天博体育

Doctors-in-training聽should be encouraged to聽do some聽on-the-job napping, according to聽the organization that sets the standards聽for residency programs around the country.

The (ACGME)聽issued new standards yesterday that came out in聽favor of a聽well-timed snooze.聽The guidelines, which are scheduled to go into effect next year, say this:

Programs must encourage residents to use alertness management strategies in the context of patient care responsibilities. Strategic napping, especially after 16 hours of continuous duty and between the hours of 10:00 p.m. and 8:00 a.m., is strongly encouraged.

Medical residency is the training that follows graduation聽from medical school. Traditionally, residents聽at American hospitals were expected to work marathon hours鈥攐ften聽overnight and聽a couple of days in a row. These long shifts聽were seen聽as a way to get new doctors thoroughly steeped in medicine and聽necessary for mastery聽of the聽complexities聽of聽a medical聽specialty.聽The聽grueling聽apprenticeship is a feature of many professions.聽Perhaps it is the rule coming into play.

And,聽not so incidentally,聽making medical residency an endurance-slash-sleep-deprivation contest聽also聽supplied聽hospitals with cadres of young, eager doctors who were paid relatively low salaries.

But聽whether overworked (and undersupervised)聽residents might be endangering patients聽became a front-page聽issue聽after the聽肠补蝉别.听罢丑别苍 and elsewhere聽started to show, in a systematic way,聽connections between the sleep-deprived聽residents,聽medical errors, and patient safety.聽Rules were changed to limit hours, require a certain amount of time off聽between shifts, and聽improve supervision.

There鈥檚 some question whether it is honored in the breach, but聽now聽residents are limited to working 80 hours聽a week on average. That is聽still a heckuva a lot of hours but聽far聽fewer than聽鈥済ood old days,鈥澛� which were actually quite bad鈥攁nd unsafe鈥攊n a lot of ways.

The Institute of Medicine (IOM) published a report on resident training two years ago.聽According to , the聽ACGME standards published yesterday followed the聽IOM鈥檚 lead in most聽respects but聽parted company when it came to聽the important issue of preventing errors by sleep-deprived residents. Here is聽how聽the聽The聽 New England Journal of Medicine report summarized the聽difference:

The IOM recommended that resident shifts longer than 16 hours include an uninterrupted 5-hour sleep period. The ACGME task force concluded that such a long sleep period was unworkable, instead recommending 鈥渟trategic napping鈥� during long shifts.

It鈥檚聽pretty聽remarkable that an organization like the聽ACGME has endorsed napping, albeit carefully qualified as being of the strategic聽sort.

But聽napping is collecting聽endorsements these days.

The says that 鈥渨hile聽naps do not necessarily make up for inadequate or poor quality nighttime sleep, a short nap of 20-30 minutes can help to improve mood, alertness, and performance.鈥�

Studies of nightshift workers have shown that their performance improves if they grab a 鈥減rophylactic nap鈥� before they start work. Other studies show that the 鈥渙perational nap鈥� of just聽 20 minutes聽during a nightshift聽improves performance at the end of the shift, although you have聽to be careful about sleep inertia鈥攖hat groggy feeling that lingers once you wake up from a nap.

, a prominent Harvard sleep researcher, says聽in some cases, a nap can provide as much benefit as a full night of sleep.

Not many businesses have truly embraced the workplace nap. But the聽.聽 (Better the聽short聽nap than those multihour energy drinks with all that caffeine, provided聽you can get the boss to agree first.)

There鈥檚 even some discussion that聽鈥攁nd that they do so anyway on long trips.

If you want to read聽more about naps, we published a piece about them 颈苍听迟丑别 天博体育 Letter last year. And our聽our brother publication, the Harvard Men鈥檚 Health Watch, published a piece two years ago.