Residents working impaired from lack of sleep
June 1, 1998 2 minutes read
Residents working impaired from lack of sleep
Interns report abuse and humiliation
Interns responding to a 13-page mail survey report they are frequently abused and humiliated, and are working in hospitals sleep-deprived almost daily.1
While verbal abuse was the most common problem cited, more than 10% of responding residents said they were "slapped, pushed, kicked, or hit," had someone threaten their reputation or career, or were "given tasks for punishment."
More than 10% also said sleep deprivation was an almost daily occurrence. Average on-call hours per typical week were 56.9, but about 25% of the residents said they were on call more than 80 hours some weeks. Seventy percent of the residents said they had observed colleagues working while impaired, with 56.9% citing lack of sleep as the most common cause of impairment. This was followed by working too hurriedly, incompetence, and emotional problems. About 15% of the residents said alcohol was the cause of the observed impairment, while 5% cited drug abuse.
Survey report authors sent questionnaires in 1991 to a random 10% sample of all second-year residents listed in the American Medical Association's medical research and information database. A total of 1,277 surveys (72%) of 1,773 mailed were returned.
A total of 1,185 (93%) residents reported experiencing at least one incident of perceived mistreatment, with 53% reporting being belittled or humiliated by more senior residents. Among women residents, 63% reported having experienced at least one episode of sexual harassment or discrimination.
AMA officials say reforms have been implemented since the data were collected, but new surveys will be necessary to gauge their effectiveness.
Study authors suggest that "residency directors must make clear the standards of conduct for all professional personnel and intervene when conduct falls short of these standards."
Reference
1. Daugherty SR, Baldwin DC, Rowley BD. Learning, satisfaction, and mistreatment during medical internship. JAMA 1998; 279:1194-1199.
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