Emergency physician stress and morbidity

Zun, Leslie S.; Kobernick, Michael; Howes, David S.

doi:10.1016/0735-6757(88)90159-3

Cited by 37 publications

(29 citation statements)

References 14 publications

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“…Revicki vious research has demonstrated the associations among work-related stress, depression, and psychological distress in family physicians,4,13,14 emergency medicine physicians," and residents. 2,1o, 15,16 Despite evidence that rotations in emergency departments are highly stresstuf'-'? and that residents have been depressed following rotations in emergency departrnents,?…”

mentioning

confidence: 98%

“…This small number of studies is surprising in light of predictions that physical and emotional stress would lead to attrition from the specialty. 16,18,19 Several recommendations have been made to remedy this situation, including 12-hour shifts for residents working in emergency departments and staffing of emergency departments by physicians who have completed 3 years of postgraduate training and are trained to evaluate and care for emergent patients,"…”

mentioning

confidence: 99%

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Organizational Characteristics, Perceived Work Stress, and Depression in Emergency Medicine Residents

Revicki¹,

Whitley²,

Gallery

1997

Hospital Topics

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confidence: 98%

mentioning

confidence: 99%

Organizational Characteristics, Perceived Work Stress, and Depression in Emergency Medicine Residents

Revicki¹,

Whitley²,

Gallery

1997

Hospital Topics

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“…110,111 Comparatively little work has been done to look at the process of shift change beyond determining that EPs, when asked, cited erratic schedules and shift changes as stressors in ED work. 112 Macias et al determined that hospital employees had a higher rate of exposure to biological fluids, such as needlesticks and splashes, during the first hour of any shift and during the last two hours of a 12-hour shift. 113 While the results presented are generalized, with only a fourth of incidents arising in an ED, this study suggests the challenges inherent in shiftwork and the lapses that can occur around change of shift.…”

Section: Automated Drug Dosing and Distributionmentioning

confidence: 99%

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

134

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Abstract. An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

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“…ACADEMIC EMERGENCY MED-ICINE 2000; 7:670-673 S HIFTWORK has been identified as a major source of attrition in emergency medicine (EM). [1][2][3] Multiple factors have been identified that affect shiftwork tolerance. These include the morningness-eveningness preferences, flexibility of sleeping patterns, and ability to overcome drowsiness.…”

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confidence: 99%

Emergency Medicine Residents' Shiftwork Tolerance and Preference

Steele

John

Watson

et al. 2000

Academic Emergency Medicine

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Abstract. Objectives: To determine the shift lengths currently worked by emergency medicine (EM) residents and their shift length preferences, and to determine factors associated with EM residents' subjective tolerance of shiftwork. Methods: A survey was sent to EM-2 through EM-4 allopathic EM residents in May 1996. This questionnaire assessed the residents' shift length worked, shift length preferences, night shift schedules, and self-reported ability to overcome drowsiness, sleep flexibility, and morningness-eveningness tendencies. When providing shift length preferences, the residents were asked to assume a constant total number of hours scheduled per month. Results: Seventy-eight programs participated, and 62% of 1,554 eligible residents returned usable surveys. Current shift lengths worked were 8 hours (12%), 10 hours (13%), 12 hours (37%), combinations of 8-hour, 10-hour, or 12-hour (34%) shifts, and other combinations (4%). Seventy-three percent of the respondents indicated that they preferred to work 8-hour or 10-hour shifts, and only 21% preferred a 12-hour shift. Shiftwork tolerance was recorded as: not well at all (2%), not very well (14%), fairly well (70%), and very well (14%). The EM residents' eveningness preference, ability to overcome drowsiness, sleep flexibility, younger age, and having no children at home were all associated with greater shiftwork tolerance. Conclusions: Emergency medicine residents generally tolerate shiftwork well and prefer 8-hour or 10-hour shift lengths compared with 12-hour shift lengths. Emergency medicine residencies with 12-hour shifts should consider changing residents' shifts to shorter shifts. Key words: work schedule tolerance; shiftwork; morningness-eveningness; circadian rhythms; postgraduate medical education; residents. ACADEMIC EMERGENCY MED-ICINE 2000; 7:670-673 S HIFTWORK has been identified as a major source of attrition in emergency medicine (EM).1-3 Multiple factors have been identified that affect shiftwork tolerance. These include the morningness-eveningness preferences, flexibility of sleeping patterns, and ability to overcome drowsiness.4,5 Age, gender, and whether children are present in the home have also been associated with tolerance. 6 To our knowledge, there are currently no data describing EM resident tolerance of shiftwork. Working different length shifts is common in EM. Two prior studies indicate that practicing emergency physicians (EPs) and EM residency faculty prefer working shorter shifts. 7,8 For EM residents, we know of no information describing their lengths of shifts worked or their preferences.The objective of this study was to determine the shift lengths currently worked by EM residents and their shift length preferences. This study also determined the association of various factors with EM residents' subjective tolerance of shiftwork. METHODSStudy Design. The self-administered survey was distributed to eligible EM residents. The medical center's IRB approved the study protocol.

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Emergency physician stress and morbidity

Cited by 37 publications

References 14 publications

Organizational Characteristics, Perceived Work Stress, and Depression in Emergency Medicine Residents

Organizational Characteristics, Perceived Work Stress, and Depression in Emergency Medicine Residents

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Emergency Medicine Residents' Shiftwork Tolerance and Preference

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