Should Doctors Be Allowed To Nap On The Job? (Response)

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During an off time on call last night (I’m on anaesthesiology now, which means I have time to breathe on calls) I read this article on BBC. And wow, did it rub me up the wrong way.

Basically, a patient in Mexico snapped a picture of a young doctor who fell asleep during her shift, and people mouthed off about it on the internet.

docs not sleep

Mexican doctors seem to be in much the same situation as their South African colleagues. They work with sub-standard resources and are under-staffed, while routinely being required to work 36-hour shifts. This, while many other countries have placed limitations on the hours doctors may work – for the safety of their patients and themselves.

Should doctors be allowed to nap on the job?

Well, CLEARLY, getting sleep is a privilege held by those with human rights. Doctors? Oh no. Clearly, they should motor through 36 hours of work on their feet with patients who are bleeding, crying, inebriated. How hard can it be?!

Oh wait.

I’ve said this before: If I, or someone I loved, were to become seriously ill and require life-saving emergency treatment, I would much prefer my doctor had not been awake more than eighteen hours. Of course, you take what you can get; but I know that I will be much better taken care of by someone who is not effectively drunk on exhaustion.

Did you know that being exhausted is no defense if a doctor were to make an error on duty? The doctor will be disciplined accordingly. At least, in South Africa, as reported by MPS recently. But if the patient is dead or disabled, that won’t change. And who is at the root of the blame? The system that made that doctor work such long hours.

I have fallen asleep during long overnight shifts. I have stood by a patient’s bedside making notes, only to wake up a minute later, still standing, with my head on the file and gorgeous abstract pen drawing across the patient’s notes. Usually nobody notices because the patient is also blissfully asleep.

I have walked past an empty stretcher and had to drag myself away before collapsing onto it.

Not every patient that presents to hospital in the middle of the night is about to exsanguinate. I’m willing to bet that the guy who took the picture of the young doctor was not fighting for his life.

No matter how tired we are, doctors don’t fall asleep when people are dying. And no napping doctor ever sleeps deeply. When a monitor beeps, we are up. When a patient so much as retches, we are up.

The blogger in question said that doctors shouldn’t nap because they get paid so well. Yeah, doctors make a decent living, but I can guarantee they don’t get compensated for all their hours. South African Interns are compensated for a maximum 80 hours overtime per month. Invariably, we work more overtime than that.

I honestly cannot understand how this is even a question anymore. It’s a DUMB QUESTION. Here’s a question we should be asking: Should Doctors Be Allowed To Work Shifts Longer Than Eighteen Hours Without A Break? Debate THAT, self-righteous online world.

If tired doctors are the only doctors you ever see, you should start asking questions about the system. Because something is wrong.

Yo Tambien Me Dormi.

I too have fallen asleep.

Two beautiful stories from OBGYN

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OBGYN is considered one of our “big” internship rotations. The hours are long, the calls are busy, the responsibility is huge.

I love when a baby is born. For the sake of honesty I’ll tell you that it’s not always a happy occasion. There are many, many babies born into seriously less-than-ideal situations. But in that moment that a baby gives his first cry, I swear the world trembles.

Womb | Beautiful Us | Aitch | Click for more.

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Ten Books Which Feature Characters with Agency

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Sometimes I get really tired of reading books where characters don’t have control. Some of the most popular books out there have plots that happen to people. I don’t want life to happen to me, I want to happen to life, and I like to read books like that too.

agency characters

I first learned about the concept of “agency” during my Illness Narrative class during Semester at Sea. It’s still a concept that is hard to describe, but I think the gist of it is that someone with agency is able to act within and upon their environment.* To illustrate, the conclusion of Mockingjay really annoyed me because it essentially stripped Katniss of any semblance of agency she had (if you’ve read the books, I think you’ll understand). Continue reading

Medicine: Keep Up!

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I love how fast this field moves, and grows. It is refreshing, and it keeps me on my toes, and it demands: if you’re not ready for change, you’re not ready for MEDICINE!

Three years ago, during a Family Medicine rotation, a young Zimbabwean girl came to us for removal of a stick-like thing in her arm. Initially I did not believe her that it was a contraceptive – I thought it was a traditional medicine! But she was so convincing that I Googled “subdermal contraceptives” and it turned out she was right.

Subdermal contraceptive devices were SO rare in South Africa that we had not even learned about them in classes. We had no idea how to remove said implant, and kind of improvised.

022715jhm71Three years later, I can put in these contraceptives with my eyes closed (but I wouldn’t, sharps are involved). Continue reading

Riding the PEP-Train

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I’m on PEP again.

And I’m angry. And miserable. But mostly angry.

Because I’m careful. I am so, SO careful all the time, but others are not. I always make my surgical needles safe. But many doctors I assist do not. I always discard my sharps. And many do not. I never point a sharp at someone. Many do.

Here's a random picture of a zebra I took a few years ago at the Vaal River. Because this post needs something pretty.

Here’s a random picture of a zebra I took a few years ago at the Vaal River. Because this post needs something pretty.

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I Hate Med School – And That’s Okay

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Here’s a quick post-call ramble: I had a pretty bad night on call last night.*

And it was still better than medical school.

hate med school

Base Image by DearFreshman, click for link

I hated med school.

In first year, I hated the loneliness. I had went in hoping for intelligent conversation with the country’s cream of the crop and at least initially, I could not find it. What I found was a narrow-minded and selfish little campus, and I hated it. Continue reading