Diagnosing house officer fatigue

doi:10.1136/bmj.327.7422.1057-a

BMJ 2003;327:1057 (1 November), doi:10.1136/bmj.327.7422.1057-a

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Diagnosing house officer fatigue

The first 150 words of the full text of this article appear below.

In a reaction to much hyped extrapolations about excessive hospitalaccidents and deaths, the educators and administrators who (over)regulateclinical medicine have decided that the root of all troubleis resident fatigue.

They might have been better off addressing the real structuraldefects of modern hospitals—too much paperwork and bureaucracy,unavailable patient records, nurses pushing paper instead ofnursing, doctors' patients scattered over 12 floors, and chiefresidents (registrars) doing everything else but closely supervisingjunior house officers.

But instead the armchair generals have promulgated specificdirections on how many hours residents may work, how many daysthey must take off for rest and recuperation, and how aftera night on call they may spend the afternoon in bed, even if80 patients are scheduled for the clinic that day.

The result is massive discontinuity and pervasive chaos. Seniorattending physicians wander about alone because their residentsare in class, . . . [Full text of this article]

George Dunea, attending physician

Cook County Hospital, Chicago, USA

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