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As an internal medicine resident in the 1980s, I essentially lived in the hospital. On ward months, we were on an every-third-night rotation such that we woke up and went to sleep at home only 1 of every 3 days. On our on-call day we admitted patients all day and all night and spent the following day caring for our patients, often with minimal sleep. We had 1 day off each month, when the “swing day” fell on the weekend.
I do not romanticize this era before the institution of duty-hour restrictions. It was very hard, and we made mistakes in our fatigued states. But handovers were a pretty minor issue because we were always in the hospital, and we took great pride in getting our patients “tucked in” so that the on-call residents could focus on their new admissions rather than the issues of our already admitted patients. If that meant staying longer, we did.
Katz MH. Mourning the Need for So Many Handovers. JAMA Intern Med. 2014;174(9):1434–1435. doi:10.1001/jamainternmed.2014.3019
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