Schools of Surgery, United Kingdom.
Surgeon. 2011;9 Suppl 1:S6-7. doi: 10.1016/j.surge.2010.11.020. Epub 2011 Feb 10.
The European Working Time Directive (EWTD) 48 h working week has been law in European countries since 1998. A phased approach to implementation was agreed for doctors in training, which steadily brought down working hours to 58 in 2004, 56 in 2007 and 48 in 2009. Medical trainees can "opt out" to a 54 h working week but this has to be voluntary and rotas cannot be constructed that assume an opt out is taking place. A key component of the working week arrangements is that the maximum period of work for a resident doctor without rest is 13 h. Shorter sessions of work have led to complex rotas, frequent handovers with difficulties maintaining continuity of care with implications for patient safety. Although there has been over 10 years notice of the changes to the working week and progress has up to now been reasonable (helped, in part by a steady increase in consultant numbers) this latest reduction from 56 h to 48 h seems to have been the most difficult to manage.
自 1998 年以来，欧洲工作时间指令（EWTD）规定每周工作 48 小时在欧洲国家已是法律规定。为接受培训的医生制定了分阶段实施的办法，工作时间稳步从 2004 年的 58 小时、2007 年的 56 小时减少到 2009 年的 48 小时。医学实习生可以“选择”每周工作 54 小时，但这必须是自愿的，且轮班不能假设有人选择退出。工作周安排的一个关键组成部分是，没有休息的住院医生最长工作时间不得超过 13 小时。较短的工作时间导致了复杂的轮班，频繁的交接导致难以保持护理的连续性，从而对患者安全产生影响。尽管已经提前 10 多年通知了工作周的变化，而且到目前为止进展情况还比较合理（部分原因是顾问人数稳步增加），但从 56 小时减少到 48 小时似乎是最难管理的。
