Are these really the people that should be required to work so much? Isn’t their job about handling life and death daily? Wouldn’t we want exactly these people to come fully rested to work every single day and be fully staffed?
I don’t know if there are jobs with similar stakes that are so carelessly staffed and disgustingly paid.
We aren’t. But it’s generally better for patient care. It’s the same nurse/doctor seeing through more of the care of a patient with less handovers.
Handovers are where minor details or context can be forgotten, dropped or misunderstood - especially after a really tough shift.
Patients also get to see the same faces more often, which makes them feel like they are being taken care of - as opposed to a part being made in a machine.But it’s wrong. It would be better to have 8 hour shifts with 2-4 hour overlaps between shifts. So it’s not a handover, it’s an actual rounds, it’s actually servicing patients and so on.
But that is likely very intrusive for patients, and 4-8 hours of the shift is with someone else (who you might not like or agree with) and communicating (which can be tiring).So yeh, it’s not great. Understaffing doesn’t help, especially since these are people that genuinely care about their work. It’s pure exploitation, because it is cheaper and hospital administration can justify it and get away with it (or whatever is higher that hospital admin in the case of free healthcare).
In some cases, it’s budget and exploitation. And it’s bullshit.
But there is a genuine argument that a doctor who is fully informed and tired is better than a doctor who is fresh and oblivious.I’m always slightly skeptical of this answer just because residency pretty much intentionally gaslights doctors into thinking that exhausted decision making is normal and unavoidable… All because the guy who started medical residencies had a massive cocaine addiction and it was 1900.
I’d be curious to see a study with data on patient outcome, wait time, use of resources etc, that measures exhausted double shifted doctors, vs fresh doctors with more context switching, vs fresh doctors + appropriate overlap to avoid context switching.
They’ve done those studies and context switching has historically been where the most problems occur. Whether they’ve repeated them with modern electronic medical records and systems, I don’t know. I think most people agree there’s probably a better middle ground between 8 hr shifts (3 handoffs a day) and the standards set by a dude who liked to experiment with coke and meth.
One of the big issues that I feel like doesn’t get touched on as much is longer shifts allow less doctors, which reinforces the artificially low doctor graduation rates. The national board in the US pegs the graduation at X thousand new doctors every year and that number is mostly tradition / vibes. No we don’t want to compromise on the ability of new doctors, but “gestures vaguely to US healthcare” good lord do we need more of them. Much the same could be said for nurses.
And all of that circles back around to not wanting to dilute traditionally higher paying job markets with more practitioners because the for-profit system will try to wring out every cent they can.
There are probably many more minds that could hack being a good doctor, but are smart enough to go into a field where the work-life balance hasn’t been a terrible trope since 1900. I think I could have been a good doctor but from a very young age I remember it seeming like the time wasn’t worth it.
That being said, I did end up becoming an RN, and I’ll say that my program is probably not unlike others in the US where sacrifice and fucking martyrdom reign supreme. Like wouldn’t you do anything to help your patient? Lose sleep, skip breaks, skip meals? If you don’t, whooo wiiiiilll???
There are probably many more minds that could hack being a good doctor, but are smart enough to go into a field where the work-life balance hasn’t been a terrible trope since 1900.
This was me. Studied for and did well on the required exams, interviewed at a couple of schools, and in between my interviews and acceptance letter I talked to a couple of people in residency at my university. The descriptions of their work-life balance was so atrocious, and the altruism of the profession so stomped out of their mentality that I decided I could probably help people in other ways.
As I watched a couple of my close friends battle depression all through medical school and residency with very little institutional or mentor support, I decided I absolutely made the right choice. I really respect you for staying within the system and becoming an RN, because you guys also have it just as rough, along with the added disrespect of “But you’re not a DOCTOR.”
I don’t know why medicine is so gatekeepy in it’s processes. Being strict in education and procedures I understand. But the heirarchy, egoism, and political games to grind down all these young trainees is quite archaic.
