What Medical Residents Need After a Long Shift
Sep 20, 2020
Published by Kathrin O'Neill
Long shifts lasting 24 to 28 hours are common for resident doctors. While coffee might help power through the day, it leaves debilitating effects on their health and their patient’s well-being.
About a third of the American population experiences sleep deprivation, a situation where you get less than 7 hours of sleep. Moreover, doctors and police officers are some of the most sleep-deprived professionals. Being responsible for the community’s safety, it’s important to take into consideration that most medical residents have around 80 hours of work per week with little time for resting.
A study has been done among residents from a Canadian medical school (surgical and non-surgical specialties) from the year 2012 to 2014. It follows their post-call actions after taking the 24-hour shift, how they prioritize these activities, and the impact this has made in their sleep and health. After analyzing these interview transcripts, the researchers concluded that residents have a hard time juggling priorities and result in using ‘trade-off-orientations’, a situation where they barter sleep in exchange for more personal time.
Though sleep is a commodity only a few residents could ‘afford’, the study showed otherwise. It dwells into a much complex set of work-life balance activities including building social connections and fulfilling errands. Thus, the duty hours may look into the recovery of sleep but not point out to the recovery of self.
There are three phases in which medical residents want to ease into full recovery (both self and sleep) following a long shift:
Most resident doctors want to forego sleep and do other things after a post-call day. This speaks of a broader idea of recovery wherein doctors re-connect with their other people (social life), identities, and roles that are beyond the hospital walls. It would seem that doctors may get into a ‘psychological detachment’, a mental disengagement of work and workplace demands to initiate recovery.
Residents should establish this boundary to be able to achieve self-recovery. Studies have proven that failure to do so can lead to emotional exhaustion, poor sleeping patterns, and work dissatisfaction.
Though this only accounts for a minute portion of their post-call activities, researchers have noted that residents still want to pursue learning despite their lack of time and energy. To add, lack of sleep further hinders them from pursuing continuous education because of its cognitive demands. Most residents would argue that they’d prefer to go for social engagements where there’s little to no need for any intellectual stimulation.
While most residents would prefer to work on errands or go socialize, sleep is also another thing that they look into during a post-call shift. Many residents see post-call days as important days for catching up on sleep and rest. But residents see this differently and find it hard to put it into practice. Though motivated to reduce their fatigue (through sleep), many find that depriving their sleep during day time could help maintain their sleep-wake rhythm.
A 2011 study from the Canadian Medical Association Journal showed that surgeons who slept less than 6 hours the night prior a surgery resulted in higher patient exposure to surgical complications. Furthermore, sleep deprivation can lead to debilitating medical performance. It is said that medical performance can be akin to ‘being drunk’ when working on 24-hour shifts or more. Medical errors are expected to rise to 300 percent for those working beyond the 24-hour limit.
A $411 billion per year loss comes from sleep deficiency. As medical practitioners, it’s important to maintain good sleep hygiene to be more productive while on shift and avoid medical errors. With this in mind, here are effective ways to get sufficient sleep on your post-call days:
