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.
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?!
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.