RESIDENT PHYSICIAN FATIGUE POLICY

Goal:
To train all residents and faculty to recognize when a resident is fatigued and when this would significantly interfere with the resident's performance and potentially impact patient care.
To establish procedures to transfer clinical responsibilities when the resident's fatigue is a potential risk to the patient or others.

Policy:
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, strategies to manage fatigue when possible, and how to transfer clinical responsibilities.

The resident must monitor oneself for the signs suggestive of fatigue that usually occur after prolonged periods of sleeplessness such as:

1. Sluggish thought patterns, inability to concentrate.
2. Inability to maintain wakeful state in the absence of external stimulation.
3. Irritability, sudden anger, intolerance.
4. Nausea or stomach cramps unassociated with physical illness.
5. Tremors, particularly intention tremors while performing delicate procedures.

Procedure:
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:

1. Transfer clinical responsibilities to another resident or to an attending.
2. If the resident cannot find another qualified person to assume these responsibilities, the supervising faculty must make arrangements to transfer the responsibilities.
3. The residency Program Director or his/her designee must be notified of this transfer of responsibilities.

Supervising faculty must 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.