A prominent Canadian medical journal is calling for established minimum best practice standards to deal with sleep deprivation for doctors.
In an editorial published in the Canadian Medical Association Journal recently, the doctors Noni MacDonald, Paul Hebert, Ken Flegel, and Matthew Stanbrook suggest that there needs to be a change in physicians' professional culture, according to the Canadian OH&S News. (WCxKit)
"Long periods on call should not be accepted as routine or a source of pride. Instead, we must admit that working while impaired from sleep deprivation is neither normal nor acceptable," the doctors stated. The editorial points out that sleep deprivation, defined as less than six hours of uninterrupted sleep, from "overnight call" has been shown to cause a likewise degree of impairment in judgment and motor performance as a blood-alcohol level higher than 0.05 percent.
"Those of us who remain overconfident that we can continue to perform our duties properly without adequate sleep should imagine the reaction if we were made to seek informed consent from each of our patients to accept treatment under these conditions," the doctors continued
According to the doctors, some hospitals, departments, and group practices have implemented innovative approaches to work scheduling, such as strict policies for going home after call, refraining from booking procedures or clinics the day following call, reorganizing call schedules to allow for more physician coverage, or moving to shift work.
"Ultimately, licensing, accreditation, insurance and government institutions need to establish minimum best-practice standards for maximum work and minimum uninterrupted sleep hours," the editorial points out. (WCxKit)
The editorial goes on to say that prolonged work hours are not limited to doctors involved in high-technology, advanced care settings. A primary care physician who is up all night assisting a birth or dealing with a patient in crisis may be, "because of sleep deprivation, at increased risk for errors in judgment when seeing patients in the office the next day," the doctors write. Unlike trainees, whose practice is supervised, doctors often have no one overlooking them to catch their mistakes, they added.
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