The first errors arrive around 8:00 p.m. and following 1:00 a.m., people begin to “doubt everything.”
Removing the 24-hour guards is one of the great demands of doctors. Beyond the discomfort, it has been shown that lack of sleep decreases concentration and attention, which is why it’s easier to make mistakes while caring for a patient. In fact, Rubén Blanco, a resident in the Family and Community Medicine specialty, has recounted on Twitter the most common mistakes you have perceivedboth in him and in his colleagues with whom he has discussed it, in medical guards.
In his tweets, he first comments on his day on call: having a consultation at the medical center as a normal 8-hour shift, stopping to eat earlier and starting work at the hospital at 3:00 p.m. He explains that, normally, when he starts to spend an followingnoon consultation at the other health center, He already has around 40 patients behind him; but the food “gives a breather”, so he remains lucid “until 8:00 p.m.”, when the first errors occur, those of an “administrative type”: forgetting to sign a prescription, not providing the papers of the tests, he lists. “Everything can be solved,” says the doctor.
The food gives a breather, so that more or less until 8 in the followingnoon the lucidity is maintained. At that time, the first errors begin. Luckily, they are usually administrative. Not signing a prescription, not providing the evidence papers… Everything can be solved. (3/9)
– Rubén Blanco (@RBlancoMFyC) December 8, 2022
“After dinner, things get worse”indicates White. The errors are still not serious, of course, but they are usually related to “confusing the right side with the left in the report, forgetting a question or some minor exploratory maneuver,” he says.
And then comes the third phase. The one in which one doubts everything. Figures that are known by heart begin to dance. The same questions and explorations are repeated because they are not sure or because they no longer remember what had been done. (5/9)
– Rubén Blanco (@RBlancoMFyC) December 8, 2022
1 in the morning, the last phase
The last phase, which arrives around 1 in the morning, is in which the doctors begin to doubt “everything.” From data that one knows by heart (and now believes that they are not correct) to the repetition of questions and explorations because “there is no security or because I no longer remember what had been done,” explains Blanco. However, “doubting is not bad”. But still mistakes are made such as reporting “wrong drug doses” or not seeing “clear fractures on x-rays.”
This happens at these hours, says the resident, “when you forget all the love you feel for Medicine”. “When you can’t be humanized because you yourself are dehumanized,” illustrates this resident.
Always with the same common denominator. All this happens from 1 in the morning. When every patient is a wall. When you forget all the love you feel for medicine. When you cannot be humanized because you yourself are dehumanized. (7/9)
– Rubén Blanco (@RBlancoMFyC) December 8, 2022
To end his thread, Blanco explains that he is free the next day, because he has already done those hours in the hospital and he just “rotates the shift”; but he asks to stop the 24-hour guards because if someone fails at five in the morning, will take responsibility for what happened to the “zombie who did too much keeping his eyes open”comments.
We have to stop this. Those responsible are calm at home sleeping and know that nothing will happen to them. Because if someone fails at 5 in the morning, no one will go following them. They will go for that zombie that did too much keeping its eyes open. (9/9)
– Rubén Blanco (@RBlancoMFyC) December 8, 2022
“We have to stop this”White concludes. And many other doctors agree with him in the comments that 24-hour calls should no longer be done. In addition, there is a health worker who points out that “even” on a normal day, when there are more than 40 patients, he doubts “everything”. The solution? There are toilets that talk regarding rotating shifts, others regarding 12-hour guards; although the final decision will be of the leaders politicians.
The information published in Redacción Médica contains affirmations, data and statements from official institutions and health professionals. However, if you have any questions related to your health, consult your corresponding health specialist.
