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.

13 thoughts on “Should Doctors Be Allowed To Nap On The Job? (Response)

  1. I agree with you. That comment “doctors should not nap because we get paid so well” is absurd. So now the measure of whether a person deserves sleep is measured by their level of pay….ridiculous. Doctors are humans just like everyone…even those who may attempt to be superhuman are simply human. Doctors sacrifice so much more to their patients and their patient’s families than just sleep-this is all consuming service commitment. The blogger is simply ridiculous…what have they sacrificed for another human being on a daily, ongoing basis as a doctor or other service oriented professions (e.g. teachers)?

  2. UGH is all I have to say. And honestly, for the amount of work doctors do, they don’t get compensated fairly, I don’t think. Especially when you factor in all the debt. Sure, some specialties do less work and get paid more than (I think) they deserve, but we’re talking about primary care physicians here.

    UUUUGH. LET THEM NAP, PEOPLE.

  3. I agree 100% about the right question. In Canada doctors remain liable even during long shifts and when sleep-deprived, too. I don’t get the righteous indignation when safety should be everyone’s top concern. Shamefully, people love to judge.

  4. Me too, I agree. I especially like that you say, “If tired doctors are the only doctors you ever see, you should start asking questions about the system. Because something is wrong.”

    No brainer! Hang in there Mariechen – sweet dreams!

  5. Calls seem like these horrible scary animals you have nightmares about when you’re young… SA has to effect changes, doctors are human too. AND no amount of pay check can justify me for working 36 hours straight. Never.

    Ps I am going to favorite this post, 4 years from now to remind me when I’m in a crappy hospital in SA, on a call & sleep deprived. Take care Mariechen!

  6. In Canada, residents are paid less than minimum wage, if you calculate our salary over the actual number of hours we work. There have been shifts I have worked where I didn’t so much as sit down to eat (are while walking between patients) for almost 30 hours… Soon they will say doctors shouldn’t be allowed to eat at work either!

    • Yep – When we started work this year we were told that “lunch time is not provided for in your contracts, so you eat when you can, not when you want to.” I’ve often found myself eating something while running a patient up to the OR or something similar.

  7. In Finland, we are allowed to sleep on call if there are no patients in need of care just then. Most emergency rooms even have a bed for that. Of course, whether you actually have time to sleep is a different thing… often, you don’t.

  8. There should be no debate on this subject. Of course doctors should be allowed to sleep while on call. During my residency, 25 years ago, all the residents would sleep when they could. Even closing your eyes for fifteen minutes makes a difference. And, even if I had to be up all night, it was usually around 5:00 pm th following day when I became really tired.

    • Thanks for adding your voice, David! You’re right: just fifteen minutes helps too, and for all we know that is what the doctor in the picture was doing. It’s especially good to hear your experience of 25 years ago, as so often we are told that today’s doctors are “weak” in comparison to those of years gone by.

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