Could allowing doctors who work long shifts to take naps reduce medical errors caused by fatigue? The answer may seem obvious, but for years it has been a badge of honor for interns and residents to power through shifts that lasted more than 24 hours. Today, doctors in Louisiana and elsewhere still power through long shifts albeit shorter, but the question of whether tired doctors cause medical errors persists.

It seems obvious: tired or fatigued people tend to perform worse than those who are well rested. And, at least one study has confirmed that assumption by showing that the motor skills and judgment of people who had been awake for 24 consecutive hours was similar to those with a blood alcohol level just over the legal limit.

The medical community began to change work hour limits for medical training in the 1980s after the occurrence of an infamous and potential medical malpractice case that involved the death of a patient. The patient had been treated by an intern who was extremely low on sleep. Though the change in new work hour limits began to occur in the late 1980s, the national organization that sets medical education standards only recommended the change in work hour limits for hospitals across the country in 2003.

Despite the new work limits it is not clear if the new limits help prevent medical errors. In studies that compared death rates of surgical patients and medical patients before and after new work hour limits were instituted at teaching hospitals, death rates did not significantly drop. However, there are a few explanations why the studies have not captured a change.

The new rules may not limit work hours enough. The rules allow residents to work up to 30 consecutive hours and 80 hours in a week. Another reason why the new work hour rules may not have reduced death rates is because some hospitals may not follow the new rules. Finally, shorter shifts translate into more patient cases that are handed off and more handoffs create a greater potential for miscommunication.

Studies still show that tired medical workers are a problem even though the problem of medical errors caused by tired medical professionals was not caught by comparing death rates. One fix may be to require medical professionals to nap on the job. Naps have been shown to prevent performance errors and newer studies that examine the effectiveness of mandatory naps for medical professionals are under way.

Source: healthland.time.com, "Should your doctor be napping on the job?" Dr. Zachary F. Meisel and Dr. Jesse M. Pines, Dec. 30, 2011