I experienced this twice, when my baby daughter was in observation after two episodes a week apart.
She recovered quickly so she was released from ER to observation for 48 hours. In those 48 hours we would see new doctors and nurses every 8 hours, explain everything again, so they wouldn't miss any details from the history, and every now and then a doctor would come up with a new theory and order studies without first consluting with a specialist in that area.
One of this theories was epilepsy, after that we went to see a neuropediatric and dismissed the theory inmediatly, even before seeing the study.
All of this was in a stable condition, I can't imagine going through the same in critical condition. So, altough I think 30 hour shifts are excesive, I can understand why long shifts are important.
My pregnant wife was bounced between clinics a few years back and subsequently spent several weeks in a hospital bed. We had the same experience of having to repeat the story every shift change (at least for the first week) and ultimately became incredibly frustrated with doctors doing rounds who would directly contradict the information provided by other medical staff or what was written in her chart.
One of the biggest lessons we took away from the whole experience was the need to be your own medical advocate (understand the health issues, pay attention to what doctors tell you, and don't be afraid to ask for clarification or challenge them if they say something that contradicts other information from a reputable source) - doctors work long hours and see many patients - it's not really surprising that they make mistakes and may miss critical information when scanning similar data sets hour after hour. Unfortunately for patients can be serious consequences to these errors.
Yes, sorry for the cliffhanger, it turned out to be allergy to cow's milk protein (most probably as it's difficult to confirm). She was 5 month's old, and the treatment was the withdrawal of cow's milk for a year, then she was able to consume it normally.
She recovered quickly so she was released from ER to observation for 48 hours. In those 48 hours we would see new doctors and nurses every 8 hours, explain everything again, so they wouldn't miss any details from the history, and every now and then a doctor would come up with a new theory and order studies without first consluting with a specialist in that area.
One of this theories was epilepsy, after that we went to see a neuropediatric and dismissed the theory inmediatly, even before seeing the study.
All of this was in a stable condition, I can't imagine going through the same in critical condition. So, altough I think 30 hour shifts are excesive, I can understand why long shifts are important.