Irishdoc on Intern hours

Is there a doctor in the house?: The Hours

Make sure and read to the end, then ask if this is particularly safe.

I remember vividly trying to survive the drive home post-call several times as an intern. I never fell asleep, but I did drive for miles with the parking brake on because I’d forgotten I’d set it, and was so sleep-addled I didn’t recognise it.


Comments

  1. I see an opportunity for someone to come up with a way to provide convenient taxi service for interns on the way to and from work — and charge the hospital for it. It absolutely is unrealistic to expect someone to drive after 24+ hours continuous work. Hospitals have many good arguments why long shifts are necessary — so, okay, part of the deal has to be transportation.

  2. Goatwhacker says:

    Nice thought Vasha, but if someone saw an intern waiting for a taxi to take them home they would just find more work for him/her to do. When I was a resident I tried to make my post-call escape with as little fanfare as possible.

  3. It’s like training for the military…have to be able to perform under extreme pressure all the time. Tired? No problem, Intern has been trained to take care of patients for 24 hrs straight and has adapted….assuming the car doesn’t crash, ending their residency early.

  4. TheNewGuy says:

    Yep… my worst weekend as an intern had up for 50+ hours straight (I was on trauma, we had a big weather system move through that produced a mass-casualty-level of injuries) I did two nights of call back-to-back, then worked all the next day. By the end of the that third day, I was in a daze; my situational awareness was zero. I was walking into things (door-frames, people). I don’t remember getting home.

    Returning to work that fourth day provided some horrifying revelations (at least I didn’t drive home with a dead body wedged in the windshield of my truck). After reading my own notes, I’d done things to patients that I only dimly remembered, including written admission orders that were not even remotely adequate. I admitted patients to the hospital and forgot even the most basic things in my orders (like omitting basic lab work, or making them NPO and not giving them IV fluids). I was ridiculed by the trauma attending that next day, and my only response was “I don’t even remember doing that… I’m sorry.”

    Thank almighty God none of the errors I made really hurt anybody… but it opened my eyes to what sleep deprivation does to higher brain function, and vividly showed me my own performance decrement. There’s no good way to ameliorate the effects either… all you can do is slow down, break things down into simple one and two-step sequences, and try to be more careful… and pray you don’t hurt anyone.

  5. my 85 yoa grandmother did this once on the way to check her rural mailbox about 1/4 mile from her home. she complained that the car ‘smelled funny’ and was ‘real hard to drive’.