Surgeons and specialists: abolish the 24-hour shift af

For medical specialists is the worldwide common to 24-hour shifts to run: after a normal business day they are at night-call for complicated questions or emergency operations, for which they need to go to the hospital. Often turning them into the weekend also 48-hour shifts. Hospitals use these grids traditionally, because it is too costly to all night for each specialty, a doctor at the hospital.

Negotiable

Dink Legemate, head surgery Professor of surgery of the AMC, and Jan Klein, anesthesiologist and Professor of patient safety by TU Delft, decided on a joint plea: specialists would no longer than 12 hours at a time, they are allowed to work. Both professors shall be construed as authority in their field.

Legemate: ' it's governed by pilots. It is governed by truck drivers. That allowed only so many hours work and that everyone will find completely understandable. But about the medical specialists has no one. Why put the society there no press? That I find odd. This must be just. '

According to the Dutch Association of hospitals, it is good that this can be discussed. Also industry associations of medical specialists call it an important signal, but are at a maximum of 12 hours. The health care Inspectorate does not respond and says that this is a matter of medical specialists itself.

Related

Scientific research shows that long stay awake has the same effect on performance as drinking alcohol. With fatigue decreases the responsiveness, the memory worse and make people more errors.

Yet never a direct link between long services and medical errors. According to Small play in the make so many factors, that this is difficult to demonstrate. Recent research by the University of Twente demonstrated that one in eight medical specialists burn-out.

' We recognize the problem ', says Erik Hahn, Professor of surgery in Groningen and Chairman of the Dutch Association for surgery. ' It is undesirable and unwise to 24 hours at a time in rope. That is a risk, we are agreed on that. But we do not believe that anyone should 12 hours as maximum. You should be able to apply different scenarios. '

Appointments

' If you go at night, then you will get two phone calls the next day not to be of his schedule, ' he says. ' Then you can just work. But if you have been on the operating room all night and you're all leeggeopereerd, then there must be such a atmosphere that patients take over colleagues and that you can go home to sleep. '

Teams must make firm commitments on there, says Heineman. ' Space In the grid should be. And if you are after a heavy night still can work, then turn and runs an outpatient visits-only tasks that require alertness may be less. '

The Federation medical specialists will find this an important signal, but sees nothing in the abolition of 24-hour shifts. ' If you have enough, you can get the best that way, ' says a spokeswoman. ' But that can not everywhere. Care must be just go ahead. In a small hospital will arrange this more difficult. There is also maybe at night doing less. We say: after a very heavy night rule that you can call on your colleagues. '

Patient safety

According to Heineman is the culture among surgeons so that you can. ' Surgeons are no longer the stereotypical machos. That is the exception rather than the rule. "

Medical errors can have many causes, he says. ' I think it's more common that doctors by private circumstances do not function properly, than working in night hours. ' At a maximum of 12 hours he fears that surgeons make too few flight hours and experience losses. ' That would be the correct patient safety deteriorate. '

Professor of traffic psychology Charles Brook House is stopping with such services just ' a particularly good idea '. ' At professional drivers is here for thirty, forty years of research to be done and that is becoming crystallized. It is quite clear: fatigue makes for a higher risk of accidents. If you really have slept too little, the chances of accidents quickly five times as large. at night between two and five is the probability of an accident nearly six times as large. Therefore there are also introduced strict driving and rest periods for drivers. '

The Dutch hospitals Association calls it a logical, useful discussion. "In the conditions of employment States that specialists have to find solutions if such a service is overweight. As that in the culture of specialists fails, then it is good that this is negotiable. Security comes first. '

By Editorial Volkskrant: Photo: Mike Roelofs