Junior doctors' shifts and sleep deprivation

Murray, Alice M.; Pounder, R. E.; Mather, H.; Black, Dame Carol

doi:10.1136/bmj.330.7505.1404

Cited by 45 publications

(31 citation statements)

References 7 publications

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“…Night shifts were reduced from a seven-day block, which may reduce performance, to periods of three and four nights on-call. 6 Patient care (as measured by in-hospital mortality and length of stay) was not affected by these changes to working practice. The percentage of inpatients who died in hospital fell slightly but their median length of stay was unchanged.…”

Section: Discussionmentioning

confidence: 99%

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare

Winfield

Crook

2010

Clinical Medicine

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Section: Discussionmentioning

confidence: 99%

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare

Winfield

Crook

2010

Clinical Medicine

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“…They have highlighted a number of areas of concern in the design of EWTD-compliant shift rotas. When the EWTD was first implemented for junior doctors, some of the newly designed schedules not only failed to eliminate problems of fatigue, but sometimes exacerbated them (32). It was tempting for some to blame the heightened problems on the EWTD itself.…”

Section: Discussionmentioning

confidence: 99%

The impact of junior doctors’ worktime arrangements on their fatigue and well-being

Tucker¹,

Brown²,

Dahlgren³

et al. 2010

Scand J Work Environ Health

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Objective Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. MethodsCompleted by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain.Results Working 7 consecutive nights was associated with greater accumulated fatigue and greater work-life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. ConclusionThe current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

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“…Some reports have called for a return to the old on-call systems 22 or have recommended that doctors be scheduled for single night shifts with 1 or 2 night shifts over a weekend. 21 Others have criticized single night rotas on the grounds of reduced daytime manpower and service provision. 23 The Royal College of Surgeons (RCS) of England suggest that night shifts should not include more than 2 to 3 consecutive nights and should be followed by 2 uninterrupted nights sleep before returning to daytime work.…”

mentioning

confidence: 99%

Laparoscopic Skills Suffer on The First Shift of Sequential Night Shifts: Program Directors Beware and Residents Prepare

et al. 2008

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Newly acquired technical surgical skills deteriorate maximally after the first night shift, emphasizing the importance of adequate preparation for night rotas. Performance improvements across successive shifts may be due to ongoing learning or adaptation to chronic fatigue. Further research should focus on assessments of both technical procedural skills and cognitive abilities to determine the rotas that best minimize errors and maximize patient safety.

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Junior doctors' shifts and sleep deprivation

Cited by 45 publications

References 7 publications

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare

The impact of junior doctors’ worktime arrangements on their fatigue and well-being

Laparoscopic Skills Suffer on The First Shift of Sequential Night Shifts: Program Directors Beware and Residents Prepare

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