Sleepless Nights

Did you know one in two physicians in BC has spent more than 24 hours continuously in direct patient care while on call?

How does this affect patient care?

Two-thirds of BC physicians do on-call work – that is, time outside of regular working hours when they are available to patients. They spend an average of 135 hours per month on call, with 36 of those being spent in direct patient care. Half of these doctors have experience episodes where they have provided continuous direct patient care while on call for 24 hours or more, and over 85% of these have had to return to work immediately afterwards with no sleep.

Sleep deprivation, both chronic and acute, is a major issue for physicians – in particular for those doing on-call work.  This is concerning because research shows that even moderate sleep deprivation can be as incapacitating as being legally drunk. Doctors who are on call for extended periods of time and who must immediately return to work without sleep may be at increased risk of medical error due to the effects of sleep deprivation.

Residents are one of the most at-risk groups, as they traditionally have worked shifts of up to 36 hours at a time. A recent ruling in Quebec has led to the elimination of 24-hour shifts for residents, capping shifts at 16 hours. The Royal College of Physicians and Surgeons of Canada is currently in the process of establishing pan-Canadian duty hour limits. Read the CEO’s message on resident duty hours at http://www.royalcollege.ca/portal/page/portal/rc/advocacy/educational_initiatives/resident_duty_hours.