How Hard is Too Hard?

One of the docs and I got into a discussion about the future work ethic of the medical field. He is a well experienced MD, and is a little aghast at some of the changes in medicine happening with each passing day. He told me that new MD's have mandated naps and breaks in long 16 hr shifts, don't do surgeries the day after they are on call were a few of the "changes" that administration has put into play in an effort to reduce medical errors. His research indicated that none of these changes had made any difference in error rates over the last few years.

His question was this; when a patient goes south and it's an "inconvenient time" will the new MD's being trained today be able to deal? He sees that the work ethic is just not there. Not to say these newbies aren't driven and determined, but sometimes the only way to be ready is trial by fire. Medical training is supposed to be awful and hard and difficult with sleepless nights because when it goes badly, you need to have walked that path before. Residency is when you are worked to death so you learn how to keep surviving while there is still a safety net.

Twice this week we have had patients crater at really bad times. One had to go to surgery from 12 Am to 4AM - that MD had already put in a 12-13hr day seeing patients. The other was on the unit. That MD had finished open heart surgery 4 hrs before and ended up massaging the person's heart with his hands for an hour and 40 minutes in an effort to save the patient. This had to be done with the bare minimum of resources as it was on the unit and NOT in the OR.

The only way to be able to deal in those situations is to have been forced to do it before.
Some things are supposed to be hard. Otherwise everyone would do them.