Surgical residents are fatigued and “over the legal limit”

Hospitals and residency programs are required to ensure that residents are prepared to handle their program and training requirements. A new study suggests that while guidelines limit the number of hours worked, surgeons in training are tired enough to raise the risk of making significant errors.

In Connecticut hospitals and nationwide, program administrators as well as faculty doctors must be aware of the potential risks posed to patients when residents are overtired. A recent study found that orthopedic surgical residents at two Boston hospitals slept only five and a half hours on average per night. The lack asleep alone was not the only indicator of fatigue. The researchers also considered exercise habits, the use of sedatives, alcohol and the use of stimulants.

Fatigue caused by overwork, stress, and minimal sleep left the residents with impaired function and mental effectiveness. According to experts, the fatigue left the functioning at only 70 percent of mental capacity, which is equivalent to .08 blood alcohol level, or, legally drunk in most states. The research team concluded that this means these doctors had a 22 percent greater risk of causing a medical injury during surgery than a doctor who was at optimal rest and alertness.

While the study was small and only analyzed data from residents at two hospitals, the results could have broader implications for residents as well as patients. Leading medical practitioners and authorities believe that the issue demands more attention than simply regulating the number of hours worked. If resident program faculty and hospitals can better understand the cycles of fatigue and know when to intervene, they can prevent future mistakes and errors.

Source: Reuters, “Tired surgical residents may up error risk: study,” Andrew M. Seaman, May 21, 2012.