The resident physician’s and intern’s fatigue and inexperience were the cause of death according to a 1995 New York jury, Zion v. New York Hospital, 15353/85 (Sup. Ct., New York Co.) A campaign by Mr. Zion after his daughter’s death led the state of New York to set new rules limiting hours worked by residents and interns.
The Zion case has sparked much discussion about the effect of fatigue on the error rate in the practice of medicine. Other articles refer to undiagnosed sleep disorders as well as long hours, but all are saying the same thing, that fatigue contributes directly to the error rate in the performance of tasks both mental and physical.
It is not new to look at the case law in medicine and see the writing on the wall for other professions. Many well-accepted principles such as "informed consent" in a liability release began just this way. Lets suppose that this fatigue principle were to be applied to some portions of the horse industry. Would there be a problem?
A similar set of circumstances to the Zion case can be imagined at many summer camps, as well as other riding establishments with popular summer riding programs. It is a given that most summer camping staff is relatively young, often under 21. Although many horse staff have had formal training, most have simply spent quite a bit of time around horses. If they are lucky, they receive some specific safety training before the camp session opens. Hopefully, there is also on the camp staff, a senior horse person who has considerable experience and training. So far, so good.
Add to that situation the horses, the care of the horses, the riding lessons and trail rides that last for the wranglers or instructors for most of the day – then the evening care of the horses; and even counselor, cabin and campfire duties that can last well into darkness. If the horses are fed a 7 a.m. and the kids are in bed by 10 p.m. that means the horse staff has just completed a 15-hour day. This is not an unusual situation; in fact it seems to be a pervasive practice in some areas and in some types of camps and riding establishments.
Overly long hours, physical labor, and sometimes boring work all combine to give some unpleasant results:
It is hard to get good staff to come back.
It is difficult to keep the riding experience lively and fun session after session.
It is hard to stop the tiny acts of carelessness that result from fatigue.
The foreseeable accident that results from fatigue-induced negligence probably has no defense.
A solution is not impossible and the situation does not exist at all camps and riding establishments. In many cases it results from BACKWARD ANALYSIS.
Backward analysis results from beginning the analysis at the wrong end. For example, if a certain number of campers, riding students or ranch guests are expected, often that number is divided up among the existing number of wranglers, instructors, and trail guides and they are accommodated. Often this means that the staff are on their feet or on a horse long hours.
A parallel problem that should be considered at the same time is the fatigue factor of the horses. Most camping personnel will admit that the horses improve the first few weeks of camp, then they go along quite nicely, but by the end of the camping season tiny mishaps increase. It may be little things, a laid back ear, a glaring eye, a raised leg that warns, or a little buck. Sometimes it can be a real buck, or a race back to the barn. Sometimes it is marked by a real kick, a real buck, and a real race back to the barn, or a refusal to leave the barn at all. And it all happens right at the end of such a lovely summer.
How many hours are too many hours for a school horse? At what point does the horse say "That’s enough. I’ve had it!"? How can we tell the difference between inappropriate behavior that is caused by physical or mental fatigue? Every horse has a limit. Every single one. Some horses, however will shut down rather than risk inappropriate behavior. This is more a matter of intimidation than of the horse’s great heart and not something to be proud of.
A safer way to organize is from the other end. Take the number of horses available, the number of appropriate staff, the number of hours that each is expected to work and use those results to figure out how many riders can be accommodated.
This may mean that the riding school, or camp, or ranch may have to say that their sessions are full for the summer or that the guest ranch must set a limit on the number of rides and number of riders each day. It may also mean that the summer camp must decide how many children can be served safely and structure the program accordingly.
While it may be possible for clinicians to teach eight to ten hours a day (they don’t catch or even help saddle the horses.), most would not do it on a daily basis and the answer is usually the same, "I get too tired and I just can’t do a good job." When one is speaking of teaching beginners one must say, "…I can’t do a safe job."
What then would be a reasonable amount of time? At the risk of being accused of summertime heresy an eight hour day of teaching and wrangling should be sufficient. It is hard to teach eight hours straight; many professionals de not teach more than four coupled with their own riding duties. Adding an extra hour in the morning and evening to care for the horses results in a ten-hour day that should be more than sufficient if the staff is expected to be fresh and responsible, session after session.
The really grueling schedules come from the programs with many week or two-week long sessions. In these situations the wrangler’s or instructor’s work becomes dangerously repetitive. The staff are starting total beginners time after time and really don’t have the time frame to go anywhere with the lessons. However, these are the students most at risk and to whom the highest duty of supervision is owed.
The problem is further compounded by budget woes. The non-profit camps and riding establishments often have boards of directors who push the camps to supply services to an increasing number of youngsters, yet give a budget that realistically will safely accommodate only a smaller number. The rest of the summer youth riding programs also suffer budget woes. Nevertheless, they often fail to see beyond what it costs to keep a horse and how much it costs to pay a wrangler. Riding programs are extremely expensive. The horses eat every day, all year long. Each horse has to have his own equipment. The program consumes more money than it makes, yet without the horses many youngsters will not attend.
There is some information available that indicates that most students feel that they get more "horse time" if they ride twice a day for five days for thirty minutes than if they ride twice a week for three hours each time. We also have heard of programs where students ride once a day and do horse-related activities at the barn the rest of that half day, and then they go to horse-related activities or other activities the other half of the day. The so- called horse camps are under a greater burden to limit their numbers to that which can be reasonably and safely served. The other organizations may have to face the fact that it may be impossible to have safe riding as available as safe swimming.
Is there a viable way off the horns of this dilemma? Maybe, yes, maybe, no. However, overworking the staff and the horses is certainly not the answer. Without increasing the budget to add staff or horses it will be necessary to limit either the overall number of participants or the amount of time each participant is directly exposed to horses instead of horse-related activities. These are the only reasonable choices. The other choices place youngsters at risk.
Contributed By: Jan Dawson (President, AAHS)