All Articles by T. A. McNamee, MD
Dr. McNamee is an associate professor and internal medicine residency program director at Sanford School of Medicine of the University of South Dakota.
Sleeping on the Job – A Program Director’s Take on IOM Recommendations
I’ve been thinking about sleeping a lot lately. Not in the sense of curling up under the blankets for hours on end, but in the sense of thinking about the topic of sleeping. As the program director of an internal medicine residency program, one of my jobs is to make sure that my residents are rested enough to provide appropriate patient care. I was under the impression that they were. But recently, the Institute of Medicine (IOM) came to the conclusion that many residents are still sleep-deprived, posing a threat to the safety of patients under their care across the United States. Based on this conclusion, the IOM made the bold recommendation that after 16 hours of continuous work, residents must be allowed an uninterrupted five hour block of time for sleep, preferably between the hours of 10pm and 8am.
Sometimes It’s Good to Be Cold – Therapeutic Hypothermia
The upper Midwest has been besieged by a bitter cold front for the past several days. Chicago recently reported wind chills of 30 degrees below zero, and several locations in North and South Dakota posted high ambient air temperatures of several degrees below zero, without wind chill. Though not exactly what most would consider desirable temperatures, cold temperatures, and more specifically hypothermia, have played an interesting role in health care. In its infancy, induced hypothermia was used primarily for amputations, in the hopes of providing some pain relief before the era of anesthesia. More recently, hypothermia has shown benefit in several areas, including the following:
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