Colorectal Surgery Resident Manual

FATIGUE

Acute and chronic sleep loss can substantially impair physical, cognitive, and emotional functioning in human beings. Overworked residents report sleepiness tendencies that are equivalent to those found in some clinical populations of patients with sleep apnea or narcolepsy. After one night of missed sleep, cognitive performance may decrease by as much as 25%. Sleep debt tends to accumulate until enough catch up sleep is obtained. Chronic sleep loss results in lower cognitive and fine motor performance, and negative effects on mood, motivation, life satisfaction and on professional and personal relationships. Fatigued drivers are at higher risk for accidents and near accidents.

It is the policy of SIU that all duty hours must be consistent with ACGME requirements. Programs are responsible for monitoring resident activities to ensure that resident fatigue does not contribute to diminished learning or detract from patient safety. Residents can help by ensuring that they get enough sleep during their off hours and by monitoring themselves for the following signs of fatigue:

1. Sluggish thinking or inability to concentrate.

2. Inability to stay awake in the absence of external stimulation.

3. Irritability.

4. Tremors.

A resident experiencing any of these symptoms must immediately get some rest. The most effective strategy to counter fatigue is sleep. Even a short nap can temporarily reverse the impact of sleep loss. Any resident who is experiencing these symptoms or feeling overly fatigued at the end of his or her work day should take a short nap before driving home or catch a ride with a coworker or taxi.

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