Healthcare: not rocket science

Look both ways, wash your hands, hold the door, say thank you. Common sense leadership, courtesy of Mom.

Mothers, grandmothers, yentas and papous (“grandfather” in Greek) will also tell you that you need your sleep or you won’t be any good to anyone, least of all to yourself.

For years, the medical profession disagreed. They required extensive work shifts for interns — 24-36 hour shifts (or longer). The reason was unclear. Was it to test their mettle in case they find themselves in a relentless theatre of war with an uninterrupted flow of casualties? Or to see if they stay composed and keep their sense of humor like M*A*S*H’s Hawkeye and B.J. Honeycutt? Or is it for a macho and exclusive purpose, like fraternity hazing?

These costs are high. As a potential patient on the other side of an ER scalpel, I don’t care what an intern scored on his MCAT, how many patients he has cared for ahead of me, or how his sense of humor is helping him cope. I want to know he is fresh, functional, capable to assess and act under pressure. I don’t want healthcare from anyone pushing through the last hour of his marathon shift powered by pizza, adrenaline and Redbull. Unless said intern is in triage and we are in disaster conditions.

I understand the need to train under harsh conditions. But during non-disaster, standard, ordinary time, medical professionals — and interns — need to be on top of their game. To do that, work shifts need to be reasonable.

Maybe it’s a stretch of an analogy, but bear with me. New teenage drivers are absorbing the dynamics and decision-making skills required by driving in real-time situations. By law, they have so many hours to complete under direct supervision. But once a new driver obtains her license, it would be ludicrous to require her to drive for 24-36 hour shifts under changing conditions to prove her endurance.

We know too much about health, safety, and human development to ask this. If one MUST drive a 24-hour shift, my vote would be for the guy with 25 years of driving experience hands down.

Likewise, in terms of life position, medical interns are navigating newly married lives; juggling first-time home ownership; starting young families. Some may go from hospital to home to care for infants or toddlers. Then ask their spouses to “hang in there” when they leave again in 36 hours. Tell me this is healthy.

We know better. We can support common sense, forward-moving industry changes — in every industry– during professional trainings, practices, apprenticeships, internships, and ordinary, licensed work shifts. Our medical professionals will benefit from a better work-life-performance balance. Our communities will benefit from decisive medical action and best use of resources when conditions are in critical.

But the ones who will benefit the most are patients: kids, spouses, brothers, sisters, aging parents, and yes, our grandparents.

On behalf of patients everywhere, thank you, Medical Community, for the change. Now, get some sleep.

http://news.harvard.edu/gazette/story/2011/07/patient-safety-experts-call-for-shorter-resident-physician-shifts/

-LMWarneka
@BluebirdOHIO (Twitter)

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