Improving medical students

On the 80-hour Workweek Cap – Part 2

Posted by medliorator on March 14, 2009

Pauline W. Chen, M.D. :

I spoke with Dr. Thomas J. Nasca, the chief executive of the council, and asked him about resident duty hours

Q. What have been some of the effects of decreasing duty hours on patient safety?

A. We know there have been a lot of unintended consequences, some of which have not been good for patients. One of these unintended consequences, for example, has been an increased number of handoffs between doctors leaving their shift and new doctors coming on. The handoff period is the most vulnerable period for a patient, not because the people handing off data are not doing their best or because institutions don’t have systems in place. It’s a vulnerable period simply because one cannot predict what will happen when a patient is ill, and the doctors left caring for those patients don’t know them.

Another unintended consequence has been placing residents in certain ethical quandaries. One resident told me about caring for a child who was dying. She had taken care of this child for 10 or 12 days and was on call when it became clear that the child was going to die in the next few hours. But this resident was supposed to go home; her hours limit was up.

This resident stayed, but there was an unintended consequence. She could tell the truth about breaking the hours rule, and thus jeopardize herself and the residency program. Or she could lie.

On Young Doctors and Long Workdays [NYT]

One Response to “On the 80-hour Workweek Cap – Part 2”

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