This is really a precursor to a larger discussion on sleep deprivation and medicine that hopefully I someday finish.
As I sit and write this, it’s Tuesday night. I worked overnight shifts this previous Friday, Saturday, and Sunday in our pediatric emergency department. My shift was from roughly 11pm-8am each night. I saw over 30 patients during each shift (with help from our residents of course). There was the usual variety of patients, ranging from not-so-sick to septic-and-need-the-ICU.
All in all, the shifts were busy, but nothing extraordinary happened during any shift. While I was physically tired at the end of each shift, I did not encounter any situations that were emotionally draining (for me that is; many ER visits are both physically and emotionally draining for the patient and/or family, regardless of circumstance).
Between shifts and after the third shift I got about 5-6 hours of sleep. When between multiple night shifts, I will also try to catch a short nap (even it’s only 15 minutes, though sometimes up to an hour) right before I walk out the door. Many times those 5-6 hours aren’t enough and the extra nap just before the shift makes all the difference.
Yesterday (Monday), after finishing up the last of the three night shifts, I got some sleep during the day, and was up with the family afterwards. I then went to bed at my “regular” bed time; this morning I headed into the office to work on projects and attending some meetings/conferences.
I was standing in the corner of a jam-packed conference room listening to a lecture, when I briefly looked down at my feet and saw this:
No Two Are Alike
I noticed this nearly three hours after arriving to work. Not a single person had said anything to me. No one said anything the remaining few hours I was there. I’m not sure if people didn’t notice (someone must have noticed), if they thought I was just making an odd fashion statement, or if they were just not sure how to broach the subject.
I don’t usually have my own “wacky-clothes day” at the office. I often dress casually, but my shoes generally match each other.
There is a point to sharing this story: when discussing whether residents (or doctors in general) should be doing 24-30 hour call shifts, I think most people are asking the wrong question.
Without entirely giving away the take-home point of my future blog post, the “anything other than call” mentality is missing large parts of the discussion, particularly ignoring the “other” things that happen.
What things have you inadvertently done when tired? Share your stories below!