Naps! Emergency medicine doctors should take naps! We haven’t been this thrilled about our career track since the introduction of handheld lasers for the ER. But a new study out of Stanford shows a brief nap toward the end of an overnight shift improved doctors’ and nurses’ skills and, um, disposition:
To determine just how much a nap would help alleviate sleep deprivation, researchers recruited 49 subjects – 24 nurses and 25 doctors – who worked through the night from 7:30 p.m. to 7:30 a.m. in the emergency room at Stanford Hospital. They divided the subjects into two groups. One group worked straight through the night as usual, while the other subjects were allotted a 40-minute nap break at 3 a.m. in the middle of their shift.
“They fell asleep really fast,” said Smith-Coggins. “Half fell asleep in less than 10 minutes. They were tired!”
At the end of their shift at 7:30 a.m., both groups underwent a series of tests including a 40-minute simulated car drive, a 10-minute written memory recall test, a computer-based I.V. insertion simulation and a questionnaire developed by NASA that measured different mood states including anger, confusion, depression, fatigue, tension and vigor.
The nap group scored fewer performance lapses, reported more vigor, less fatigue and less sleepiness. The doctors and nurses who napped also tended to complete more quickly the simulated intravenous insertion, and they were safer drivers in the tests.
The research was apparently conducted by a sympathetic leader in the field:
“I’ve been really worried about physicians,” said Smith-Coggins, whose research has focused on sleep deprivation and its effects on health-care workers for the past two decades. “Everyone was complaining around me, ‘I’m so tired.'”
…many of those without naps would “crash over and over again” in the driving simulations, Smith-Coggins said. Their cars would often leave the road or collide with oncoming vehicles. “I felt so badly after seeing how tired they were.”
One of the study authors has already implemented naptime in his ER. Now we just need a place to crash…
More from Dr. Smith-Coggins…
