Pediatric Resident Physician Fatigue Policy
- In accordance with the ACGME Common Program Requirements, the program must:
- Educate all faculty members and residents to recognize the signs of fatigue and sleep deprivation.
- Educate all faculty members and residents in alertness management and fatigue mitigation processes.
- Encourage residents to use fatigue mitigation processes to manage the potential negative effects of fatigue on patient care and learning.
- Each program must ensure continuity of patient care in the event that a resident may be unable to perform their patient care responsibilities due to excessive fatigue.
- The program, in partnership with its Sponsoring Institution, must ensure adequate sleep facilities and/or safe transportation options for residents who may be too fatigued to safely return home.
- Annually, Program Directors (or designee) will present a PowerPoint lecture from the American Academy of Sleep Medicine (or similar lecture) to all residents and hospital-based faculty. This lecture will include recognizing the signs of fatigue and sleep deprivation, strategies to manage fatigue when possible, and how to transfer clinical responsibilities.
- The resident must monitor oneself for the signs of fatigue that usually occur after prolonged periods of sleeplessness such as:
- Sluggish thought patterns, inability to concentrate.
- Inability to maintain wakeful state in the absence of external stimulation.
- Irritability, sudden anger, intolerance.
- Nausea or stomach cramps unassociated with physical illness.
- Tremors, particularly intention tremors while performing delicate procedures.
- The resident must stop and acquire rest when fatigued.
- If a resident is sufficiently fatigued to potentially impair his/her ability to perform, the resident must:
Transfer clinical responsibilities to another resident or to an attending and contact the Pediatric Chief Residents.
- If the resident cannot find another qualified person to assume these responsibilities, the supervising faculty or residency program leadership (PD, APD, Chief Residents) will make arrangements to transfer the responsibilities.
- Supervising faculty or the residency program leadership will assist with the transfer of clinical responsibilities when a resident has been identified, either by staff, other residents, or the resident him/herself, as unable to perform and all attempts to transfer responsibilities to other residents have failed.
- If a resident or his/her supervising resident or attending feels that the resident is too fatigued to drive home safely after duty hours are completed, the resident has the following options:
- Sleep in an available call room until able to drive safely.
- Alternatively, the resident can contact pediatric Medical Education (Chief Residents, PD, APD, or Program Coordinator) and a taxi or Uber ride home will be arranged.
- All efforts must be made to implement and utilize these policies without fear of negative consequences for the resident who is unable to provide the clinical work.