List Archives

Thu Jan 6 21:59:49 GMT 2011

Here here
Rw

Sent from my iPhone so I can reply quickly so please forgive any errors

On Jan 6, 2011, at 1:04 PM, "Gross, Ronald" <Ronald.Gross at baystatehealth.org> wrote:

> A-friggin-men!!!!!!
> 
> 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Dave Napoliello
> Sent: Tuesday, January 04, 2011 1:19 AM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: Doctors Urged to Admit Fatigue Before Performing Surgery
> 
> you get good at taking care of emergencies dead tired at three in the morning after working all weekend by doing it hundreds of times in training.  what is being lost here is priceless training and experience. I fear more lives will be lost do to inexperience then lack of sleep.....who do you want fighting your wars, a battle hardened tired seasoned veteran on the line for a year or the green recruit in clean clothes and with a good night sleep.dn
> 
> Sent from my Verizon Wireless Phone
> 
> caesar ursic <cmursic at gmail.com> wrote:
> 
>> I detect an undercurrent of 'blame the residents' here.  becasue they don't
>> want to pay the price.
>> 
>> Remember the old adage about kids:  "Children don't spoil themselves."
>> 
>> On Mon, Jan 3, 2011 at 4:13 PM, saad shebrain <shebrain1 at yahoo.com> wrote:
>> 
>>> 
>>> I think what will hapen is that the attending surgeon  will be the one who
>>> has to take care of everything for his patients from reviewing the orders to
>>> progress notes, etc. because of these new rules. The continuity of care from
>>> resident standpoint will be gone.
>>> 
>>> It is either you know your patient very well or you don't. It's hard to
>>> belive this will be better with these changes and will see.
>>> 
>>> Question; Did ACGME look at this from the point of country interest? Is
>>> this going to solve the shortage problem in GS? Don't think so!
>>> 
>>> 
>>> 
>>> 
>>> ---------------------------------------------------------------------------------------------------------
>>> IMPORTANT WARNING: This email (and any attachments) is only intended for
>>> the use of the person or entity to which it is addressed, and may contain
>>> information that is privileged and confidential. You, the recipient, are
>>> obligated to maintain it in a safe, secure and confidential manner.
>>> Unauthorized redisclosure or failure to maintain confidentiality may
>>> subject  you to federal and state penalties. If you are not the intended
>>> recipient,  please immediately notify us by return email, and delete this
>>> message from your computer.
>>> 
>>> ---------------------------------------------------------------------------------------------------------
>>> 
>>> --- On Mon, 1/3/11, Gross, Ronald <Ronald.Gross at baystatehealth.org> wrote:
>>> 
>>> 
>>> From: Gross, Ronald <Ronald.Gross at baystatehealth.org>
>>> Subject: RE: Doctors Urged to Admit Fatigue Before Performing Surgery
>>> To: "'Trauma-List [TRAUMA.ORG <http://trauma.org/>]'" <
>>> trauma-list at trauma.org>
>>> Date: Monday, January 3, 2011, 11:49 AM
>>> 
>>> 
>>> It was just a matter of time until this came to be, as the new ACGME
>>> regulations regarding the number of hours an intern can work (16) and how
>>> often the intern must nap must be implemented in July 2011.  Still to be
>>> determined is just who will be providing the rubber mats, milk and cookies
>>> for these kids after their naps, and exactly how we will cover the time
>>> slots; as it appears currently, the night float system will prevail, and all
>>> of us "more mature" surgeons who fail to admit fatigue might not see the
>>> same shift worker resident more than once in the course of a 3 or for day
>>> cycle.
>>> 
>>> Things that make you go "Hmmmmmmmm"............
>>> 
>>> 
>>> -----Original Message-----
>>> From: trauma-list-bounces at trauma.org [mailto:
>>> trauma-list-bounces at trauma.org] On Behalf Of Vic Werlhof
>>> Sent: Saturday, January 01, 2011 11:28 PM
>>> To: 'Trauma-List [TRAUMA.ORG <http://trauma.org/>]'
>>> Subject: Doctors Urged to Admit Fatigue Before Performing Surgery
>>> 
>>> 
>>> Doctors Urged to Admit Fatigue Before Performing Surgery
>>> 
>>> 
>>> Proposed new rules suggest informing patients, requesting consent before
>>> procedure
>>> 
>>> 
>>> <http://www.healthday.com/> HealthDay/ScoutNews LLC
>>> 
>>> WEDNESDAY, Dec. 29 (HealthDay News) -- A new commentary calls on doctors to
>>> disclose when they're deprived of sleep and not perform surgery unless a
>>> patient gives written consent after being informed of their surgeon's
>>> status.
>>> 
>>> There currently aren't any rules about the number of hours that fully
>>> trained physicians may work. The proposed new rules would change how
>>> doctors
>>> handle their own fatigue, the authors of the editorial pointed out.
>>> 
>>> "This approach would represent a fundamental shift in the responsibility
>>> patients are asked to assume in making decisions about their own care and
>>> might prove burdensome to patients and physicians, and damaging to the
>>> patient-physician relationship," the authors wrote in the Dec. 30 issue of
>>> the New England Journal of Medicine, adding that "this shift may be
>>> necessary until institutions take the responsibility for ensuring that
>>> patients rarely face such dilemmas."
>>> 
>>> Research suggests that sleep deprivation impairs a person's psychomotor
>>> skills -- those that require coordination and precision -- as much as
>>> alcohol consumption and increases the risk of complications in patients
>>> whose surgeons failed to get much shuteye.
>>> 
>>> "Sleep deprivation affects clinical performance. It increases the risks of
>>> complications. And it is clear from survey data that patients would want to
>>> be informed if their physician was sleep-deprived and that most patients
>>> would request a different provider," editorial first author Dr. Michael
>>> Nurok, an anesthesiologist and intensive care physician at the Hospital for
>>> Special Surgery in New York City, said in a news release from the hospital.
>>> 
>>> "We think that institutions have a responsibility to minimize the chances
>>> that patients are going to be cared for by sleep-deprived clinicians,"
>>> Nurok
>>> added.
>>> 
>>> Some hospitals try to reduce the likelihood that physicians will lose sleep
>>> due to their work schedules. However, "a lot of institutions are not going
>>> to be able to take that leap immediately, so as an interim step, we believe
>>> that patients need to be informed," Nurok said. "This is going to be a
>>> policy issue that develops. Elective surgery is the low hanging fruit
>>> because there is no urgency to doing it and it can be rescheduled --
>>> ideally
>>> as a priority with institutional support. It's a nice place to start to
>>> think about policy approaches."
>>> 
>>> More information
>>> 
>>> The U.S. National Library of Medicine has more on surgery
>>> <http://www.nlm.nih.gov/medlineplus/surgery.html> .
>>> 
>>> -- Randy Dotinga
>>> 
>>> SOURCE: Hospital for Special Surgery, news release, Dec. 29, 2010
>>> 
>>> Copyright C 2010 HealthDay <http://www.healthday.com/> . All rights
>>> reserved.
>>> 
>>> 
>>> 
>>> ----------------------------------------------------------------------
>>> Please view our annual report at http://baystatehealth.org/annualreport
>>> 
>>> 
>>> CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may
>>> contain confidential and privileged information for the use of the
>>> designated recipients named above. If you are not the intended recipient,
>>> you are hereby notified that you have received this communication in error
>>> and that any review, disclosure, dissemination, distribution or copying of
>>> it or its contents is prohibited. If you have received this communication in
>>> error, please reply to the sender immediately or by telephone at
>>> 413-794-0000 and destroy all copies of this communication and any
>>> attachments. For further information regarding Baystate Health's privacy
>>> policy, please visit our Internet site at http://baystatehealth.org.
>>> --
>>> trauma-list : TRAUMA.ORG <http://trauma.org/>
>>> To change your settings or unsubscribe visit:
>>> http://www.trauma.org/index.php?/community/
>>> --
>>> trauma-list : TRAUMA.ORG <http://trauma.org/>
>>> To change your settings or unsubscribe visit:
>>> http://www.trauma.org/index.php?/community/
>>> 
>> 
>> 
>> 
>> --
>> 'Twas brillig, and the slithy toves
>> Did gyre and gimble in the wabe:
>> All mimsy were the borogoves,
>> And the mome raths outgrabe.
>> --
>> trauma-list : TRAUMA.ORG
>> To change your settings or unsubscribe visit:
>> http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> 
> ----------------------------------------------------------------------
> Please view our annual report at http://baystatehealth.org/annualreport
> 
> 
> CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please reply to the sender immediately or by telephone at 413-794-0000 and destroy all copies of this communication and any attachments. For further information regarding Baystate Health's privacy policy, please visit our Internet site at http://baystatehealth.org.
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

Doctors Urged to Admit Fatigue Before Performing Surgery