New rules are going into effect that will impact an estimated 30,000 first-year medical residents. Just what would the new rules entail? For starters, the new rules “could add eight or more hours to their shifts,” increasing the previous hour limit of 16 hours to 24 hours. Understandably, this is “causing a rise in patient safety concerns.”
New rules are going into effect that will impact an estimated 30,000 first-year medical residents. Just what would the new rules entail? For starters, the new rules “could add eight or more hours to their shifts,” increasing the previous hour limit of 16 hours to 24 hours. Understandably, this is “causing a rise in patient safety concerns.”
According to CBS News medical contributor Dr. Tara Narula, the medical community has been debating this move for nearly three decades. When making their decision, many went back and forth trying to determine “the ideal working hours for both medical care and on-the-job training.” And while many are concerned how the increase in hours will impact patient care, some are actually welcoming the longer shift. For example, Melissa Garuthara is a doctor at Long Island Jewish Medical Center. “During her first year as a doctor, she was required to clock out after 16 hours, even when she wanted to stay longer.” Oftentimes she found herself wanting to stay longer than her assigned shift.
In a recent comment, Garuthara said, “I don’t want to say, ‘Oh, you know, I’m leaving for the day but the night intern is going to come and check on you.’ I want to be the one doing that.”
That’s exactly the same reason why many other doctors are welcoming the new 24-hour shift. It is also believed that “critical patient information is relayed during handoff to the incoming shift.” Oftentimes “shorter shifts mean more frequent handoffs, bringing more opportunity for error and interruptions to doctor training.”
As Dr. Rowen Zetterman pointed out, “Medical emergencies don’t all occur between 8 and 4.” After analyzing studies, Zetterman found that “when you had one resident who was only there 16 hours and another one that was there 24, it interfered with the team-based care that occurred.” Zetterman was one of the doctors that helped “update the rules to bring training in line with the realities of hospital care.” As the new rule is written now, first-year residents will be able to stay longer than 24-hours if they want, though their total hours worked cannot exceed 80 hours per week.
However, not everyone is excited about the new rules. Dr. Sammy Almashat, who tracks doctor training for Public Citizen, believes the change could have serious consequences. He said, “Keep in mind interns have just graduated medical school. They are the least experienced, the least knowledgeable members of the medical team caring for patients.” He believes that the longer hours could end up being “detrimental to patients and residents,” and there is evidence to back up those beliefs.
According to a recent Harvard study, “residents made almost 36 percent more serious medical errors when working 24 hours or longer.”
It certainly will be interesting to see the long-term effects of this new rule change, and how it impacts patient care.
Sources:
Patient safety concerns over new 24-hour shift rule for first-year doctors
First-year doctors will be allowed to work 24-hour shifts starting in July
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