Doctors' Working Lives News
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Tuesday, August 31, 2004
Long hours linked to nursing errors
Ooh, interesting. A study by the University of Philadelphia has shown that nurses make more errors when they work longer hours. More specifically, they show significantly more errors when they do longer than 12-hour shifts, work overtime, or work more than 40 hours per week.
Friday, August 27, 2004
The HSJ (subscription only) also has an article on the difficulty of maintaining "goodwill as a resource" (in the words of Nigel Crisp) when under the European Working Time Directive, all goodwill will have a financial impact.
There is also a great article on impenetrable NHS management jargon.
On that topic, for anyone who is struggling with jargon-laden letters, can I direct you to the British Dialect Translator. It is really remarkable how much easier some management letters are to understand when translated into Yorkshire dialect or Cockney Rhyming Slang. Or even the Ali G Translator: "Da hostipal hat night control room sometimes can get crowded wiv peeps hangin around, so da bus' hout room would serve da purpose. 11 hours chill in 24 otherwise compensatory chill iz due. The DTI guidance iz da wicked bit hof papa."
Need I say more?
Have a great bank holiday.
There is also a great article on impenetrable NHS management jargon.
On that topic, for anyone who is struggling with jargon-laden letters, can I direct you to the British Dialect Translator. It is really remarkable how much easier some management letters are to understand when translated into Yorkshire dialect or Cockney Rhyming Slang. Or even the Ali G Translator: "Da hostipal hat night control room sometimes can get crowded wiv peeps hangin around, so da bus' hout room would serve da purpose. 11 hours chill in 24 otherwise compensatory chill iz due. The DTI guidance iz da wicked bit hof papa."
Need I say more?
Have a great bank holiday.
BMJ articles
The new edition of the BMJ has a number of useful articles and letters:
There is a very good letter on the problem of discrimination in appointing SpRs to training versus non-training/locum posts.
The latest article on doctors with disabilities is available. Includes links to other articles in the series.
There is also an article on faking it - the emotional labour of medicine.
Finally, it's definitely worth reading an article by a doctor on how a personal crisis led her to find new depths in her professional role.
There is a very good letter on the problem of discrimination in appointing SpRs to training versus non-training/locum posts.
The latest article on doctors with disabilities is available. Includes links to other articles in the series.
There is also an article on faking it - the emotional labour of medicine.
Finally, it's definitely worth reading an article by a doctor on how a personal crisis led her to find new depths in her professional role.
Wednesday, August 25, 2004
Research news
A small-scale study by Roehrs, Greenwald & Roth, published in the US journal Sleep, has shown that sleepiness can lead to poorer decision-making. Co-author Thomas Roth, PhD, told the National Sleep Foundation: "Everybody assumes that sleep loss causes car accidents because people fall asleep while driving. Our study is the first to show that accidents also can occur because (sleepy) people make bad decisions."
Local updates
Hot off the press - today's Glasgow Evening Times reports that 84% of Scottish doctors are now compliant with New Deal, up from 80% in January 2004.
Meanwhile in Wales, nurses' roles are being extended as part of the Hospital at Night rollout.
Meanwhile in Wales, nurses' roles are being extended as part of the Hospital at Night rollout.
Research update
A small-scale study by Roehrs, Greenwald & Roth, published in the US journal Sleep, has shown that sleepiness can lead to poorer decision-making. Co-author Thomas Roth, PhD, told the National Sleep Foundation: "Everybody assumes that sleep loss causes car accidents because people fall asleep while driving. Our study is the first to show that accidents also can occur because (sleepy) people make bad decisions."
Thursday, August 19, 2004
EWTD three weeks on
The Health Service Journal (subscription only) has a follow-up article on EWTD which looks at the strain hospitals are under following 1st August. According to the article, most trusts in England are generally compliant but there is a lot of fragility in the rotas, particularly when doctors go off sick. Some trusts are struggling with recruitment and others are reliant on some junior doctors signing out of the EWTD.
There are also significant problems in Scotland, Wales and Northern Ireland, particularly in small hospitals where the Hospital at Night approach is not always seen as viable. "I hate to be fair to managers," says Dr Brian Patterson, the Northern Ireland BMA chair, "but I think they'll have a hard job to make all posts compliant without help from the Department of Health."
There are also significant problems in Scotland, Wales and Northern Ireland, particularly in small hospitals where the Hospital at Night approach is not always seen as viable. "I hate to be fair to managers," says Dr Brian Patterson, the Northern Ireland BMA chair, "but I think they'll have a hard job to make all posts compliant without help from the Department of Health."
Monday, August 16, 2004
Compensatory rest form
I've added a template compensatory rest form to the downloadable documents section. Thought it might be of interest - it's been developed by various trusts in London. We're using it to track whether doctors are actually taking their rest, and to pick up on potential problems where doctors aren't getting their full 11 hours. Our local BMA office has been supportive of this but comments/suggestions would be welcome!
US survey links lack of sleep to medical error
A recent survey by Baldwin & Daugherty, reported by Psychiatric News, confirms that US residents are still struggling to get enough rest - and more significantly, it supports the link between sleep deprivation and medical error. According to PN, "Residents who got less sleep were nearly twice as likely to report they had made a significant medical error, been named in a malpractice suit, had a serious accident or injury, or had a serious conflict with other residents, attendings, or nursing staff." A validated study hopes to show whether these results are statistically significant later this year.
Anoter survey of resident physicians by Kingman Strohl also found the following:
"Residents make different choices about how to spend unscheduled time" - decreased working hours did not automatically translate into more sleep;
Lack of sleep leads to objectification of patients and "feelings of detachment from everyday life";
Residents reported that their driving also suffered when they had less sleep.
Dr Baldwin also recommended the use of napping, stating "As little as 20 minutes of sleep can rejuvenate a person for several hours". The debate continues...
Anoter survey of resident physicians by Kingman Strohl also found the following:
"Residents make different choices about how to spend unscheduled time" - decreased working hours did not automatically translate into more sleep;
Lack of sleep leads to objectification of patients and "feelings of detachment from everyday life";
Residents reported that their driving also suffered when they had less sleep.
Dr Baldwin also recommended the use of napping, stating "As little as 20 minutes of sleep can rejuvenate a person for several hours". The debate continues...
The lead editorial in the Lancet is on Professor Carol Black's comments about women in the medical profession. Medical News Today has a summary.
Wednesday, August 11, 2004
BMA handover guidance available to download
Even better! We now have a copy of the BMA/NPSA guidance on handover, so non-BMA members can download it from here. (It's also on the downloadable docs page.)We also have the official press release online. Thanks to Rachel Hooke from UHCW Trust and to the BMA Press Office.
Tuesday, August 10, 2004
New guidelines for doctors
The Royal College of Physicians have launched 12 standards of good practice to improve the continuity of care for medical patients in hospitals.
At the same time the BMA JDC and the NHS National Patient Safety Agency have launched guidance on safe handover. You will need login access on the BMA site to see the guidance document.
At the same time the BMA JDC and the NHS National Patient Safety Agency have launched guidance on safe handover. You will need login access on the BMA site to see the guidance document.
More local updates
icSurreyonline reports on changes at Epsom & St Helier to comply with EWTD, including the recruitment of 48 new doctors.
At Edinburgh’s Royal Hospital for Sick Children, there are patient safety fears after the on-site anaesthetist was moved to non-resident on call at weekends (Edinburgh News).
At Edinburgh’s Royal Hospital for Sick Children, there are patient safety fears after the on-site anaesthetist was moved to non-resident on call at weekends (Edinburgh News).
Monday, August 09, 2004
Working hours and religion
The atheist sloth ethic, or why Europeans don't believe in work
is the rather unhelpful title of Niall Ferguson's article in the Telegraph, which links the reduction in working hours in Europe to the decline of religion (and particularly Protestantism), contrasting it to the high working hours and high productivity of the more religious US.
It's an interesting if highly provocative argument, based on Max Weber's 1904 thesis "The Protestant Work Ethic and the Spirit of Capitalism". However if you're really interested, Ferguson explores this argument much more thoroughly in his 2003 New York Times article, Why America Outpaces Europe (Clue: The God Factor).
is the rather unhelpful title of Niall Ferguson's article in the Telegraph, which links the reduction in working hours in Europe to the decline of religion (and particularly Protestantism), contrasting it to the high working hours and high productivity of the more religious US.
It's an interesting if highly provocative argument, based on Max Weber's 1904 thesis "The Protestant Work Ethic and the Spirit of Capitalism". However if you're really interested, Ferguson explores this argument much more thoroughly in his 2003 New York Times article, Why America Outpaces Europe (Clue: The God Factor).
Regional updates
Junior doctors in the Forth Valley will be EWTD-compliant within weeks, reports icStirlingshire.
In Edinburgh, the Western General's emergency clinic may have to close overnight due to reductions in junior doctors' hours.
On a more encouraging note, at Bucks Hospital Trust three nurses are now operating on patients after qualifying as surgical practitioners.
In Edinburgh, the Western General's emergency clinic may have to close overnight due to reductions in junior doctors' hours.
On a more encouraging note, at Bucks Hospital Trust three nurses are now operating on patients after qualifying as surgical practitioners.
Friday, August 06, 2004
More updates on EWTD progress
The Leamington Spa Courier has an excellent article on the EWTD impact, including an interview with Hannah Tomes, a junior doctor representative from Warwick Hospital, who comments "The reality is we are not necessarily seeing an influx of doctors to fill in the time. It's quite difficult to stick to these hours. If someone is acutely unwell you cannot just say to the relatives 'it's 5 o'clock, I'm going home'."
The BMJ has a fascinating summary of compliance across Europe. Compliance in other EU countries is very variable, but even the most compliant countries (eg Italy, the Netherlands) are struggling with the SiMAP judgement, while in France, according to union leader Raphael Gaillard, "doctors are not even discussing the directive with the government as they consider it "so totally abstract that it seems inapplicable." " The Belfast Telegraph also reports fears that up to a quarter of doctors in Northern Ireland are working illegally.
The BMJ also has an editorial on the pros and cons of EWTD implementation for doctors.
The BMJ has a fascinating summary of compliance across Europe. Compliance in other EU countries is very variable, but even the most compliant countries (eg Italy, the Netherlands) are struggling with the SiMAP judgement, while in France, according to union leader Raphael Gaillard, "doctors are not even discussing the directive with the government as they consider it "so totally abstract that it seems inapplicable." " The Belfast Telegraph also reports fears that up to a quarter of doctors in Northern Ireland are working illegally.
The BMJ also has an editorial on the pros and cons of EWTD implementation for doctors.
BMA condemns overworking of SAS doctors
The BMA has spoken out against the excessive hours worked by staff grades and associate specialists. A BMA survey has shown that full-time SAS doctors work on average 73 hours a week, and that the morale of these doctors is very low.
Mohib Khan, the Chairman of the BMA's Staff and Associate Specialist Committee, has expressed concerns about these doctors being overworked as a response to the changes to hours for doctors in training. Staff grades and associate specialists are of course already covered by the full effect of the EWTD.
Mohib Khan, the Chairman of the BMA's Staff and Associate Specialist Committee, has expressed concerns about these doctors being overworked as a response to the changes to hours for doctors in training. Staff grades and associate specialists are of course already covered by the full effect of the EWTD.
Wednesday, August 04, 2004
BMA press release
The BMA has published its response to Professor Carol Black's comments about women in medicine.
More concerns over doctors' hours
The Evening Telegraph reports that a local councillor has raised concerns over junior doctors' hours at Perth Royal Infirmary. This is based on the apparent 85% compliance rate in NHS Tayside.
The Hindustan Times has an article on doctors' duty hours in the US and India.
The Hindustan Times has an article on doctors' duty hours in the US and India.
Tuesday, August 03, 2004
House change
It's house change time again and hospitals are welcoming new doctors to their first jobs. BMJ Careers Focus will be running some useful articles over the coming months and we will post links as they come up.
In the meantime here's the link again for tips on surviving your first week of nights.
In the meantime here's the link again for tips on surviving your first week of nights.
Latest news on EWTD changes
New working hours are a threat to patient care, the BMA tells the Telegraph today. Simon Eccles highlights potential problems with overuse of foreign and locum doctors to cover areas where they may not have enough experience.
North Wales Weekly News argues in favour of reducing junior doctors' hours even further as quickly as possible.
The Huddersfield Daily Examiner reports that Huddersfield Royal Infirmary are temporarily closing their neonatal intensive care unit due to the requirements of EWTD.
North Wales Weekly News argues in favour of reducing junior doctors' hours even further as quickly as possible.
The Huddersfield Daily Examiner reports that Huddersfield Royal Infirmary are temporarily closing their neonatal intensive care unit due to the requirements of EWTD.
Monday, August 02, 2004
"Too many women doctors"?
The Independent today has a front page interview with Carol Black, President of the Royal College of Physicians, which opens with the sentence: "The medical profession is in danger of losing its power and influence because too many women are scaling its ranks". Professor Black is concerned that because women choose a better work-life balance, they will not be able to take on roles which require long hours and extra-clinical commitment. However, dig a bit deeper and you'll find Carol Black is actually advocating more support to "make it possible for women to participate in everything - doing research, attending committees, influencing the Department of Health".
Explosive though the article seems at first glance, it emphasises the need for a proper work-life balance in all medical careers; if this is not possible then women - and indeed men who are primary carers - will struggle to access certain specialties and to attain leadership positions in medicine.
Explosive though the article seems at first glance, it emphasises the need for a proper work-life balance in all medical careers; if this is not possible then women - and indeed men who are primary carers - will struggle to access certain specialties and to attain leadership positions in medicine.
Update
The BMA have begun monitoring the hours junior doctors are working, reports the Guardian.
The Scotsman reports on reductions in hours and Modernising Medical Careers.
The Sunday Herald is reporting that doctors in 11 out of 15 Scottish boards will be "forced to work illegally".
SpR Jo Hilborne talks to BBC News about the difference the new regulations will make to doctors.
In other news, the Medical Journal of Australia has a study which shows that some mobile phones do cause electromagnetic interference with hospital equipment in Australia. However, "mobile phones operating at 1800 MHz [the common European frequency] appear to cause less clinically relevant EMI and need to be closer to medical equipment to affect it."
MJA also has advice on Teaching On The Run.
The Scotsman reports on reductions in hours and Modernising Medical Careers.
The Sunday Herald is reporting that doctors in 11 out of 15 Scottish boards will be "forced to work illegally".
SpR Jo Hilborne talks to BBC News about the difference the new regulations will make to doctors.
In other news, the Medical Journal of Australia has a study which shows that some mobile phones do cause electromagnetic interference with hospital equipment in Australia. However, "mobile phones operating at 1800 MHz [the common European frequency] appear to cause less clinically relevant EMI and need to be closer to medical equipment to affect it."
MJA also has advice on Teaching On The Run.
This site is maintained by Ellie Pattinson. All rights reserved. This website is maintained independently of the NHS and the views expressed are not necessarily a reflection of the views of that organisation. For any queries, contributions or amendments, please email me on admin@idwl.info.
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