By Anonymous - 16/07/2016 15:16 - United States - Jasper
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And when you came to, you recommended that your reflection get you 30 CCs of "Plamperdol", a medication you invented in your trauma-induced state. Meanwhile, the nurses shared concerned glances.
I'd be the first to admit my knowledge of healthcare is limited at best, but why are such long shifts even a thing? I know I wouldn't want to be treated by a doctor who hasn't slept for 30 hours.
There could be a variety of reasons. One problem is there is a shortage of hospital employees in our world and depending on size of the hospital, its employee total per department, and how busy it is, it can cause long overtime shifts. You do have the correct thinking though as there is movement to reduce these instances from occurring due to sleep deprivation and other health issues.
I doubt the shift was 30 hours long, OP had been without sleep for 30 hours. How that happened can be for many reasons. I've known nurses to work at 2 different hospitals and work a full shift at one, then drive to the other and do a full shift. Or maybe they had insomnia and couldn't sleep between an afternoon and a morning shift. There are laws regulating how long staff can work, particularly doctors. Look up Libby Zion Law. If that is actually followed is another story. Before they changed things at the hospital where my husband works as a radiographer, once a month he would be on call from 5pm Friday to 9am Monday, while working from 9am to 5pm at the hospital on Saturday and Sunday. Most weekends were fine he would often get called in 3 or 4 times during that time, but would get adequate time to sleep. However one weekend, the longest break he had away from the hospital was 4 hours. The whole weekend. It seemed just as he got home and into bed, another emergency required an X-ray or CT scan. I was starting to freak out by Sunday afternoon and was trying to contact another radiographer to take over so he could get a proper sleep. Thankfully things changed not long after that and they started splitting into morning and afternoon shifts. The reason was that they were paying a fortune in overtime to the staff, not because of patient safety. It was cheaper for the hospital to pay for extra staff to come on. It's mental.
Unfortunately, the Libby Zion Law (NY law) only makes regulations for resident physicians (doctors who are training in their speciality right after finishing medical school, e.g. Internal Medicine, General Surgery, Diagnostic Radiology, Pathology ...). The ACGME (accreditation council for graduate medical education) has extended these to all programs which are accredited. Violating the policy can mean a training program loosing accreditation and thus federal funding. There probably are non accredited programs that don't comply with duty hour recommendations. Certain other states have made these official laws as well. However, these restriction don't really apply to fellows (second stage of training/subspeciality, e.g. Cardiology, Gastroenterology, Pulmonology ...) or to fully trained practicing physicians. Hospitals may have certain policies in place but there is no specific law governing fully fledged doctors. I'm sure for nurses, technologists, and other hospital employees there may be hospital restrictions or specific union requirements, but I don't know too much about the specifics of those.
As far as I know one of the reasons for longer shifts is because when "handing off" patients any small detail that isn't recorded can lead to the new doctor not understanding why a problem is happening. The idea is basically to decrease the amount of "switching out" during a patient's stay. I'm by no means a doctor, this is just what I was told by a friend who is.
Nurse here: I'm usually up for 24+ hours during my first night shift. I wake up at normal hours (7-8am) and if I'm not able to nap in the afternoon there's not much one can do about it. The night shift is from 9:30PM-7 AM, adding the trip home it's 8ish until I'm in bed.
It happens when there is a shortage in staff, whether it be people taking time off (vacation or sick calls) or when you work in departments that are opened 24/7 and NOBODY at the next shift comes in. I used to work 12 hour shifts and I have spent shifts where I get no breaks or done last minute 16 hour shifts.