Tea and Books, etc.

In medical school we learned about a law that protected medical students and residents from sleep deprivation. It won't allow us to work more than a certain number of hours per shift.

 

Hey, Angel, Jr. :0)

You're referring to the Bell Regulations, I believe, which sprang from the Libby Zion case right here in NYC.

I'd like to say that these regulations (this is law in NYS) have made a big difference in protecting medical students and residents from sleep deprivation (and, as a consequence, protected patients), but the truth is, the law is violated every day, in this state and others, because in healthcare, there is no such thing as a 36-hour (or whatever-hour) maximum.

As medical students, yes, they have some protection because, after all, they are students and supposed to be under the supervision of an attending physician (hey, they're not licensed yet!), but as residents, good luck, especially if you are part of a residency that comprises long hours to begin with, such as surgery or ob/gyn, or trauma/ICU/CCU, etc.

In essence, let's say you have your regular day (eg, 7 am - 4 pm), then are on call (eg, 4pm - 7 am). Technically, post call, you should be done by, say, noon (if we're talking 30 hours).

The reality is that there are always things to follow up on (labs, radiographs, etc), notes to write, grand rounds to attend and so forth. No one can simply drop what they're doing whenever their shift technically ends because that's not how healthcare works. Well, you could, but then you'd be negligent in your patient care. Not to mention your fellow residents will likely resent you for leaving them to follow up on your patients when they have their own caseloads to deal with.

Is there a solution? I don't know, to be honest. The 'easy' solution would be to hire enough residents to cover the workload, but it then boils down to costs and availability of residents. With hospitals strapped for cash and personnel the way they are, and this administration and the past ones doing a lousy job of reforming healthcare, there is no easy solution.

 

In Arizona they use Meth to stay awake. Of course it eventually kills you, but then you get the big sleep so you can enjoy terminal rest.

I tend to cat nap, plus huskies have to get up and check the yard from time to time, just to make sure it is still there, apparently.

 

I have sleep apnea and use a CPAP most nights when I can manage it. I find this really makes a big difference in my energy levels during the day.

If I don't use it I never get below REM sleep. I rather enjoy all the dreams, but this will really tire you out after a few nights.

With the CPAP I get some good delta wave periods, which is what you need to be well-rested.

Do you have any idea how many millions of people have sleep apnea but don't know it?

 

. . . - oh! sorry, I think I dozed off there for a minute . . .

 

Not everyone in Arizona uses Meth to stay awake.

 

A vicious circle. I used to work an eighteen hour day and slept for around four hours, for two years only, fortunately.
The only things that kept me going were the amino acid and ginseng supplements I got used to taking and therefore relied on. Nowadays, I don't work enough...this causes sleep deprivation too. If only we could find a good balance, which more often than not, is a difficult thing to achieve.

 

I use CPAP too, it has the advantage of not leaving that funny meth taste in your mouth...

 

PK: cat naps (or dog naps) are good. Wish I could do that in the office, but I'd be fired, lol.

As for meth to keep one awake -- definitely an iffy proposition from both a health and legal standpoint. :-)

CPAP is a wonder, isn't it? Do you use it because of sleep apnea, because you are/were a smoker, or because you have other respiratory issues?

Nanuk: In the US, it's about 18 million who are estimated to have sleep apnea, and you're right, it is hugely underdiagnosed and undertreated, mostly because, as you've mentioned, many people are unaware there's a problem and don't mention it to their doctors.

Glad that the CPAP is helping you. How do you get your supplies?

Suz: Lol. I'll try to be more entertaining.

Sarah: You're right; and not everyone in NYC is a cawfee addict (not being facetious).

Fuff: Yikes to the 4 hours/night for 2 years! I well remember the days when I worked 80-130 hour weeks and it was pure agony.

On the whole, I'd say I'd rather have sleep deprivation due to having more time on my hands than that due to working long hours. Right now, it's the latter, and has been for the past several years.

If you or anyone can tell me how to find the right balance, I'd be forever grateful! :-)