I've been meaning to update everyone on orientation for a bit. Friday night we had a BBQ with faculty, staff, residents and everyone' families, sig O's. Of the class graduating (the leaving R3's) there are 8 residents and 11 children. The trend continues through the ranks - our class only having 5 kids for 8 residents. I was fashionably late, and apparently missed the part of the BBQ where everyone stands up and introduces their siginificant other, kids, etc. The photo is of my attempt at eating the world's largest hot dog.
I think it's required, but late last week we had a lecture on sleep deprivation. I thought it was very interesting. More interesting, surely, than the discussion on hospital protocols. Personally, I think the presentation should be for the rest of the world. We know
we are sleep deprived, and hungry, and gaining weight, and grumpy and falling asleep at the wheel. But the nurse who gets mad at us because we weren't cheerful after a 30-hour shift, or the guy in the Mercedes behind us, who's honking because we didn't immediately gun it at the green light? They
need to learn how tired we really are.
Yeah sure, we learned some tips and tricks. But the real message is that nothing helps sleep deprivation like sleep.
I was a little concerned about a bit of a double standard. The program here adheres very strictly to the resident work hour rules. These rules, for those who aren't aware of them, have been imposed upon programs in the US. Not as punishment, but because if they weren't imposed upon them, the wouldn't adhere to them. However, even here, I have heard little bits and pieces of things that concern me. "I'll definitely respect you if you want to stay past your hours... but you can't." Or "Dedication is admirable
, but we have to assure you aren't exceeding hours." There's also "One resident was mad at me because I was sending her home after 30 hours. She said I was impeding her educational experience." Hm. If that's not sleep deprivation talking I don't know what is. Yes, I'm sure there will be times, as my 30 hours ends, that I will want to stay and finish this one last thing. But I know
that after 30 hours awake, you'll have to show me something ten times before I learn it. Alert, I might pick it up the first time. (photo from my window at night.)
I also told some folks I'd put the following on my blog. Here are some of the resident work hour rules. And, for those in need of even more education, click here
for more information on the resident work hour regulations (the first link is AMA, the second is AMSA's ...photo explained in last paragraph).
Some of the Standards (right off my handout)
1. Call scheduled no more than every third night
2. One full 24-hour day in 7 free of patient care [averaged - not enforced per week]
3. Limit of 80 duty hours per week averaged over four weeks
4. 24-hour limit on continuous duty with up to 6 additional hours for transfer, debriefing or didactic activities [that pretty much covers anything in residency].
5. a 10 hour minimum rest between duty periods
There's more but that's the gist of the regulations.
Interesting point our residency director made: in "his day" they worked longer hours. However, according to him, they had more hours that were less productive. Since we are cramming the same education in to 80 hours (instead of 100 or 120) a week we have virtually no downtime. So our 80 hours are intense and spent running around, admitting patients, going to didactics, getting our work done, with very little down time. Hmm... makes me wonder if the Gray's Anatomy folks are adhering to the work hour regulations since they do
seem to have a lot of downtime. (photo from art festival)
Also interesting. There was discussion of brain-washing. How do you brain-wash someone? You sleep deprive them, give them bad food, and expose them to repetitive messages. Again I say: hmm...
Regardless. I'm not working much at all this past week and had lots of time to go to the Urban Art Festival
here in Tacoma. It was a great time! I didn't go until rather late in the evening as it was pretty nasty all day. It rained and even hailed
! Definitely not good street fair weather. However, a rainbow emerged (literally) and the sun came out for a few hours and I moseyed on down to the Art Festival to see what was happening.
By the time I got there many booths were packing up. I talked to two artists who said the winds and rain were so bad they were literally hanging from the support beams of their tents to keep them from blowing away. The exhibitors did look spent, but those like me who had the luxury of coming when the weather was nicer were enjoying ourselves. The music was great
- it was "I can't believe this is free" kind of great. There was a main stage with live performers and a DJ in a covered parking lot (not sure if that was his original location, given the rain). The DJ was playing techno music - making me a little homesick for Detroit and, again, bummed I missed the electronic music festival there. I listened to both for a while but preferred the live music ultimately as the crowd gathered there was much more diverse.
The exciting thing is that there were a lot of left-wingers there. I saw a guy in a tie-dyed lab coat (see above), people wearing PFLAG stickers, dancing old hippies (both near the music venues and far from them). It was pretty great and made me like Tacoma even more. I hope the weather is more favorable for the Festival next year since it seems like something I may want to spend more than an hour at if possible.
Labels: residency, Tacoma