Doctors’ Other Bedside Challenge: Getting Enough Sleep
Fighting healthcare’s hidden enemy, eight hours at a time.
Leaving something you love is not an easy decision. For me, it became unavoidable. After 13 years, I walked away from being an Emergency Medicine Pediatrician. I loved the work…but it was a simple case of saving my life.
Being a pediatrician was my vocation, stemming from my childhood experience of adoption. I was born in Vietnam and adopted at the age of two by a young soldier — connecting with children in need is something that comes naturally. Medicine is the only profession that allows me to carry out my love of science and passion for helping others, and I thrived while leveraging my ability to emotionally connect with patients and their parents.
But my passion came with a steep price.
Like many doctors, I learned to accept sleep deprivation. An emergency medicine physician’s life has a way of making the body’s need for eight hours of sleep a day virtually unattainable, and that lack of restful sleep was negatively impacting my quality of life. It’s true that physicians are often better at dispensing medical advice than taking it, and I was no exception.
For many of us, these harmful habits begin in medical school — where the intensely competitive environment prioritizes one’s ability to ingest enormous amounts of complex information within a limited time.
Residency follows, which is the chance to truly learn one’s craft. But an 80-hour (when I started, 120-hour) work-week is the norm and “power naps” are an acceptable substitution for a full-night’s sleep. On a call night, this may mean cadging one or two hours of furtive, low quality napping. Then, staying at the hospital the next day until completion of evening rounds, ending a 24- to 36-hour work day.
The problem finally occurred to me during my intern year. While admitting a child to the hospital for a routine overnight observation, alongside my senior resident, we were both awoken by the soft voice of the child’s mother saying, “Um…doctor?” She later informed us, much to our chagrin, that we had both fallen asleep in front of her. This kind of experience isn’t unique to me — it’s all too common in residency programs and in certain areas of the medical community.
In any profession, it’s nearly impossible to function on limited sleep. Sleep deprivation isn’t a life choice; it’s a disorder with severe repercussions. But this is especially true in medicine. The alternating shift work impedes the brain’s ability to perform well and we aren’t dealing with repetitive processes, but finite complex judgements involving everything from carefully dosing the correct medications to carrying out life-saving procedures.
The danger of sleep fatigue for doctors is that we don’t always feel its side-effects. In the emergency room, our adrenaline is pumping, and we feel focused. Doctors don’t dread Mondays and live for Fridays. In fact, it’s just the opposite — which can be a problem. We risk the inability to appropriately self-assess the level of mental fatigue and don’t recognize when there’s cognitive impairment, as we should.
The work-related sleep issues eventually took a toll on my personal life. I wanted to be present as a father and husband, but found extreme difficulty in sleeping during the day. I was more irritable and unable to think clearly, leaving me prone to bouts of insomnia.
So, two years ago, I decided to leave clinical medicine. After reviewing my options, I became Physician Executive and Medical Director at Accenture’s Health Management Delivery Operations team. It has proven to be one of the best decisions I have made (besides marrying my lovely wife).
Because of my normal work schedule, I have an improved work-life balance that puts my family and personal happiness as the central focus. I truly believe developing healthy sleep habits is essential to living a longer life. I still suffer from insomnia, but my sleep problem is less severe than it was before, and it’s getting better.
Science has recently revealed a great deal about the growing problem of sleep deprivation. We now know interruptions to our well-documented circadian rhythms can heighten stress, among other issues. Unfortunately, these problems continue to affect the medical community.
As a consultant with health organizations, I can see much that can be done to get smarter about sleep. Increasing the number of available physicians on staff and grouping hospital shifts so workers can set aside regularly scheduled periods of time for sleep is a good start. And improving night shift workers’ nutritional choices in hospitals and increasing the levels of light where they work is also helpful.
My experience in Accenture Operations has also shown me incredible technological advances in intelligent automation — for example, artificial intelligence, machine learning and evidence-based medicine — which could augment physicians’ work, relieving the pressure of routine tasks and freeing them up to be where they are needed most.
But more than anything, physicians should be practicing what they preach to patients about good sleep hygiene. I call on you to lower the temperature in your bedroom, turn off your cell phone at night, don’t watch TV at bedtime, eat foods conducive to sleep and avoid foods that aren’t — all good sleep hygiene practices. By taking care of ourselves as healthcare workers, we can ensure the best, high quality care to our patients.
Did you hear that? That’s the alarm for a healthier life telling you it’s time to wake up and get more sleep!