Should Doctors Work for 26 Hours Straight? No. (and Yes…)


Should Doctors Work for 26 Hours Straight? No. (and Yes…)

As a resident, I worked between 26 and 36 hours straight. Should every doctor do the same? Let’s find out! Friday’s Digest #113

Table of contents

  1. Life Update
  2. Tools and Tips
  3. Readers’ Favorite
  4. Stuff


Life Update

It's been almost a month since returning home from my fellowship.

Do I still enjoy the little things I did on my first day back?

Absolutely.

Nothing has changed.

Meeting friends and family, savoring good (healthy) food—everything still feels special. I suppose I'll get used to it eventually, but for now, I'm enjoying it so much.

This week, I took my first on-call shift as an attending since returning.

It lasted 4 days, with several visits to the hospital and OR.

On two of those nights, I barely slept.

This experience got me thinking about how I want to manage my phone.

During my fellowship, it was simpler. I had a pager for work and a phone for my personal life, which helped balance the two.

During my fellowship, I was ALWAYS on call, but I trusted my pager and slept really well.

Here at home, my phone serves both for work and personal life.

So, if I want to receive urgent work messages while I sleep, every (non-urgent) notification also wakes me up. Turning off the internet on my phone didn’t feel reliable, so I slept really poorly.

Should I get a pager here as well? I'm not sure. Maybe. We'll see.

Speaking of sleep and being on call, today we'll discuss doctors working 26-hour shifts. Is it necessarily bad?

Let's find out!

Number 113


Tools and Tips

Storytime!

It's 2014, and I'm taking my first call as a resident.

This means staying in the hospital when everyone else goes home. Back then, the regulations weren't strict, so being on call meant arriving at the hospital around 6:30 in the morning and leaving around 16:00 (4:00 pm) the next day. You would work 32-36 hours straight.

I remember the first time I came home. I was absolutely exhausted.

I opened the door, mumbled a few words to my dear wife and 2-month-old son, and crashed on my bed.

There was no way I could function.

But with time, it got better.

First, I learned to work much more efficiently as a doctor. In addition to becoming a better surgeon, I learned how to document everything faster and how to treat a large group of patients in a short period.

Initially, you're a bit shocked when you see 10 patients waiting just for you in the emergency department. They've all waited a long time and are upset and worried.

I learned how to introduce myself and explain how long it will take until I see them, why it's taking so long, and how I won't compromise on the quality of their treatment when I get to them.

They always left the hospital very pleased—even when it was 4:30 in the morning, even when I was exhausted.

You're probably asking yourself, "What does all of this have to do with 30+ hour shifts? Can't you learn it all on 12-hour shifts?"

Probably. But being pushed to the extreme makes you better much faster.

On the flip side, we've all heard how destructive it is to work 26-28 hour shifts (that's how long residents currently work in my hospital). We've all heard the comparison between doctors and air traffic controllers—how both professions are responsible for human lives, but only the latter get reasonable working hours.

So no, I don't think doctors should work that long. And I disagree with the notion that "If I did it when I was a resident, I think the younger generation should do the same."

However, since residents are still pulling 26-28 hour shifts, I would like to share the 3 things I liked about those long shifts.

Take it as my version of seeing the glass half full:

🔵 You Get Better, Faster

The more times you do something, the better you become at it.

But HOW OFTEN you do it is even more important.

Take facial lacerations in kids, for example. Placing sutures in kids is something I did SO MANY times. On some occasions, I treated 10 kids within 3 hours.

And when you have 26 hours to do these things, you walk home a better doctor than you were when you walked into the hospital.

During those on-calls, I taught myself to keep children calm when their faces are sutured. It became EXTREMELY rare for a kid to cry during my treatment.

I couldn't have done that well if I had only treated 2-3 kids a day. And the same goes for everything you do during your residency.

🔵 You Earn a Superpower

Being able to work for so many hours straight becomes a very powerful tool you use when you don't have a choice. It's a superpower no one can ever take from you.

For example, I can now stay awake throughout the night to complete an important project and keep my focus. I don't like doing it, but I can do it pretty easily.

I don't have jet lag. I used to have it, but it went away during my residency. If I travel overseas, I simply stay awake until the sun sets and then go to sleep, even if it means staying awake for 40 hours straight.

And if a surgery gets complicated and lasts 15 hours, I'm not bothered by it. I keep my focus, and it's relatively easy for me to do.

🔵 The Morning After

And then there's the day off after your call.

Oh my god. It's like magic.

When you walk out of the hospital the morning after (usually around 10 am) and have a full day ahead of you, it makes you feel so happy.

You go home while other people rush to work.

You take a shower that feels so good. You eat breakfast and savor every moment. And then you go to sleep for a few hours. And let me tell you, that sleep feels SO SWEET.

So, am I glad that I worked 26 (or 28, 32, 36) hours straight?

No.

And yes…


Readers’ Favorite

For those starting a residency, I've prepared a 7-day email course sharing insights from my experience as a resident.

Ready to dive in? Enter here.


For The Soul

“We cannot fully appreciate the light without the shadows.”
― Matthew McConaughey

Resurfaced using Readwise.


Epilogue

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That’s it for this issue.

See you next week!

Shay



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Friday's Digest - The Newsletter for Doctors & Scientists

For two decades, I've been developing tools that have improved my practice in medicine, dentistry, and scientific research. Join me every Friday to discover a new tool you can integrate into your workflow as a doctor, a scientist, or both. I believe in sharing knowledge, embracing automation, boosting productivity, and finding joy in the process.

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