The authors were unable to demonstrate any superiority of actual performance by the better-rested doctors, as measured by the crude outcome of patient deaths. This was not surprising because their sample size was too small; the experiment would have to be repeated on a larger scale to prove what seems intuitively obvious: that exhausted doctors – or perhaps I should say more exhausted doctors – are more inclined to make medical mistakes than less exhausted doctors.
Strangely enough, another study of a similar kind has shown that while protected sleep lessens the fatigue of young doctors, it increases their level of anxiety. The authors of that study hypothesized that the extra sleep merely compressed the amount of work they had to do, which remained the same, into fewer hours, thus increasing their anxiety. And when anxiety increases beyond a certain beneficial level, it tends to depress performance just like fatigue.
Perhaps young doctors are also so used to hearing how hard their elders and betters worked when they were their age that they feel slightly ashamed of their protected sleep periods, unluxurious as they might seem to the great majority of the population, as being indicative of a lack of commitment and stamina, what was known in my childhood as moral fiber. All I can say is that I would certainly not have wanted to be treated by me at the end of one of my forty-eight hour shifts.
Previously from Dr. Dalrymple at PJ Lifestyle: