Sleep Times

Sleeping sickness is a resident evil

Sleeplessness, however, is at its most lethal when the insomniac is a doctor or a surgeon taking decisions that can make or break your fever - or your life.

Working for more than 16 hours without sleep results in resident doctors committing serious, preventable medical errors, reported the journal Nature & Science of Sleep on Saturday. While there is no data for India, the US Health and Human Services reports that 180,000 (1.8 lakh) patients die of medical negligence each year in that country.

Work shifts longer than 16 hours increased medical errors by 35.9 per cent while shorter shifts reduced errors, reported Harvard Medical School researchers in the New England Journal of Medicine (NEJM). Following the report, Harvard Medical School announced a 16-hour limit on the time resident doctors can work at a stretch.

In India, resident doctors live in the doctors' duty room 24x7, on call at all hours for any length of time. They routinely do 24-hour shifts, which can go up to 36 hours in departments such as neurosurgery, where emergency cases such as accidents and stroke need immediate attention. By the end of a shift, the fatigue is apparent not only in the dramatically shortened fuses but also in cases needing a second opinion for final diagnosis.

Rising patient load and staff shortages are too blame. While patients at teaching hospitals have more than doubled in the past decade, medical staff strength remains the same. Given the easy access to medication and addictive medicines, addictions are a norm. Apart from smoking, most residents take stimulants or "uppers" to see them through the day. "What are we to do? After MBBS, we do 3-5 years of junior residency and another 3 years of senior residency. Most of the time we are too tired to keep our eyes open," says a senior resident at the All India Institute of Medical Sciences.

The US Institute of Medicine has recommended major changes in residency training programmes, including re-designing training to eliminate dangerously long shifts (over 16 hours without sleep), and reducing residents' workload by focusing on academic training and transferring a lot of the routine things they do - bandaging, drawing blood, filling out paperwork and starting intravenous lines - to nurses and other health personnel.

"It's an abuse of patient trust," says Dr Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health and a co-author of the NEJM report. "Few people enter a hospital expecting that their care and safety are in the hands of someone who has been working a double-shift or more with no sleep. If they knew, and had a choice, the overwhelming majority would demand another doctor or leave.

Surprisingly Simple Trick to Losing Weight Revealed

My good friend Liz and I are very much alike. In fact, we often joke that we must have been separated at birth.

We tend to enjoy the same activities. We’ve never had a single argument over where to go for dinner on a “girl’s night out” for example, and more times than not we end up ordering identical meals when the waiter comes to take our orders.

But one place we have always differed is in the weight department.