David Oliver: Staff hydration matters more than keeping up appearancesBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l7088 (Published 08 January 2020) Cite this as: BMJ 2020;368:l7088
All rapid responses
Firstly, thank you for highlighting such an important issue. As a foundation doctor, I have experienced the struggles of 12 hour on-call shifts without adequate fluid or toilet breaks, despite being in the job for only a few months. Upon discussion with colleagues, this was most apparent during our general surgery rotation. From the perspective of a foundation doctor, I am worried as this instills feelings of despair and demotivation at such an inexperienced and impressionable stage of our career.
As you have mentioned, lack of proper hydration can lead to impaired cognition and poor judgement. I have witnessed this transpired in the form of prescribing errors, incorrect specimen labelling and inadequate documentation just to name a few.
I believe that it is the responsibility of the whole team to ensure that clinical staff are well supported. In my experience, protected break times were available and utilized for nursing staff, but doctors did not seem to benefit from this. It would therefore be useful for this time to be provided for all clinical staff.
Often, junior doctors may feel like there is not enough time to have any kind of break during a shift. There is often a worry of being reprimanded or being seen as lazy by seniors. It would be beneficial for seniors to encourage juniors to take breaks which would eliminate such feelings.
Finally, it is also the responsibility of the rota coordinator to work with clinicians to ensure that the wards/teams are adequately staffed. This is not only important to ensure patient safety but would in turn allow staff the freedom to have rest periods and therefore provide the highest quality care.
Competing interests: No competing interests