From prescribing overdoses to sticking a tube in the wrong vein, doctors-in-training made one-third more serious mistakes during typical long shifts than they did during “short” 16-hour ones, a Harvard study found.
At the same time, those first-year interns were wired up with electrodes to measure how often their sleepy eyes rolled, and they ended up nodding off more than five times a night during long shifts.
Together, the findings suggest that recently imposed limits on how many hours new doctors can work do not go far enough, the researchers said.
The studies were the first to measure the real-life toll that sleep deprivation takes on interns’ medical judgment. The results were reported today in the New England Journal of Medicine.
“There are currently more than 100,000 physicians-in-training in the United States, most of whom work these kinds of 30-hour shifts on a regular basis,” said Dr. Christopher Landrigan, who led the study on medical errors.
Since July 2003, interns at U.S. hospitals have been limited to a four-week average of 80 hours a week. Also, they cannot work with patients for more than 24 hours straight, though six hours can be tacked on at the end for paperwork and classes.
“These long shifts are perhaps more hazardous than the number of hours in the workweek,” Landrigan said.
The two studies involved 20 interns and were conducted in the cardiac and medical intensive care units at Harvard-affiliated Brigham and Women’s Hospital in the year before the new limits took effect.
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