Word: patients
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...their presence, dizzy with exhaustion, on the hospital floor is a help or a hazard. An oft cited 2004 study of intensive-care units found that medical residents made 36% more serious mistakes during 30-hour shifts than during shifts half as long. So the simple solution to ensuring patient safety - and resident sanity - would appear to be reducing the length of their shifts, a plan endorsed by a lengthy Institute of Medicine (IOM) report in December 2008 that assessed the impact of resident fatigue and proposed a new set of guidelines restricting shifts to 16 continuous hours...
...many in the medical community, including residents themselves, worry that shorter shifts could come at the expense of educational opportunities and possibly even patient safety. And implementing the changes wouldn't be cheap, potentially costing teaching hospitals $1.6 billion a year, according to a study co-authored by Nuckols and published this week in the New England Journal of Medicine. (Watch TIME's video "Uninsured Again...
There is no guarantee, however, that limiting residents' shifts is the key to patient safety. Dr. Kenneth Polonsky, chairman of the Department of Medicine at Washington University in St. Louis, who co-wrote an editorial accompanying Nuckols' study in the New England Journal, says that while some studies show a correlation between fatigue and mistakes, not all reach the same conclusion. What's more, Nuckols says, studies aimed at determining the cause of a mistake are inherently complicated: they require highly skilled researchers to pinpoint exactly what went wrong and when, and many rely on self-reporting from residents...
...better retain everything, "to consolidate some of the learning that happens on an almost daily basis," he explains. But he worries that more mandatory rest could mean missed educational opportunities. "More days off always sounds nice, but it distances us from what is going on in day-to-day patient care. A lot can change in 24 to 48 hours," he says...
...fast, say Barcelona officials. "If you're a patient, the person whose diagnosis you're going to trust is the doctor treating you," says Miquel Trepat, director of Barcelona Zoo. "And in this case, our veterinarians and technicians - the people who deal with Susi every day - say that she's in a perfect state of health." To be clear, he emphasizes, "Susi's behavior hasn't changed since Alicia died." (See 10 animal species in danger of extinction...