Comin' down on the nightshift


I was contacted by the folks at RN Central about running an infographic about the dangers and errors associated with hospital night shifts.

They thought I should publish it, "since you run a site about nursing."

Since that statement is an error, and since the email was sent at night, I assume the sender had to be overworked or undertrained. That off-the-cuff assumption, it turns out, may be more rigorous than anything in the infographic.


As I wrote in an exchange with the excellent Michelle Lin, this info graphic is horrible -- proclaiming lots of undocumented "facts" that you can't be sure about (are they pulled from the pre-work-hours reform era?) and "tips" no one can follow (such as "avoid going to the hospital during Spring Break" -- what?).

Other "pearls" just reflect reality: 50-70% of hospital admissions happen at night or on weekends! Well, hey, nights and weekends make up the majority of the week.

The chart is capped it by highlighting 5 bad outcomes across the US (world?) over the past 22 years. Does that enlighten anyone? My ED alone sees 100,000 patients a year.

The thing is, I've generally been a fan of this new wave of infographics. As Steven Davidson has pointed out, charts and graphs used to be designed with journals and powerpoint in mind; today's colorful and long infographics are built for the social media / Prezi age. And through web-surfing, I've definitely come across some nicely-distilled points in various economics and political infographics. Perhaps I like those kinds of infographics because I'm not versed enough in that field to catch the simplifications or misdirections, or to mind the lack of true citations.

Still, I think an infographic should make a succinct and compelling case, like "boost overnight staffing with more experienced providers" ... this one seems to be lashing out at all kinds of problems, from overnight staffing to residency training to preventable errors, and fails to make any compelling cause/effect relationship or implementable policy recommendation.

Worse -- if I wanted to learn more about that stat, "babies born at night are 16% likelier to die" (seriously, think about how ridiculous that number is without confidence intervals or ARR) where would I go? The Halifax Medical Malpractice Lawyer Blog? (that's one of the sources, next to WSJ and NEJM).

I just can't figure out who this infographic is trying to educate or warn. I think it's mostly a promotional tool for RN central. In the process, though, it's spreading fear and confusion. Be sure to only look at the chart during the day, when the muddled thinking and errors are less likely to harm you.