The ACGME rules are changing this July and interns will no longer be allowed to work more than 16 hours. I'm not sure of all of the particulars of the rule change, but I know that at least as an intern (and I think as a resident), I won't be asked to take call for 24 hours. But currently, I am.
I do okay being up for about 20 hours, but then I just get so tired. I know that there is debate as to whether or not the limitations on residents is a good or bad thing with questions surrounding whether or not it is safer for patients and do we need to extend the years of residency training because of the limitations on hours. I think the arguments for both sides of regulation are compelling and it is beyond my pay-grade to decide what rules and regulations are best for training of residents.
Nonetheless, this Friday I was on-call from 7am until about 9am on Saturday (yes, that is 26 hours). As I was working on notes at 2am, I was wondering if I would have been tough enough to go to medical school twenty years ago. They don't make doctors like they used to. I've talked to doctors who said during residency they started their shifts at 6am on Friday morning and got off at Monday afternoon. Obviously, they got to sleep in the hospital, but from what I can tell no one sleeps too much when they are on call. I don't think I am that tough, but then again you never know what you can do until you try.
When I was working on notes at 2am Saturday morning, a nurse came up to me and asked how long I'd been there. I said I arrived at 7am, but I woke up about 5:15am and he told me I really needed to try and sleep before going home because he was worried I wouldn't make it home okay. I did manage to sleep for 45-60 minutes, which was surprisingly refreshing. I am fortunate that I take the train rather than drive, because I know I could not have safely driven myself home. I was capable of staying alert and awake for the train ride, but that is a different level of alert and awake than driving a car is.
I think the worse part of the overnight call is that I am so tired, but by the time I get home, I wake up again and then wonder if I should just go about my day. Usually I come home, take a shower, eat something and force myself to bed, even though I have a second-wind by then. Then generally, I sleep soundly until the early evening and I get up for a few hours then go back to bed (to try and keep my schedule on track). I didn't sleep as well yesterday as I usually do, but I think it is because it was so sunny and beautiful in New York and the light was pouring into my room. I really wanted to be outside taking a walk and enjoying the spring-like day, but I knew I had to stay in bed because my head was pounding and my body ached.
I have two more 24-hour calls to do in this surgery elective. I really don't mind the work, but about 2am or 3am, I am so tired that just want it over with. There have been a few nights, when other students have been on call, that have had multiple emergency surgeries and other major problems. The two 24-hour calls that I have had this month, have been busy, but there have been no major emergencies. I hope that my next two 24-hours calls will be relatively painless without any major emergencies.
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