Quarter of hospitals not ready to comply with working time directive
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7447.1034-d (Published 29 April 2004) Cite this as: BMJ 2004;328:1034
All rapid responses
New York State has laws (Bell Regulations) since 1989 which
rationalize the working conditions and SUPERVISON of resident (junior)
physicians.Sleep deprived and chronically fatigued juniors cannot safely
care for patients(Errors including deaths increase with sleep deprivation)
or readily learn. In New York State, hospitals have learned to comply
with the law or risk fines and very unfavorable publicity. Hospitals
insist that senior doctors take on greater responsiblity for patient care.
Hospitals have also been funded to hire ancillary help and utilize
computer systems to allow doctors to doctor and not spend time as clerks,
transporters,aides etc. The survey of senior physicians in England and
Wales is reminiscent of similar palaver heard from The American College of
Physicians ,surgeons, OB/GYN etc. ever since the public (government) have
demanded the rationalization of working time for residents.
Competing interests:
None declared
Competing interests: No competing interests
With droopy eyelids, walking with us like a machine,
This young Doc is attending the rounds in a dream.
He has been ‘On’ since previous morning when bright,
He was on call, up and about, didn’t sleep the whole night.
He now answers in monosyllables, understands little;
Miss-spells and miss-reads, is even slow to twitter.
His eyes are red, legs frail, brain very hot,
A little more and he will either shout or just drop.
This is not the first or the last time, that he knows is his fate;
It happens every third or fourth day and he can’t escape.
It takes two days to recover; he can then see the next date,
He’s wedded to the ‘Duty Rota’ for his career’s sake.
Seniors won’t help him for they have been through it all,
Since nobody helped them then, why now bother at all.
This is the eternal cycle through which all Docs must pass,
Like it or not, they don’t give you any choice!
Long hours prey on young Doc’s health and take their toll,
They also make him thick skinned and insensitive to others call.
He may learn avoidance techniques, not respond to some calls,
Someone definitely suffers from this mismanagement of ‘Calls.’
Now they’ve realized that our clients- the patients- do suffer,
If the doctor on call is not well-rested and doesn’t appear fresher.
If the nurses, pilots, factory workers have eight hour shifts,
Is the doctor super human to give quality in 36 hour shifts?
Now somehow though late, the wisdom has dawned,
A shift of longer than 13 hours for doctors is banned.
After the shift, for 11 hours they must rest and not work,
The quality of care will improve as 56 hours a week, law works.
Young people have been deserting Medicine as a career for long,
They may now be brought back happily, they may sing a song.
We work for the good of the patient; we don’t want any harm,
Let’s have more doctors- dedicated to serve and charm!
-------------------
Competing interests:
None declared
Competing interests: No competing interests
Triad: Working conditions, doctors' morale and well being!
Dear Sir:
This "News Roundup" is stimulating to junior doctors and may be
destimulating to senior doctors and more destimulating to hospital
administration staff and also to some governments in EU. It is a universal
phenomenon that majority of hospitals worldwide are short of doctors,
which does not mean a special catogory of doctors, here for example junior
doctors/specialist registrars, must suffer genuinely because they are
delegated work with long shift schedule affecting adversely their well
being, morale and most importantly their productivity and , delivery of
excellent health services to the clients with acute medical/surgical
problems. Now EU has come up with some reasonably good working time
directives,if changed into law will enhance the moral of suffering doctors
and their well being will improve and ultimately acute patients will be
served in a much better way. Probably, as a result of all this, overall
acute medicine supported by appropriate law will improve considerably.
From now onwards, hospital administration staff must recruit from
within or from outside i.e. outside EU the required number of competent
doctors in order to respond favourably to the European Working Time
Directive.
Reference:
Debashis Singh . Quarter of hospitals not ready to comply with
working time directive. BMJ 2004; 328: 1034-d-0-d
Competing interests:
Pro-Junior Doctors
Competing interests: No competing interests