The levels of continuous duty and work hours for health care personnel are much greater than those allowed in the transportation and nuclear-power industries.
In this article, the authors describe fatigue as a risk factor for impaired performance in healthcare. Residents often work long shifts back to back, with little to no sleep. The effects of fatigue have been covered in other industries, but is slow to catch on in healthcare. Limiting hours for on-duty and on-call shifts may be helpful in reducing errors, but these limits will address a symptom, not the problem. A culture change is needed that encourages physicians to get proper rest, with support from organizational policies and procedures. When the definition of a dedicated physician is based on rest rather than working long hours, the system may begin to improve.
Gaba, D. M., & Howard, S. K. (January 01, 2002). Patient safety: fatigue among clinicians and the safety of patients. The New England Journal of Medicine, 347, 16, 1249-55. doi:10.1056/NEJMsa020846