The 28-Hour Workday Controversy – Do Long Working Hours Help Or Harm Patients?

The Drawbacks Of Allowing Long Working Hours For Medical Professionals

While all of the above benefits sound good on paper, the fact remains that working long hours does have a negative impact on all medical professionals – from residents working 24-hour work days to nurses pulling 16-hour overnight shifts.

• Increased supervision required to avoid mistakes – This is especially true of newer nurses or first-year residents. Mistakes happen – and the more fatigued you are, the more likely you are to make a silly mistake. But in the medical world, even a silly mistake can be the difference between life and death.

Because of this, increased supervision is often required in hospitals that routinely allow medical professionals to work extremely long hours.

• Excessive tiredness can lead to burnout – working 24-hour days may have some benefits, but it’s not normal. Those of us in the medical profession may lose sight of this – but there are very few other professions where a 24-hour workday is common – or even legally allowed!

Particularly among residents, these extreme hours can lead to “resident burnout”. It has been estimated that up to 70% of residents experience some level of burnout. In minor cases, this can lead to a poorer level of care and a negative mental state – in extreme cases, residents may leave the medical profession entirely.

• Lack of work-life balance – Doctors, nurses, and residents are all human – and all of us want to live a life that isn’t just about work. 16 and 24-hour shifts can lead to a terrible work-life balance, and a large majority of medical professionals report poor work-life balance as one of the primary drawbacks of their profession.

Now, some level of sacrifice is obviously required to provide great medical care. Broken bones don’t care that you want to go out to eat with your husband – meningitis doesn’t care that you planned a weekend in the Poconos. If you’re a nurse, doctor, or resident, you have to accept that you will, occasionally, have your life come second – and your work will come first.

But your life shouldn’t always come second – and long working hours can often make you feel as if your life is only about work.

The Medical Community Agrees With The ACGME Decision

When the repeal of the 16-hour workday regulation was announced, it generated quite a bit of buzz among medical organizations, and most of it was quite positive.

According to the ACGME, over 110 professional and medical organizations wrote statements or testimonies about the potential changes in first-year resident working hours – and the vast majority were positive.

Many organizations pointed out that the 28-hour limit was just that – a limit – and that the vast majority of physicians and residents never exceed 18-20 hour days at all, except in rare cases, and that the maximum limit of 80 hours of work per week was still in place for all physicians and residents.

So, despite the controversy, it seems that the medical community at-large has decided that longer working hours are worth the risks.

So what do you think? Do you have experiences working long shifts alongside residents? Have you felt the negative effects of an 18-hour – or longer – workday? Do you agree with the decision? Let us know in the comments – we’d be happy to hear your thoughts.