I think that sleep is extremely important especially when it comes to life or death situations. When you or anyone else find out how to get enough sleep being a mom to 3 small kids, trying to be healthy by going to the gym before the kidos wake up, being a wife, taking on the responsibilities of the house, bills, etc….. PLEASE let me know! I love my sleep, but somehow since becoming a mommy I can’t enjoy it much anymore!
xoxoxo

Di,

It sounds like our job requirements share a similarity. And yes I think sleep is just as ‘life and death’ as it is to a physician. A chronically cranky mommy can do a lifetime of damage to a developing soul. I’m guessing many psych docs would concur. I dare them not too!

Gwen

This is definitely one of those topics that so many people relate to! Parents, pilots, physicians, nurses, firefighters, etc… My sister has the most gorgeous kids and I love them…during my Residency she gave birth to her 3rd. She was just as sleep deprived as I was. My sister-in-law has 5 fantastic kids…all under the age of 10. They both, fortunately, have incredible spouses to share in the joy of sleepless nights.

Many of my patients’ parents (some who are single parents) ask me about sleep, sleep ‘training’, healthy sleeping habits for their children. There is so much information and ‘advice’ from MDs, PhDs, RNs, etc… I don’t support any one ‘technique’ – what do your Pediatricians recommend? I’ll have to have some of my colleagues weigh in.

One of the most important concerns both Jaime and Gwen re-highlighted is the ‘life death’ decision-making that may occur under sleep-deprivation. I wouldn’t want a pilot to fly the plane if I was a passenger if he/she was not fully alert even if he/she reports feeling absolutely fine and 100%. As Residents there’s a culture of superiority about being able to ‘handle’ it…being fully functional despite science and reasoning showing us otherwise. That’s something the NYT article hints at. I think a 5-hr sleep block is a good idea in theory (and probably necessary) but the reality is that patient care doesn’t work around a set-time table. So…it will be interesting to see if the IOM’s recommendations are somehow implemented.

Tough issue! One time carpooling home from work on the freeway (in Utah), my carpool mate fell asleep at the wheel. In a matter of seconds, we crossed three lanes and spun around to drive the opposite direction of traffic on the inner lane of I-15. During rush hour.

My poor friend obviously did not realize just how sleepy he was (I don’t think he had the type of bravado that would have prevented him from asking me to drive the rest of the way), but the reality is, we were lucky to have come away from the incident alive.

I agree. Sleep is important.

Sleep is so important- but so is a doctor’s training. I don’t know enough about how they do things in the training to see where they can change- I figure it’s set up that way for a reason. I just count myself lucky that I have to do the crazy hours every now and then for a specific event, emergency or project- but then I typically have quite a bit of time in between to catch up on sleep and get back to a normal schedule- just in time for the next crisis! I don’t know how docs do it when they don’t have any recovery time!!

I have worked as a resident both pre and post work hours regulations, and I am definitely much safer since the week was limited. I do think those people promoting an even shorter work week in training are kidding themselves though. Many residents stay up electively to study or socialize and catch up on all the experiences they miss because they live at the hospital. The other big question is what happens when you are in practice and It is just you and whoever you share call with. Work hours no longer apply. Should They? How would it be enforced?

very interesting article. interesting but hardly had me convinced for his case. seems to me the bulk of what he is claiming is that a 120 hour work week is necessary to keep up those tight doctor-patient relationships. as if quantity=quality. it is impossible to have quality hours, just less of them? and if he felt like he would have gotten ripped off of some valuable experiences had he had 40 hours less a week, couldn’t they just make residencies longer (heaven forbid!)? i think he has a very weak case.
but di, i’m ready to hear what you think! you’re going through it yourself!

Honestly Jen, I have mixed feelings. But overall, I believe in sleep. I think sleep is healthy. I’m for sleep. But mandating it into a program with all the complexities of medical residency training to begin with seems unlikely. Making residency training longer is an option that has been discussed, but I will be the first to say that I NEVER want to be a resident again. EVER. I actually have my life back (and more) as an Attending . My good friends are scattered in places all over the country and for the most part, the experience as a Resident is the same…it sucks. Prolonging that experience…I shudder at the thought.

There were nights (mostly as an intern) when there was no way I could even contemplate sleeping – going 200%. I think that is the challenge – working 30 hours straight with no break (ok, noon conference when we’re suppose to be paying attention and learning, but we’re being paged left and right), no downtime, nothing PLUS doing it not only fullsteam but super fullsteam and sometimes making life-death decisions. After a day of utter exhaustion, overnight not only are you managing every patient on your team/floor, but you are also admitting new patients… there’s no time to sleep. I was ready to get off the Residency trainride.