The Catch-22 there is that a majority of medical errors occur during shift changeover. (Google will reveal an abundance of commentary / articles). In my personal experience (Medical school) the shift change's amongst Doctors could occasionally be profoundly short, unprofessional, and unregulated (think Resident handing off to Intern, in a rush, late in the evening, using a some notes hastily written on a notepad).

Importantly, changeovers often happen AFTER a 12 hour shift - makes it hard for this to directly causal of the changeover vs the tiredness.

Maybe Google's new project in the NHS will attack this problem by giving smartphones/tablets to medical staff and arranging the data in such a way to make accurate and fast changeover possible.

This is not a perfect study by any means but this was just done, it's known as the FIRST trial[1] and it looked at flexible vs standard surgical residency work hour restrictions. The conclusions were that work hour restrictions did not improve mortality or patient outcomes. There is a related study that is currently ongoing that looks at the same thing but in medical specialties.

1. http://www.nejm.org/doi/full/10.1056/NEJMoa1515724 2. http://www.nejm.org/doi/full/10.1056/NEJMe1516572

If I'm reading Table 1 of the FIRST study correctly, the comparison is between doctors working up to 28 continuous hours with those working more than that. The 28 hour mark seems so far beyond the "starting to get sloppy" threshold that I'm not surprised there weren't major differences.

By contrast, pilots are typically allowed to work for 9-13 hours in a row, and a bit longer with extra support/breaks.

Typically a nurse working 12 hour shifts will do 3 days one week and 4 days the next week.

The 7pm - 7am shift is actually EASIER then the day shift because a lot less happens. The patient is sleeping, the doctors are away, family is gone, and the test labs are closed. At that point the nurse has one job and one job only, keep the patient alive until morning (a hospitals real job is not to fix you, but to keep you alive. It's your primary's job to fix you).

Of course the ED plays by none of those rules :)

Hopefully, some of the studies showing that work detriments after 6-8 hours will spillover from select tech companies and academia to the broader market and other industries at some point.

Also, if demand is so high that they need to work such hours why doesn't the nurses compensation reflect that? Shouldn't they all be making 300k a year?

Oh, they are still working 40 hour weeks, just with a crazy schedule.