the name just came back to me:
the patient is Libby Zion

 

a good read
http://www.newyorkmetro.com/nymetro/...atures/n_9426/

 

Yup... "The Zion Case" I seriously doubt that being tired had ANYTHING to do with it...more likely, the person didn't take the time to review the chart/labs and prescribed the med out of a knee-jerk response. Being tired was just an excuse.

 

No apology needed Trit.

 

WOW! What a great read. It sums up everything, and much better than I could say it. I have been in that same situation a couple of times and this quote sums it up..
But here

 

woah, that article was an eye-opener.

in order to get that law changed-- maybe not repealed entirely-- but atleast rolled-back, it will likely take a concerted letter-writing campaign from numerous members in the medical field. are there any efforts currently underway?

it's going to be a challenge, because 24+ hr days dealing with life-and-death situations flies in the face of "conventional" wisdom, which is why 405 passed. but clearly, the hospital cannot be viewed as a "conventional workplace" (as pointed out in that article). and the bottom line is, those experienced doctors-- when given the choice between a regular, shorter work-day, or an obviously more challenging extended one-- choose the extended one because it is in the best interest of the patients, much to their own personal sacrifice.

I think those in the public, looking from the outside in (like myself) viewed it as probably a form of hazing, and thus 405 was passed.

but, also, something not totally mentioned in the article, is the long workday really it *IS* a filter to separate the wheat from the chaff. by having such a grueling workload, it will filter out those people who's hearts may not be completely commited and willing to give 200%, from those that are.

that article was a real eye-opener. I know my opinion has been changed.

 

Trit,
I try to explain it to folks like this: When an average Joe hears that a marathon runner jogs 10miles a day, they flip out. Its unfathomable how someone could run that distance daily. For the trained athelete, its no big deal. Now, when you tell the average joe, that surgey resident X worked 30hrs, they flip out. Again, they can not imagine doing that and therefore, they assume that other people can not. Well, to the surgery resident, who has been conditioned, its no big deal.
S2020...thanks for the link.

 

You get used to the lack of sleep and you actually perform at the same level (perhaps a little slower) as a well rested Doc. I took my boards without any sleep, yes 0 hrs. and passed with flying colors. When the adrenalin kicks in sleep is the last thing you think of.

 

Yikes! I didn't mean to touch on anyone's nerves.

I am currently a family medicine intern and started this thread more b/c I was bored rather than tired (I got 3 hours of uninterrupted sleep that night, which is relatively awesome!). Of course, I should be reading an article right now instead of wasting bandwidth.

Since starting med school, I'm quite used to working on holidays and working long hours. If anything, the 80-hour work-rule was recently implemented in Texas during my 4th year of medical school. In my opinion, my 24-hour shift was cake-walk compared to my 3rd-year medical school rotations when we would be on for 24 hours, then round on our patients post-call for an additional 10-12 hours. This routine usually lasts every 4th night. My father is an old-time doc (internal medicine) and felt that being on-call every 4 nights was cush. He was on-call every 2-3 nights on average.

I agree with tenblade's views. Sure, you might be tired after being up all night, but if an emergency situation arises, you quickly wake up to stabilize a patient. At my program as well as many family medicine programs, you're on admit call and then you leave when the clock strikes 7am. No post-call rounds?!?! If I was on the inpatient internal medicine/pediatrics/OBGYN service, I have new patients to see every morning and heavily rely on some other resident's history/physical from overnight instead of my own. At least my residency program still has call every 5-6 nights with night float months. Many family medicine, OB/Gyn, and int Medicine program have done away with call completely and instituted a night float system to "make-up" for it.

As tired as one might be after being on-call overnight, ironically you get most of your learning post-call with the attending physician as I'm sure many docs would agree.

To remedy this 80-hour work rule, many programs across the nation are thinking about adding an extra year to the residency program. I don't know which ones specifically, but I do recall the Chief of Staff for Gen Surgery at my med school were contemplating on adding that extra year as they reluctantly want to comply with the new 80-hour work-rule. The Amer Assoc of Family Med have proposed adding a 4th year to the standard 3-yr program for FP.

Many of the older docs are quite frustrated with this new system. Like it or not, this is the new reality. I think lengthening the residency is a good way to compromise between the new rules and the pursuit of education.

After long nights, I drive home top-down in my S2000 and think "life is good".

 

I agree with Tenblade's assessment.
Even though it's a relatively cushy residency, I still can function when I don't have a good night sleep. So making the student/resident work a little hard is good in the long term.
I think this system "weeds out" the individuals who is unwilling to commit themselves 100%.

I give props to the G-surg. I had wanted to go that route but my 3rd year G-surg rotation made me realize that I'm not cut out (pun intended) to do this. I picked a surgical field that let me sleep more.