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Study: More likely to die of a heart attack at night - 2/23/2008 6:55:39 PM

cyberdude611

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Well, a new reason to refer to it as the "graveyard shift."
If you are having a heart attack...just hope it doesnt happen at night. A study shows hospitals may not be well equipt to respond properly to a cardiac arrest during the night and your chances of dying are higher.

Researchers say the reason is because hospitals usually go down to a skeleton crew at night and the staff that is there is prone to fatigue and is not as experienced as the hospital's day shifts. It is also correlated with weekends. The absolute worst time for a heart attack is the early hours of a Friday or Saturday night.

The study is based on 85,000 cardiac arrest incidents across more than 500 hospitals in a 7 year period. They are recommending hospitals re-evaluate how the assign their shifts.

http://health.yahoo.com/news/ap/night_code_blue.html

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RE: Study: More likely to die of a heart attack at night - 2/23/2008 6:58:15 PM

kittinSol

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quote:

ORIGINAL: cyberdude611

Well, a new reason to refer to it as the "graveyard shift."
(...)

Researchers say the reason is because hospitals usually go down to a skeleton crew

A sure sign of things to come.

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RE: Study: More likely to die of a heart attack at night - 2/23/2008 7:20:14 PM

cyberdude611

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Yep. With socialized healthcare, the staffs are likely to get lighter and less paid. According to this study....that is correlated with increased deaths of cardiac arrest.

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RE: Study: More likely to die of a heart attack at night - 2/23/2008 7:55:39 PM

wkdshadow

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It also doesn't help that for a good portion of the night, most people are laying down and at rest. When you're at rest, your blood naturally is moving slower. Pulmonary edema is more likely, and the decreased bloodflow leads to platlets clotting more readily which of course leads to issues such as strokes and thrombosis.

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RE: Study: More likely to die of a heart attack at night - 2/23/2008 11:16:26 PM

thompsonx

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quote:

ORIGINAL: cyberdude611

Well, a new reason to refer to it as the "graveyard shift."
If you are having a heart attack...just hope it doesnt happen at night. A study shows hospitals may not be well equipt to respond properly to a cardiac arrest during the night and your chances of dying are higher.

Researchers say the reason is because hospitals usually go down to a skeleton crew at night and the staff that is there is prone to fatigue and is not as experienced as the hospital's day shifts.
The article does not say this. The article does speculate as to the cause but does not draw any conclusion. Why do you presume to do so?

It is also correlated with weekends. The absolute worst time for a heart attack is the early hours of a Friday or Saturday night.

The study is based on 85,000 cardiac arrest incidents across more than 500 hospitals in a 7 year period. They are recommending hospitals re-evaluate how the assign their shifts.
I read both the Yahoo article and the JAMA article and this was not there.

http://health.yahoo.com/news/ap/night_code_blue.html

(in reply to cyberdude611)

Post #: 5

RE: Study: More likely to die of a heart attack at night - 2/24/2008 5:05:06 AM

LadyEllen

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Friday night and Saturday night are the busiest in UK ERs - thats when all the drunken idiots get brought in - well, the ones who dont stab the ambulance crew anyway. Thus they are the times when more staff are on duty, including security staff to cope with those who didnt stab the ambulance crew but want to attack the nurses and doctors.

E

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 5:13:00 AM

MissMorrigan

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I guess that would depend on town/city, Lady Ellen. Worthing, for instance, is pretty quiet at weekends, they get a few drunken yobs causing problems, but on the whole it's low-key. Brighton, on the other hand, is immensely busy and it matters not what time of the day a person is taken in, they can expect a full staff. What IS alarming though, and which needs addressing, is that it doesn't matter how many staff are on duty, but whether they are trained at using the equipment on hand, and indeed, whether correct life-saving equipment is on hand. I was in a ward, some years ago, when a person was on their way to the lavatory and had a cardiac arrest. Not only was it difficult for the nurses to get access to specific equipment, but none of the three present knew how to operate it and while figuring it out, the person died infront of me. So, A & E is pretty specialist and well-prepared, but that is little-good to the rest of the hospital and its wards.

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 5:28:48 AM

LadyEllen

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Hi MissM

My friend is a nurse and she said that one of the issues theyre uncertain about these days is the move towards training them to do things which normally only a doctor would do. Ostensibly, this is meant to be career development, but it seems more apparent that its about there not being enough doctors, and nurses are cheaper and more plentiful - apparently for all these added abilities and so responsibilities (and so liabilities), the nurses get no additional pay.

But youre on to something - when we have equipment to counter heart attacks installed in many public buildings (the zappy thing whose correct name I cant recall since I cant stand "Casualty"!), it seems a little odd not to have it on hand in hospital wards too?

E

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 5:39:32 AM

wkdshadow

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Defibrillator.

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 6:33:24 AM

MissMorrigan

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Hi Lady Ellen, I think, fundementally, that it's not unreasonable to expect a nurse to be able to operate the equipment should it be available to them. I do understand that's not really feasible with more specialist equipment such as a defib, although it would be ideal if all nurses had to undertake a short course in equipment operation. It's pretty alarming that a ward does not have quick access to such equipment and even if they did, to have nurses untrained in how to operate it... I even witnessed nurses attempting to figure out the instructions for a basic suction device when a patient in their charge ran into difficulties - this was at night, although I'm loath to believe that the day duty nurses would have been more adept at being able to operate it either.

I do not, for one moment, place blame on the nurses, I can only imagine how impotent they must feel at times. The blame lies solely with the lack of resources and an already over-stretched NHS, and general mismanagement.

The thing with nurses being cheaper and more plentiful is that many of our nurses are heading abroad to places such as Australia/New Zealand b/c our government is failing them, and we are hiring many from the Philippines/Zimbabwe, etc... and while I do not object to that per se, I do object to overseas nurses not having refresher courses prior to working in the UK's hospitals/Nursing homes, etc... My last job, in the health sector, was as an administrator and part of that was processing accidents/complaints, and it was not untypical for overseas nurses to be 'confused' regarding needle gauges, sterile/unsterile gloves, even how to properly clean a tracheostomy tube. This, to me, should be covered in BASIC nursing training and it seems it isn't.

quote:

ORIGINAL: LadyEllen
My friend is a nurse and she said that one of the issues theyre uncertain about these days is the move towards training them to do things which normally only a doctor would do. Ostensibly, this is meant to be career development, but it seems more apparent that its about there not being enough doctors, and nurses are cheaper and more plentiful - apparently for all these added abilities and so responsibilities (and so liabilities), the nurses get no additional pay.

But youre on to something - when we have equipment to counter heart attacks installed in many public buildings (the zappy thing whose correct name I cant recall since I cant stand "Casualty"!), it seems a little odd not to have it on hand in hospital wards too?

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 6:34:52 AM

thompsonx

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quote:

ORIGINAL: cyberdude611

Yep. With socialized healthcare, the staffs are likely to get lighter and less paid. According to this study....that is correlated with increased deaths of cardiac arrest.

The OP must have read the article incorrectly or perhaps not at all. The article in JAMA does not say that and does not speculate as to what would happen to staffing levels or pay rates in the case of socialized health care. There is however a quote in the Yahoo article that is not in the JAMA article and whether it reflects some discussion the Yahoo author had with the research team or "poetic license" is anyones guess.

thompson

< Message edited by thompsonx -- 2/24/2008 6:36:22 AM >

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 6:44:42 AM

LadyEllen

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Totally agree MsM

Although I do object to the insourcing of nurses from countries who need them, and may have paid to train them, simply because our lot cant manage their way out of a wet paper bag and our people leave as a result. The recent programme where the leading businessman came in to a hospital to try to get it running more efficiently, really said it all I think - people far more concentrated on administrative procedures at whatever cost to the purpose of the hospital.

If we imagine a hospital is a factory, which takes in ill people as raw materials and outputs healthy people, then it would seem that instead of being focussed on the market and producing what is required, the management spend most of their time counting paper clips and auditing how the count was done according to policy document blah blah, and then discussing this as if this was the purpose of the business.

E

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 6:51:04 AM

pahunkboy

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i had a neighbor who died BEFORE the intense winter that year. he did want to shovel snow.lol

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 7:01:12 AM

velvetears

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i also think it depends on the hospital. If it is a major metropolitan medical center i doubt it matters. If it is some country bumpkin hospital then it probably is a factor.

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RE: Study: More likely to die of a heart attack at night - 2/24/2008 7:02:14 AM

MissMorrigan

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What I find perplexing to say the least, in this day and age with MRSA running rampant and mutating strains cropping up, nurses AND doctors are still ignoring basic hygiene. I was in Brighton Sussex County when I almost popped my clogs in recent years as I had quinsy and it closed my airway to the point I had to be intubated, and then an emergency operation to whip the affected tonsils out. A few hours after my op and while I was fully awake and aware of what was going on around me, a nurse came to check on me, directly after she had finished changing the dressing of a lady in the next bed to me, she then straightened her bed out, moved the woman's plastic cup out of the way and then came over and attempted to put her hands on me. Some may say I overreacted, but I refused to allow her to touch not only me, but my bedding, my charts, my bedside table, etc... until she had washed her hands and used the gel which was actually in position at the foot of my bed - and often ignored even by the consultant/doctors. The only person during my stay that did observe basic hygiene was a young male doctor who initially attended me, and who came to visit me later on after my operation to see how I was.

It's a piss poor day when the hospital cleaner, that has just finished removing the defecation from the door of the ward toilet from some poor bugger that had diarrhoea, and then cleaning the whole ward, goes on to then serve the lunches and beverages! I wholly recommend a hospital stay to anyone considering weight loss. I did write to the hospital's management to complain, I never received the courtesy of a reply.

To improve hospital conditions the entire management structure must come under review before any changes are implemented and my way of thinking is that if nurses are ignoring basic infection control/hygiene, it stands to reason they arent going to be on the ball when it comes to operating equipment but then, again that's a management issue.

< Message edited by MissMorrigan -- 2/24/2008 7:04:08 AM >

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The Tooth Fairy who teaches kids to sell body parts for money.

A free society is a society where it is safe to find one's self unpopular and where history has shown that exceptions are not that exceptional.

(in reply to LadyEllen)

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RE: Study: More likely to die of a heart attack at night - 2/27/2008 12:57:27 AM

wkdshadow

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I just thought I'd link http://uploads.ungrounded.net/357000/357557_acci.swf

It explains things well.

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RE: Study: More likely to die of a heart attack at night - 2/27/2008 1:24:35 AM

MissMorrigan

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Hah! thank you for that, "A study that shows studies are a complete waste of the taxpayer's dollars!" I would say they're a useful inclusion as toilet paper, but then, hospital administrators would likely start using them as...

Post It Notes!

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A free society is a society where it is safe to find one's self unpopular and where history has shown that exceptions are not that exceptional.

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RE: Study: More likely to die of a heart attack at night - 2/27/2008 2:20:52 AM

PanthersMom

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why should this surprize anyone? not only are hospital staffs overworked but rescue services are as well. family members may be unreachable if the patient cannot get to them easily, a whole host of problems can interfere with one's chances for survival. many patients just die in their sleep. it happens, we all have to go one way or another.

PM

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RE: Study: More likely to die of a heart attack at night - 2/27/2008 2:56:24 AM

MissMorrigan

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It's only surprising insofar as the continuance of mismanagement.

It's not unfeasible for people to expect that once they have reached the appropriate healthcare environment that the least they can expect is one which will observe basic hygiene/infection control. While we all have to go sometime, being riddled with MRSA as a result of a minor procedure is not a pleasant or just way to go.

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The Tooth Fairy who teaches kids to sell body parts for money.

A free society is a society where it is safe to find one's self unpopular and where history has shown that exceptions are not that exceptional.

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RE: Study: More likely to die of a heart attack at night - 2/27/2008 6:55:01 AM

thompsonx

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quote:

ORIGINAL: PanthersMom

why should this surprize anyone? not only are hospital staffs overworked but rescue services are as well.

PM

Just curious as to how you came to this conclusion?
thompson

(in reply to PanthersMom)

Post #: 20

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