I feel like a lot of people think that a residents life is like Grey's Anatomy....or Scrubs....or House. Well, our life is not like those shows (although I've never watched Grey's Anatomy, no one in my program is sleeping with anyone else out of wedlock, and from what I gather, that's a good portion of the story-lines). Regardless of the program or specialty, we all must bow down to the all-powerful ACGME (the accreditation board), and follow their group of rules, some of which may seem silly and may seem to stand in the way of our getting the most out of our education. The most recent big 'shake-up' in ACGME rules was the big duty-hour change that came out before my intern year, and it states....
"Duty periods of PGY1 (intern) residents must not exceed 16 hours in duration....PGY1 residents should have 10 and must have 8 hours, free of duty between scheduled duty periods....Duty hours must be limited to 80 hours per week averaged over a 4 week period."
(note: the last one applies to all years of residents)
Now duty hours are what we document....what we actually work is often much different. We are allowed to do what we want (ie. work extra hours) with our "free time," so long as it doesn't interfere with our work; for whatever reason, you may end up staying at work late (for a delivery, to finish an admit, to tie up loose ends), and your hours exceed the "allowed" time worked, but who's going to just walk out when they're in the middle of their work? I suppose some may, and that's their choice and their right, but then they end up with more stuff to do at home, or more stuff to do tomorrow, or (god forbid) 'dumping' their work on whoever is taking over (big no-no). I have no problem working long hours, and I don't mind putting in my time and even extra time; more time worked is more experience, and more experience is what EVERY resident needs.
My problem, is that I feel like I'm not allowed to admit to being tired.....EVER!
If someone asks me how I am, and I've worked six 12+ hour days in a row, with other stuff work to be done in my off time, plus regular life tasks (cleaning, feeding myself, laundry etc), and I end up sleeping only 4 or 5 hours a night, I feel like it's okay that I'm tired. But would I EVER admit that to certain people who work 'above' me (senior residents, attendings, etc)? Nope. Because then I would get the "you have no idea what tired is...." or "you have it so easy, I can't even believe you're complaining!!" or "when I was a resident we had to work 36 hours, then go to clinic, and walk to work in the snow, uphill both ways." I get it. Your life as a resident sucked. You were miserable, and my 80 hour week is a cake walk. Now don't get me wrong....some of the attendings really had it hard....they did work ridiculous hours, and there were no 80 hour work weeks. But everyone who's a resident right now has had the restriction of an 80 hour work week, just like us (true story - it was implemented in 2003.) Ours just has us working less of those hours at a time, which (if any of you are good at math) means that we get shorter chunks of time off as a result.
"How are you?"
I'm not complaining when I answer the above question with
"I'm tired."
I'm just stating a fact. If you don't want to know how I'm feeling, then don't ask me. Sure, I'm not working 30 hour shifts and then rounding on other patients. But I also don't get post-call days in the middle of the week. The only post-call day I get as an intern in our program is on a Sunday after working 3pm Saturday till 7am Sunday.....so usually I spend my whole Sunday sleeping, and then I go back to work from M-F, so essentially, I have no weekend. Again, let me state clearly that
I AM NOT COMPLAINING ABOUT THE HOURS....
(I'm trying to prevent any "you're a whiner" backlash here)
I just want to be able to say that I'm tired when I'm tired when I get asked how I am, and not get $hit all over for saying so. It's getting pretty old having to walk on eggshells and pretend that I'm feeling all puppy-dogs and rainbows when I'm exhausted (yes, believe it or not, MY 80-hour work week can be exhausting too), have work piling up, and haven't been able to do laundry or grocery shop in a week cause I have 'other things to do'. For those people who get all bent out of shape when the T word comes out of my mouth, you do realize that I didn't make the new rules, don't you? You do realize that there are a lot of interns out there that WISH they were in residency when we were working the long hours, cause that was also the time when we weren't being babysat...er, I mean supervised, at all times. Don't get me wrong, I get that the supervision is a necessity, and that's fine, but personally I would have given anything to have a chance to be on call alone as an intern without having a senior resident looking over my shoulder, watching my every move, and questioning the (usually appropriate) decisions I make (note: this is not our average senior, but it happens). When you were residents your extra hours and autonomy was a sink-or-swim sort of way of learning, so when you think of it, you guys had the opportunity to perfect your back-stroke by the end of your intern year more than we have. I would have loved that!
Bottom line: sometimes I'm tired, and if that pisses you off then I'm sorry, but I'm not sorry about that. I'm allowed to be tired. I'm allowed to say that I'm sleep-deprived. I'm allowed to nap when I'm on call and there's nothing going on, without being mocked about being 'lazy.' Every current resident has it easier than those above you, and you're allowed to complain, right? What makes you so different and special and able to process this feeling called 'tired' when I can't? Note - I can. And if you feel otherwise, then you'd better get some dip, cause you got a big 'ol chip on your shoulder.
Always remember, there are people who are reading this who have never, and will never work 80 hours a week....and sometimes, they get tired too!
**note: all the quotes are from the ACGME website, and are applicable to all residency specialties and programs**
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