Posted on 07/14/2019 1:47:25 PM PDT by Kaslin
In the words of the acclaimed writer JoJo Jensen, “Without enough sleep, we all become tall two-year-olds.”
Many scientists have pondered the question of why sleep is of such vital importance. From an evolutionary perspective, it would be ideal if we could survive without sleep. After all, shut-eye leaves animals, including humans, vulnerable to predation.
If you travel quite frequently, you’ve probably succumbed to “first night effect,” or FNE. In simple terms, this means that many humans tend to have a difficult time sleeping during the first night in a new place. According to numerous evolutionary theorists, this reveals something interesting about the ways in which our brains function. FNE, they argue, is an evolutionary remnant rooted in our brains’ hardwired self-defense mechanisms. We sleep with “one eye open,” quite literally. It’s known as the unihemispheric effect. In new environments, we employ a 50/50 sleep system, where one half of the brain sleeps and the other half stays alert. We are on guard, primed to expect disturbances.
Why is sleep so important?
Scientists think sleep is important for two reasons. First, sleep helps repair and restore our organ systems. This includes “cleansing” our muscles, immune systems, and brains. A function of sleep is to flush metabolic byproducts and toxins from the brain -- including the beta-amyloid plaques that accumulate in cases of dementia.
Furthermore, sleep plays a critical role in memory, especially retention and consolidation. Although there is still a lot that we don’t know about the potential benefits of sleep, one thing is for sure: we simply can’t survive without it. Think about it, readers, we spend about a third of our lives sleeping -- so it must serve a function of real significance.
(Excerpt) Read more at americanthinker.com ...
That’s the truth. I was not a doctor, but there were times as a Forest Service firefighter on a category I crew when we’d do 48 or 50 hours at a stretch. We used to say that the first night was easy, but you found out who you were on the second.
but we're just the nurses...
You are not “just” nurses. But I remember in residency working 6 am til 5 pm the following day, crawling home to sleep them back at the hospital 6 am the next day. We would work 12-12-36 them repeat. My longest stretch without a day off was north of 3 months. They don’t do that anymore. Residents cannot work more than 24 in a row or 80 in a week and have to have one day a week off. More humane but I will say they aren’t as prepared leaving residency as we were. I’m not sure what the answer is.
boy I am not seeing this with interns and residents today.
Because of hosptialists, many residents have more of 12 hour schedule.
I’m not going to put patients’ lives at risk while I’m discovering myself. Even Jesus interrupted his practice and retired to a quiet place.
Anyway, I’ve run out of my last feck.
I’ll risk the dementia. Benadryl works wonders and is not addicting
diphenhydramine used regularly is suspected as a contributor to dementia.
They have limited hours. I have to say the newer grads are not as prepared but need a little more mentoring after residency. I’m not sure what the answer is. I’ve certainly seen the extremes. You know you are tired when it literally takes too much energy to fall asleep.
I tell my patients to have boring easy crosswords or word searches at bedside, the stuff one would be embarrassed to be seen doing in public, and the equivilant of the warrentee to their refrigerator to read.
Along with no phone, no computer, dark room, cool room, low lighting, no stimulants or ETOH, Some need heavy blankets for sleep, use heavy wool or quilts. The weight helps some people sleep, mimics swaddling.
for most no excercise for four hours before sleep, and no baths for they raise core temp, and the work is to cool down to sleep.
We had no choice on the hours during training. However this was before the days of hospitalists in house 24/7 and I believe we provided a real service for patients. Now as a older provider I have made the rule no one in our group can pull a 24 hour shift unless it is an emergency. Once trained there isn’t really a reason for it. But you sure learn a lot about the natural course of an illness when you spend 36 hours straight managing it. I’m sure there is a middle ground I’m just not sure where it is.
You are right, they are not as prepared. As a matter of fact, some of them terrify me. I am not sure that it is the hours worked, for I see some amazing medicos coming out of the same programs from which some pretty unprepared ones emerge. Perhaps it is the disipline.
Heck now the local Center is crowing from the hilltops that they are no longer using live animals in their training programs. So all my friends and acquainences who used animals to practice cardiac surgery now really dont have a fallback. I dont care what you do with a dummy, it is still a dummy and flesh and blood is different.
It’s like training soldiers for war
They HAVE to press their limits
When one is at the end of their ropes
One has to know how to survive, and keep going
The new interns are a bunch of weenies
Nursing students used to staff hosptials in the past. they were that competent.
Today they are going through 2 to four month internships so they can find their way to the rest room.
Daughter just became nurse. As a nurse she was not permitted to TOUCH the patients. As a CNA she did many proceudres that she was not permitted to do as a nurse.
Units stood in line to hire her.
It’s like training soldiers for war
They HAVE to press their limits
When one is at the end of their ropes
One has to know how to survive, and keep going
The new interns are a bunch of weenies
____________
There are some good ones out there, but there seems to be a different emphasis. When I was young we had a lot of the WWII docs, and the empshisis was on marching through, now there seems to be a more focus on feelings.
as a nursing student.
“feelings” will not save lives when the rubber meets the road
One other downside of diphenhydramine is of course its persistent sedative effects—which have been documented to increase likelihood of having a MVA if you are driving within 24 hrs of usage of doses as low was 25 mg. Not a good factor, given the accident statistics that have been reported for clinicians. I have vague memories of a study published about 20 yrs ago documenting higher risk in house staff driving home post-call—that reminded me of some of my motoring adventures as an intern...and I got off easy. No accidents or tickets. Just lots of impromptu naps on the way home post-call. One of my cohorts was not so lucky. He fell asleep driving home, woke up hanging upside down by his seatbelt, after having run up an embankment on a country road, hitting a phone pole, and falling back to the middle of the road with the greasy side of his Honda up, and shiny side down. He walked away. Did not get cited. His wife was PCP for the cop who showed up. But overall, not a good thing.
I have had to do this in combat and in training. In one of a very arduous training situation, I and many other leaders in my unit were subjects of a study on the effects of sleep deprivation.
Sleep deprivation occurs in both combat and in training and the SOP is to tough it out and in fact leaders are expected to do this. If you can't, you are a wimp.
What the study showed was that while you can force your body to function in a sleep deprivation environment, your brain does not play. Decision making functions crash towards zero. You appear to be alert and in control, but you are not, your brain has checked out. The implications are clear, as the leader, you are about to lead your soldiers to their death through your dysfunctional decisions. I learned this lessons in combat and therefore had disciplined myself to get sleep. The study directors did not like the fact that I figured out how to get sleep since I was the battalion commander, but those who followed the Ranger School creed could not function after a week of sleep deprivation.
Doctors experience the same culture with similar disasterous results.
Working Resident Doc's to death...isn't the answer.
... Doctors experience the same culture with similar disasterous result
My friends call it operating as a “Brainstem Prep”
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