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by gus_massa 2644 days ago
Handovers are dangerous, but making decisions that need your full attention after hard working 11:30 hours is also dangerous. And sometime doctors have even longer shifts.

It's an insane culture.

My guess is that it is easy to spot error in handovers (X didn't say/write this, Y didn't hear/read that). But errors due that you have worked 11:30 hours are more difficult to isolate.

1 comments

Why do you think the hospitals do long shifts then? Just for fun?

They don't do it for people who aren't doing handovers, like general practitioners who can work half-days just a couple of times a week if they want, or administrations. So we know it isn't inherent for doctors or for the staffing of the hospital. Only for those doing handovers...

> Why do you think the hospitals do long shifts then? Just for fun?

Because the culture of US medical training was initiated by a coke addict, and it's extremely conservative and slow-moving.

https://en.wikipedia.org/wiki/William_Stewart_Halsted

But medical shifts are like this the world-over.
That’s exactly what I mean - cf

https://www.theguardian.com/society/2009/nov/05/nhs-confiden...

In the UK they always worked long shifts because it’s safer. They’re trying to stop them, and it’s less safe.

Why do you think the reason the UK has always worked long hours is due to a drug addiction in the US rather than experience in safety?

> Two case studies involving teenagers who died highlighted the failures to consult senior medical staff early on.

It looks like they are not hiring enough senior staff, not handover problems.

Personally I don’t find “everyone is doing this so it must be rational” a very convincing argument. After all, maybe everyone else followed that same weak argument.
But conversely how do you think everyone arrived at an unsafe practice particular to just these doctors who do handovers and no others? And why do you think they’re campaigning themselves to bring them back for safety in the UK?
All of these countries didn't independently discover medicine, and they do speak with each other i.e. they share a culture. Why do they all dress the same, why are so many addressed with a title in front of their names, and why do they all seem to refer to a lot of things in Latin?

We can choose to think that they independently arrived at an ideal state, but that's not reasonable.