. I think it’s asking for trouble the extend hours beyond twelves or the occasional 16. I do appreciate the continuity of care factor for all patients in seeing the same faces. That’s why change of shift reports are so important, especially for scared little ones.
Peggy says
From what I’ve read on it, what made it more dangerous was the trade off. When the new shift comes in things get missed in the transition. I think they should continue to improve practices in that area rather than continue to encourage dangerously long shifts. I think 12 hrs should be the max for a nurse or doctor.
Mary says
This is ridiculous! People — all people — function poorly when they have gone without rest. I don’t believe the 12 hour shifts for nurses is good for patients. And I certainly wouldn’t want an intern treating me or a family member after 24 hours of a 28 hour shift! Just because this is the way it’s always been done doesn’t make it right; this makes it hazing, which focuses only on seeing who will break under the pressure. The business of scheduling all medical personnel needs to be reformed so that the safety of patients is the ultimate goal.
KC says
28 hours awake is not safe at all.
I’m pretty confident that the answer to continuity of care is to have better shift handoffs and lower patient-to-caregiver ratios, not to have people who have been awake for way too long. I’d like to see more shift overlap so that the incoming care providers can do a review of what’s happened on every chart under their wings and ask questions as necessary of the departing crew – and so patients can confirm things between the departing provider and the incoming one.
Plus, med students are already burning out and having health and mental problems with what they’re undergoing in certain phases of internships – we don’t need to make that even more intense!
It’s slightly different once they have gone through the internship years – they have more autonomy and authority, so would be more likely to be able to manage their schedule to get naps, potentially – but I wouldn’t want anyone who had been awake for 28 hours attending either myself or my family members. If (for very good reason) you’re not allowed to drive a semi truck after a certain amount of time without sleep, you shouldn’t be allowed to administer/decide medications, etc., either!
HeatherS says
During the birth of my first child, the man who did my epidural had obviously been on call way too long. He looked absolutely exhausted and at one point both my mother and husband were convinced that he had fallen asleep while standing there trying to figure out why mine was not working. At the end of delivery, the next morning, a fresh faced new person came in to take over and immediately found the problem – it had come out of my back about 10 hours earlier!. By then, however, I had delivered and it was too late anyway. Thankfully I was not injured, just went without the expected epidural for many long hours, but no way would I want another person doing something medical to me when they had not slept in that many hours!
Mable says
I am not sure who did the studies you mentioned but as far as I can find, no reputable organization makes those claims—in fact, precisely the opposite. Sounds like something a lobbying firm for truckers would quote, since they hate having federally mandated maximum hours for truckers (which cuts into the profits of the trucking firms, so they are always fighting the rules.) It reminds me of people who say they can multi-task for greater efficiency, when every study out there has shown that mono-focus is more effective and more efficient in the long run.
Brianna says
My husband often works 24-30 hour shifts and has a 30-minute traffic dense commute home at the end of it. I have packed up the kids on several occasions to go and pick him up from work because he can’t have a focused and alert conversation on the phone at the end of his shift and it is by no means safe for him to drive. He hit the driver mirror one night on a gate and that was when I realized he most likely shouldn’t be driving home after his shifts.
The brain requires adequate quality rest and without it many functions are impaired. There have been many studies done on rest-sleep cycles and cognitive function, but this article seems to lack much scientific research to support the claims. I would not want to be taken care of by anybody in the medical profession who doesn’t get adequate sleep or rest. I suppose this article is bait for malpactice insurance companies to target interns and teaching hospitals with excessive fees.
Jenny Young says
Have you heard this guys story?
https://en.wikipedia.org/wiki/Cliff_Young_(athlete)
Amazing that he could keep moving that long!I don’t think I could be much help after 12 hours, let alone 16 or 28.
Lynn says
Medical interns are the bottom of the pole for young doctors. They are still learning. While my son was in the ICU at a large teaching hospital with septicemia and a life-threatening heart condition, they kept the interns out of his room. Only the nurses, radiology techs, fellows and specialist doctors were allowed in. I don’t see how extending an intern’s hours would help with patient care.
Kimberly says
My sister is a RN who works 12 hour shifts routinely (often forced to stay longer than that though). There is no way it is safe, for either the patients or the staff. My sister has almost fallen asleep while driving home after shifts (especially after working night shift-they HAVE to rotate so aren’t always working the same shifts.) I don’t think anyone who is in a role where you have to provide lifesaving care should be on for more than 8 hours. I don’t think one’s judgement or reaction time will be the same.
Carrie says
Sometimes I feel myself drifting after 6 hours of work! Days where I can take an hour break to go walk I can last 8 hours fine. The longest shift I’ve done was 12 hours and I was so loopy by the end of it, even though I would have been home and awake during that time it is different than working.
I agree it sounds like the “hand over” between shifts needs to be improved. And don’t employees want a normal schedule? I really doubt someone wants to work 28 hours!
Lorie says
Isn’t it interesting that studies show drowsy driving is just like drunk driving?
Yet it’s ok for a drowsy person to perform a life saving task?
No thank you.
Rosemary says
I’m married to a physician who spent 8 years in residencies and fellowships before starting practice on his own. Sleep schedules during medical training are already deplorable. When he was “On call” pulling 30+ hour shifts, he was not sleeping. Nor were they allowed to sleep. They WORK those hours straight through. When people are sleep deprived they make poor decisions and even though my husband never hurt his patients, it was definitely not good for him. People need sleep to function normally. This new rule makes me ill. I was a floor nurse for several years and worked with interns and residents who were often pulling these long shifts. I could only feel bad for these hard working medical professionals. They do more work than is required of anyone else I know and frankly, do it at a detriment to their own health. I worked 3 12 hour shifts in a row as a nurse many times, but I had a break between each one. It was doable and I enjoyed the continuity of care for my patients. The fact that programs are extending the inhumane practice of denying breaks for these medical trainees makes me sick. I say it’s a bad idea.
Amber says
I am a family medicine physician and while in residency 15 years ago, we routinely pulled 30+ hour shifts. We would go in at 6 AM and finish up around one or 2 PM the next day. Even if you get the chance to lay down, which was rare, you’re so afraid that your pager will go off that you can’t relax to get even a few minutes of shut eye . I chose my family over my career and have never taken call since finishing, just working in the clinic. This has been a lifesaver as I now have four kids. You develop ways to cope, but ultimately, I agree that it’s not safe.
Speaking of hospitals and drs…have u gotten your colonoscopy yet Mavis?
CathyB says
I would not want anyone working on me who had been awake that long. Too easy to make mistakes. I wonder if patients and patient families could drive a change. If we routinely asked every nurse/intern that came in how long they have been on shift and then asked for someone else if they have worked too long, maybe things would change? Or maybe there would be no one else and we would just get nothing.