Health intervention and training

Residency Program Insider, November 21, 2005

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Dear residency program colleague:

Maintaining a healthy lifestyle is crucial for workers in extended hours operations, considering the added stress represented by their non-standard work hours and their increased risk of suffering certain health problems. However, shiftwork has also been associated with poor lifestyle habits, such as increase use of alcohol and caffeine, and lack of regular exercise.

Residents are notorious for neglecting their own health and well-being to focus on providing care for others, including patients, families, and friends. A good place to begin our discussion of this issue is by asking residents the question: "When was the last time you had a thorough physical examination?" It's no surprise that physical illness and injury cause fatigue, but how many of your residents follow their own advice about maintaining health and wellness when they aren't ill?

It's difficult to determine which residents are failing to receive preventive healthcare, because there are issues of confidentiality. But suppose during regularly scheduled meetings with your residents, you explain that physical health is important in the fight against fatigue and consequential medical errors. You might consider asking residents to complete self-assessments concerning their health and tell them that they need not share that information with anyone, including you, unless they want to. Distributing such written assessments may clarify needs for them. This self-assessment, therefore, also can be used as a teaching tool.

Specific training about challenges related to working extended hours and how to address them would also be useful. The training should show how to cope with the residents' specific work schedule. For example, rather than simply receiving information about good sleep practices, residents should learn how to schedule their sleep to obtain the best possible sleep when working different shifts, different strategies on how to prepare for the first night shift, and how to nap wisely.

That's all for this week!

All the best,

Acacia Aguirre, MD, PhD
Circadian Technologies, Inc.

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