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One of the big problems during the pandemic was the stress caused by healthcare employees having to constantly work overtime to meet the huge spike in hospital patients infected with the virus. This overtime can be resolved in three ways:

  1. Reducing the number of Covid cases - via lockdowns or vaccinations. This was done by almost every nation, with various degrees of effectiveness.
  2. Increasing the number of healthcare workers. This could be done by increasing the number of medical schools or via immigration.
  3. Limiting the number of hours that each healthcare worker can spend on the job.

Did any nations implement option 3, either during the pandemic or sometime prior? Obviously this would increase the mortality rate in hospitals as patients would get less care or wait longer to be admitted, but at the same time such a policy would prevent burnout and ensure doctors and nurses don’t quit en masse due to the stress of working during a pandemic. For an example of such a policy outside the medical field we can look at truck driver regulations. Truckers are only allowed to work a certain number of hours per day, must take breaks often, have a mandated period for sleep, etc. Similar regulations exist for pilots.

I do imagine hospitals already have limits of some kind based on human physiology as most people cannot stay awake for more than 72 hours at a time but those limits are clearly beyond what would be required for a healthy work environment, judging by how overworked doctors were during the pandemic. An ideal policy would probably limit any individual healthcare worker to 12 hours per 24 hour period and at least 1 day of complete rest per week, with no exceptions for surges of patients.

Note that this a question of Politics as such a regulation would go against modern norms of medicine and would require a lot of political capital to push through.

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    The EU working time directive was supposed to achieve this, but under NHS rules doctors are not allowed to leave while they know a patient is at risk, which often turns a 12 hour shift into a 15 hour shift. And hospitals average out the hours worked across a period, which includes two weeks of annual leave valued at “0 hours worked”, bringing “illegal” working weeks back into legality. Is this the sort of thing you are looking for? If so, I will write up a fuller answer.
    – user16741
    Oct 31 '21 at 8:39
  • @Moo yes something like that. I’m curious if any attempts are made to close these loopholes. Oct 31 '21 at 15:38
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    Close? No. Make doctors feel worthless, devalued and add even more work to their workload? Yes. I could write an entire diatribe on how the Tory government has tried to diminish doctors over the past decade if you would like - even including how the suicide rate amongst doctors is significantly higher than the national average.
    – user16741
    Oct 31 '21 at 20:17
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    @quarague I have no knowledge of European countries in this area, but I have extensive knowledge of how the NHS screws over its staff, particularly doctors. Its why we no longer live in the UK and why my wife no longer works as a British doctor - we are much better off in NZ. And thats the outcome - a general exodus of doctors from the UK has been growing for about the past 5 years, with no signs of slowing (other than borders closing elsewhere). The NHS is losing its staff because of the way it treats them.
    – user16741
    Nov 1 '21 at 18:43
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    I changed your title to "work hours" since that is what you are asking about. "Workload" could include patient ratios, which are regulated in some places, but you don't ask about. Nov 2 '21 at 17:43
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The limit on resident doctor hours in the US is (and has historically been) as follows:

They compared the outcomes for patients of two groups of physicians: those trained before 2003, when the typical work week was 100 hours; and those trained later under the new rules, which capped weekly hours at a mere 80, with no individual shift exceeding 30 hours. . . . Since 2017, when the latest reform was implemented by the Accreditation Council for Graduate Medical Education, the cap remains 80 clinical and educational work hours per week averaged over a four-week period, with no shift exceeding 28 hours.

This is generally not a function of statutory law and is instead imposed by medical professional organizations as an accrediting standard for institutions to be eligible to participate in medical resident placements (something over which there is a de facto monopoly that gives the standards some bite).

While a typical nurse works four tens (four ten hour shifts a week) or three twelves (three twelve hour shifts a week), or five eight hour shifts a week, in ordinary times, this isn't a maximum. Nurses (unlike resident doctors who are salaried and don't receive overtime pay) are generally hourly workers who are entitled to time and a half over forty hours a week. Legally, at the national level:

At present, there are no restrictions on the number of hours a nurse may voluntarily work in a 24-hour or a 7-day period in the United States.

Some states have different rules, however.

For example, Alaska limits nurses to fourteen hour shifts followed by at least ten hours off from work. There are exceptions for: school nurses along for a prolonged field trip or event, long medical transport flights or very long single medical procedure, act of terrorism, a disease outbreak (i.e. now), a natural disaster or major disaster, when an unforeseen event such as weather not forecasted ahead of time causes a scheduling issue, a temporary staffing emergency at a rural facility, a federal government employee, or a tribal employee.

At least seventeen other states, like Alaska, also have restrictions on mandatory overtime. California, for example, limits nurses to twelve hours in twenty-four outside of "an emergency." Variations on this theme of twelve hour shifts in normal circumstances are common. Limits on imposing hours in excess of those originally scheduled are also common.

Studies that resulted in the modest reduction in resident doctor hours have shown, unsurprisingly, that excessive hours worked greatly increases the risk of medical malpractice.

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    Interesting, so looks like the root cause of the problem is "emergency" exceptions. I'm assuming whoever wrote these laws/regulations didn't imagine an "emergency" lasting for 1.5 years... Nov 2 '21 at 0:12
  • @JonathanReez That is a fair conclusion although I don't have a deep enough knowledge of what is going on at ground level and in the details of these regulations to say so confidently.
    – ohwilleke
    Nov 2 '21 at 0:16
  • Related (cosmetic surgery placed on hold by Colorado's Governor statewide due to hospital overloading from COVID) denverpost.com/2021/11/01/…
    – ohwilleke
    Nov 2 '21 at 0:17

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