Would you trust an airline pilot to fly your plane if they had not received enough sleep? Almost everyone would answer “no” to this question. After all, we depend on airline pilots with our lives. The same goes for doctors and other health care professionals. Would you trust a sleep deprived doctor to carry out complex procedures or an important diagnosis?
Unfortunately, many people working in hospitals are not catching enough sleep. Medical and surgical residents are most likely to be affected by sleep deprivation. There is talk that we should allow these residents to work more hours.
Most recently, the Accreditation Council for Graduate Medical Education has proposed allowing residents to work an extra 16 to 28 hours per week! An increase in work hours was proposed even after the Joint Commission admitted sleep deprivation may be linked to more medical mistakes.
How Sleep Deprived Doctors Make Mistakes
Overworked and sleep deprived medical residents have been a major patient safety concern for years. In 1984, the tragic case of Libby Zion brought this issue to light. Libby, a college freshman, had checked into a New York hospital with symptoms of agitation, fever and jerking.
During her time in the ER, two medical residents evaluated Libby. The residents in charge of Libby’s care had 40 other patients under their supervision. After being admitted, Libby’s symptoms began to spiral out of control. Her fever spiked to 107 degrees and she began to suffer cardiac arrest. Shortly afterwards, she passed away.
It turns out Libby had been prescribed phenelzine, an MAOI antidepressant. The hospital residents had prescribed her meperidine, which interacted with the MAOI and caused serotonin syndrome. Serotonin syndrome can cause agitation, confusion, headache, loss of muscle coordination and high fever. If left untreated, serotonin syndrome can be fatal.
New York authorities investigated Libby’s death. The results of the investigation concluded long hours worked by the residents caring for Libby had played a role in her death. Libby’s death eventually led to caps on the number of hours worked by residents.
Keep in mind, work hour caps on residents is a contested patient safety issue. Some groups believe that long hours and sleep deprivation do not have a negative effect on patient safety. We would love to hear what you think. You can comment on this blog or post your response on our Facebook.