The news media this morning had several stories noting that beginning in July medical residents may work consecutively from 16 hours to 24 hours. Interestingly, there were many medical residents that were in favor of this change. Taking this change to resident's shifts and the upcoming changing of the clocks for Daylight Saving Time, this Friday Five is focused on shift work.
Some residents looked forward to the increased hours as a way of reducing mid-case handoff of ER cases due to hitting the 16 hour mark. A research letter by Charlie Wray, DO et al. in JAMA looked at handoff policies for residents at hospitals as implemenation of these practices, despite guidelines, is left to each hospital to implement.
A study published last year investigated the effect of hours per week worked by an admitting resident on patient outcomes. It found that individuals admitted by residents working 80+ hours per week had longer hospital stays and more ICU transfers than those admitted by residents working less than 80 hours per week. However, there did not appear to be a relationship between hours worked and 30 day readmission rates or in-hospital mortality rates.
Fernando and Roswell looked at the work performed during nursing shifts and noted that the types of work and volume of work performed varied through a 24 hour work cycle. They note that the scheduling of shifts needs to take type of work and work volume into account.
Two older studies looked at the incidence of work related injuries following onset of Daylight Saving Time. A study of American mine workers found an increase in injuries on the Monday following the start of DST and a decrease in total sleep for that night by 40 minutes. A Canadian study found no statistical relationship between injuries and the onset of DST.
Interestingly, researchers found that the rate of ischemic strokes increases during the first two days after the onset of daylight saving time.