The risk from overworked sleepy interns

Recent TV sitcoms show interns (physicians in their first year of training) as working extended schedules, consecutive shifts, and sleep deprived. It turns out that this is a realistic portrayal of their extremely demanding schedules. However, it raises the question whether an overworked and sleep deprived person (in any position) can reliably make the life-and-death decisions required in a medical environment. New studies in the New England Journal of Medicine (v 351, p 1829 and p 1838, 2004) shed light on this issue and provide a provocative answer.

The first result is that for every three hours the interns work less, they get one more hour of sleep per week. As a consequence, there were significantly less episodes of attention failures (determined by slow eye movement) in interns working at night.

The second publication actually determines the number of serious medical errors in an intensive care unit for the different work schedules.The total seriour error rate in the critical care units was 22% higher when the interns worked on the more extended (sleep deprived) schedule. Also, interns made almost 6 times (!) the number of serious diagnostic errors - 18.6 instead of 3.3 errors per 100 patients in 10 days - when working on the extended schedule, compared to the reduced schedule.

In many of the studies we provide on this site, we discuss 10-20% improvements from a variety of treatments. Here we have an opportunity to provide a 500% improvement, by insisting that interns and other medical providers get adequate sleep! How many people have been killed because we try to squeeze the very last drop of work from medical providers? Surely it must be high, given these numbers. Our lives are too precious - if needed, throw out the expensive medications, and just put a few more medical workers in to share the load and prevent their sleep deprivation!

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Last Modification - October 28, 2004