Alert
Close

Introducing AARP RealPad: The Wi-Fi Tablet That Makes It Easy to Share, Learn, Connect and Play. Learn more

HIGHLIGHTS

Open
10,000 Games Galore Sweepstakes from AARP
Celebrate Hispanic Heritage Month

AUTO BUYING PROGRAM

AARP Auto Buying Program

Download the ipad App

AARP-iPad-ePub-app

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP BOOKS

Planning for Long-Term Care for Dummies

Get expert advice on planning for your own or a relative’s future care needs.

Webinars

Learn From the Experts

Sign up now for an upcoming webinar or find materials from a past session.

Learning centers

Get smart strategies for managing health conditions.

 

Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

Nothing has been viewed

share your thoughts

What does the health care law mean to you? Your story is important. We read and learn from every story and it helps us in our educational efforts. We may even use your comments (with permission) to brief legislators, inspire readers and more. Please share your story with us. Do

Finding Your Way: Does Your Doctor Need a Nap?

The pilot who safely ditched the U.S. Airways jet into the Hudson River drew on years of skill, training and sound judgment in the critical moments before landing.

Chesley “Sully” Sullenberger and his crew reacted calmly while facing potential disaster. The miraculous outcome drew attention to the pilot’s skill and courage in an extraordinarily stressful situation.

One variable—limits on pilots’ work hours—also played a positive, if hidden, role. To reduce the risk of error caused by fatigue, pilots cannot fly more than eight straight hours, according to airline industry and government rules.

Like piloting a jetliner, some medical situations, especially in the hospital, also have life-and-death consequences. You might be surprised to know that, until recently, doctors who train in hospitals, called medical residents, did not have limits on their work hours.

Before limits were put in place, some residents worked more than 100 hours each week. And a resident’s day could last 36 hours or longer. Cases came to light showing that doctors who worked those long hours were more likely to make errors—sometimes very serious ones—when taking care of patients.

A weekly 80-hour limit for medical residents was put into effect across the United States in 2003. Unlike the work-hour limit for pilots, the rule for medical residents is voluntary. It also lets residents work up to 30 hours in a row as long as they do not take care of patients after they’ve worked 24 hours.

Nearly six years later, are we safe from the errors an overly tired medical resident might make?

Not likely, says a recent report from the Institute of Medicine (IOM). A yearlong review found that residents still aren’t getting enough time to sleep and require more protection of the 80-hour limit. The study was funded by my agency, the Agency for Healthcare Research and Quality (AHRQ).

Specifically, the report found that many hospitals do not follow through on the 80-hour work limits. It also found that people aren’t reporting violations of the rules to the agency that oversees training programs. This is often because of residents’ fear that reporting the hospital could hurt their careers.

In its recent report, the IOM described what it would take to protect residents from ongoing or serious fatigue. It said hospitals should allow residents to work only 16 consecutive hours when they are treating patients. After that, they should have an uninterrupted five-hour sleep period.

Other changes the IOM called for include:

• Increasing work-hour oversight. More reviews should be conducted to ensure hospitals follow the work-hour rules. Residents and others who complain that the rules aren’t being followed should be protected.

• Providing days off. Residents should get a 24-hour break from duty each week and get one 48-hour break each month.

• Giving residents safe transportation after long shifts. AHRQ research has shown that residents who work extra-long shifts are more than twice as likely to have auto accidents.

• Training on better communications during hand-overs. Many errors happen when a patient’s care is taken over by another doctor. If doctors work shorter hours, handoffs will occur more often. Therefore, residents need better training on how to communicate with the new doctor and others about the patient’s care.

I realize that patients can’t tell how long their doctors have been awake or whether their judgment is affected by fatigue.

What you or a family member can do is to take as much information as you can to the hospital. Bring a complete list of the medicines you are taking. That way, your medical team will have this information even if your doctor forgets to ask.

Don’t be surprised if you see new people taking care of you, but don’t be afraid to ask who’s in charge of your care. As I always advise, ask questions.

For too long, our system of medical training has overlooked the risks that come when residents work extreme hours. That has slowly begun to change, but this change must continue.

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Reading eyeglasses eyemed 6 membership benefit health

Members save 25% on orders of $200 or more and get 25% off lens upgrades at glasses.com.

AARP/Walgreens Wellness Bus Stops in Clarksdale, MS

Members can get exclusive points offers from Walgreens and Duane Reade.

Member Benefits

Join or renew today! AARP members receive exclusive member benefits & affect social change.