Doctors' Do Not Give Pain Relief Because of the Night Shift, According to a Study

Doctors' Do Not Give Pain Relief Because of the Night Shift, According to a Study ...

A new research suggests that physicians are less likely to prescribe pain medication after a long night shift than they were at the start, perhaps indicating a decreased empathy for patient pain when physicians are themselves worn out.

Researchers behind the study are urging hospitals to do more to manage the schedule and the workload of health professionals, so that clinical decisions aren't influenced by fatigue in this manner.

Researchers believe that even educating physicians about possible bias at the end of their shift may be helpful. More stringent guidelines for the prescription of pain medications might also be helpful in ensuring patients receive the treatment they need.

"Our conclusion is that night shift work is an important and previously unrecognized source of pain management, likely due to a diminished perception of pain," according to psychologist Anat Perry from the Hebrew University of Jerusalem in Israel.

"Even medical professionals who strive to provide the best treatment for their patients, are susceptible to the effects of a night shift."

31 resident physicians in Israel were just beginning their 26-hour shift, and 36 were about to complete their 26-hour shift. They were given devised scenarios depicting a female patient with a headache and a male patient with backache.

In these hypothetical situations, those who came off their shift rated the pain of the patients as less severe, and were less likely to prescribe analgesics to relieve pain. It would seem that fatigue plays a role in making a determination about how much another person is suffering, and therefore the kind of therapy they need.

Physicians were 2030 percent less likely to prescribe pain medication during a night shift, according to the survey.

According to pediatric pulmonologist David Gozal of the University of Missouri School of Medicine, the fact that the variation in analgesic prescription from the general World Health Organization recommendations is greater during night shifts suggests that there is indeed an under-prescription during night shifts rather than an over-prescription during daytime.

Researchers claim that the bias remained after controlling for the intensity of pain reported, the demographics of patients and doctors, the severity of the complaint, and variations in emergency departments.

Pain is one of the most common reasons to seek treatment, and almost 60 percent of US adults have experienced pain in the last three months, so it's critical to ensure it's managed effectively and prevented from developing where possible.

Night shifts are now allowed to be added to a long list of studies that demonstrate how detrimental night shifts can be if not properly managed.

"These findings underscore the need to address this bias by developing and implementing more comprehensive pain management guidelines and by educating physicians about this bias," says Gozal.

The investigation has been published in PNAS.

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