Although 8 hours of sleep is recommended for all adults, the average American receives only 7, and obstetricians and other physicians may receive much less, particularly during training. As a result of increasing awareness of the danger of physician fatigue, the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion related to OB-GYN working hours in the latest issue of Obstetrics & Gynecology.
According to the opinion, research clearly indicates that missing even one night of sleep seriously impacts the cognitive performance of physicians, and could lead to declines in language and numeric skills, memory retention and concentration. ACOG warns that it has been shown that surgeons perform more slowly when deprived of sleep, and ER physicians take longer to intubate mannequins. Until more specific research has been conducted regarding OB-GYN physicians, the group recommends that those doctors adopt, whenever possible, the sleep guidelines of the National Highway Traffic Safety Administration (NHTSA):
- "Structure work to take advantage of circadian influences
- Recognize that the drive to sleep is very strong between 2 am and 9 am, and especially between 3 am and 5 am. Avoid unnecessary work during these times
- Apply good sleep habits which includes a quiet, dark room with adequate ventilation and a comfortable temperature
- After a night shift, go immediately to sleep to maximize sleep length
- Arrange for backup during the time that sleep impairment is likely
- Recognize behavioral changes, such as irritability, that may indicate dangerous levels of fatigue
- Use naps strategically"
Previously on the DC Metro Area Medical Malpractice Law Blog, we have posted articles related to:
- The patient safety consequences of long shifts for medical residents
- A study indicating that shorter physician shifts result in fewer medical errors
- Harvard research on medical errors and overworked medical interns
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