Education

Resident work hours and sign-out

Maria comments on the recent debate about the pros and cons of limiting residents’ work hours. The key is limiting the perils of the hand-off/sign-out to covering physician. Some don’t seem to realize the potential dangers of this.

"Is an error-free residency what we really want?"

retired doc on the effects of limiting residents’ work hours:

Do we not learn in part by making errors in an environment where we are buffered and protected by our mentors and more senior colleagues? How will this cohort of residents fare when they are truly out on their own and there will be no team to hand off to when they have been up most of the night …

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Work hour restrictions = less teaching

Attendings pick up the patient care slack when house staff goes home, resulting in less teaching.

Work hour restrictions, or the death of professionalism

A case where a patient died due to multiple handoffs. retired doc criticizes the trend:

We seem to be replacing personal physician responsibility with “systems”.

What lessons are being implicitly taught to the house staff? The procedure doc seems to have no post procedure responsibility but is content to delegate care to a NP. In that environment how surprised could you be to learn the intern …

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