Faculty and residents should be alert for signs of fatigue among housestaff. These signs include falling asleep, irritability, apathy, and careless medical errors. When faculty and residents observe these signs, the houseofficer should be questioned about sleep loss and fatigue. Brief counseling should be provided if a sleep deficit is identified. This counseling may include information about naps, use of caffeine, and good sleep hygiene. If the symptoms continue, referral to the chief residents or program director should occur.
If the houseofficer's fatigue symptoms at any point are sufficient to jeopardize patient care, the houseofficer or attending physician discovering the problem should consult immediately with other members of the team or with the chief resident or program director so that the houseofficer may be immediately relieved of duty. Patient care should then be delivered by other members of the team or by another houseofficer designated by the chief residents. All housestaff must complete the “Resident Fatigue Training Module”.