Young doctors still too tired for safety

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Report: Young doctors still too tired for safety

WASHINGTON – Doctors-in-training are still too exhausted, says a new

report that calls on hospitals to let them have a nap.

Regulations that capped the working hours of bleary-eyed young doctors

came just five years ago, limiting them to about 80 hours a week.

Tuesday, the prestigious Institute of Medicine recommended easing the

workload a bit more: Anyone working the maximum 30-hour shift should

get an uninterrupted five-hour break for sleep after 16 hours.

At issue is how to balance patient safety with the education of

roughly 100,000 medical residents, doctors fresh out of medical school

who spend the next three to seven years in on-the-job training for

their specialty. The long hours are in some ways a badge of the

profession; doctors can't simply clock out if a patient is in danger.

But sleep deprivation fogs the brain, a problem that can lead to

serious medical mistakes. So in 2003, the Accreditation Council for

Graduate Medical Education issued the first caps. Before then,

residents in some specialties could average 110 hours a week.

The government asked the IOM to study the current caps. Violations of

current limits are common and residents seldom complain, the committee

found. While quality of life has improved, there's still a lot of burnout.

And despite one study that found residents made more errors while

working longer shifts, patient safety depends on so many factors that

it's impossible to tell yet if the caps helped that problem, the

report said.

So it also recommends:

_Experienced physicians should more closely supervise residents.

_Better overlap of schedules during shift changes to reduce chances

for error as one doctor hands patients' care over to the next.

_Increase mandatory days off each month, and extend hours off between

shifts depending on how long the resident worked, during day or night.

The accreditation council didn't immediately say if it would follow

the recommendations.

http://news./s/ap/20081202/ap_on_he_me/drowsy_doctors