Sleep deprivation due to extended work hours and circadian disruption has long been a concern in medicine. The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries. The problem is most severe for residents in training but extends to experienced physicians and nurses. Clinicians who have been deprived of sleep are part of a health care system in trouble. A report from the Institute of Medicine concluded that the system fails to ensure that patients are safe or that the quality of care they receive is high.
In this article, David Gaba and Steven Howard discuss current and proposed policies concerning clinicians' work hours and fatigue.