Are these really the people that should be required to work so much? Isn’t their job about handling life and death daily? Wouldn’t we want exactly these people to come fully rested to work every single day and be fully staffed?
I don’t know if there are jobs with similar stakes that are so carelessly staffed and disgustingly paid.
If I recall, most medical mistakes take place over shift changes. Things like a patient getting a double dose of meds because they didn’t realize the prior shift already gave them. The idea is that minimizing the number of shift changes reduces the number of mistakes.
I mean, in my experience a lot of those “mistakes” are kind nurses saying “fuck this idiotic Emergency Department Physicians Assistant. Someone go get the MD. This patient is in a shitton of pain why did they only prescribe a half a milligram of relief? I cannot find the patient’s face or butt or really tell the difference to tell how much pain they are in exactly though so I will just write down a 7. Whoopsie poopsie they just got the dose twice oh no look at them they are not screaming anymore we will call treatment a success” type mistakes.
But I have also had some very excellent nurses
This is the explanation I’ve heard. It seems like someone should have thought of a better solution by now, though.
This is accurate. It has to do with minimizing handoff risk.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7539758/
Lots of uneducated responses in this thread that are pure conjecture and drivel.
That study doesn’t really address the issue here though. That study demonstrated hand-off risks. But as far as I can read, it didn’t address shift length at all. All the providers in question had 8 hour shifts.
Obviously hand-offs produce certain risks. But that’s a trivial question. Obviously changing shifts will have some negative effect as providers must get up to speed. But the right question to ask isn’t “do hand-offs produce risks?” The right question to ask is, “if long shifts are used, do the reduced medical mistakes from the shift change counteract the increased medical mistakes from fatigue and unreasonable shift length?”
Do you have any studies that show this? Otherwise the benefits of long shifts are pure conjecture and drivel.
When I worked as a nurse in CA, the standard for shifts was 8 hours, we had 3 shifts in 24h. Some travel nurses took 12h shifts, but staff RN had 8s. Not saying we never made mistakes, but it can be done with proper staffing (4 patients to hand off instead of say, 7) and a culture that respects the handoff time. We did it at the bedside in most cases so the patient could hear what was going on. In CA there are strong unions advocating for patient safety, and as a result, minimizing exploitive working conditions. We were still exploited to be sure, but not like if you’d dropped that hospital in any other state without those protections. Pay was outstanding as well.
Strong unions are the answer to this problem, at least for nurses/support staff. Idk about docs and residency but that is a big part of why becoming a doc never seemed attainable to me.
As a patient I really liked bedside handoff. Because I’m supposed to theoretically be in charge of my own care, right? Can’t do that unless you tell me what’s going on.