Clear links between long hours and mistakes in the medical profession

Medical malpractice is an ever-looming threat for doctors, nurses and other health care professionals. Hospitals and insurers invest millions of dollars into strategies for minimizing mistakes. Yet for many practitioners, the greatest risk of error comes from the nature of shift work.

Studies show that long hours and nighttime shifts can lead to impairment similar to a blood alcohol concentration of .01% – which exceeds the legal limit for driving in Florida.

The shocking toll of fatigue on patient safety

Historically, physicians-in-training routinely worked 24- or even 36-hour shifts. The Accreditation Council for Graduate Medical Education (ACGME) now imposes some limits. Generally, medical residents and interns can only work a maximum of 80 hours per week, and their shifts typically can’t exceed 24 hours (or 30, in limited circumstances).

Nonetheless, even these hours can lead to dangerous fatigue. Studies show that nurses who work 12- to 14-hour shifts are two to three times more likely to make mistakes than their colleagues who work shorter shifts. Likewise, doctors who routinely work 24-hour shifts are 36% more likely to make errors, 60% more susceptible to accidental needle sticks, five times as likely to make diagnostic errors and twice as likely to get into a car accident while driving home.

What about naps?

Napping during long shifts is likely not the answer. Sleep inertia – that is, drowsiness and impaired cognitive function upon waking up – can lead to further impaired judgment. What’s more, many residents and doctors find it difficult to get quality rest in the midst of such a high-pressure environment.

The far-reaching ramifications of strenuous shifts

Patients aren’t the only ones who suffer the consequences of shift work. Over the long-term, medical professionals who work long hours or night shifts are at greater risk of depression and other health issues.

Given these far-reaching ramifications of long hours, it may be time for the medical field to take a closer look at how working conditions affect patients and professionals.