Doctors' Working Lives News
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Wednesday, August 16, 2006
Excessive hours "led to patient death"/Shift work proposals from RCS, BMA, HSE
A junior doctor who gave a patient a fatal overdose of insulin after working a 100-hour week has been giving evidence in a coroner's court. The incident took place in December 2003 and although the doctor was scheduled to work six 13-hour shifts, she worked over 100 hours due to extra work and swapping shifts with colleagues. The hospital involved has said that since this incident, the EWTD has come into force and was being followed. However, this case does add to existing concerns over the scheduling of full weeks of nights and/or weeks of long days.
The Royal College of Surgeons has published a policy statement on Safe Shift Working for Surgeons in Training. The RCS also has a useful EWTD page with updates and recommendations on implementing the 2009 requirements for surgeons in training.
The BMA JDC and Academy of Medical Royal Colleges have released a position statement on on call rooms which recommends that on call rooms should be retained and ideally at least two hours rest provided on a night shift (as per Murray et al's proposal in the BMJ), but that as a minimum "quiet resting areas" should be provided and EWTD/New Deal breaks enforced.
The HSE has also revised its fatigue/risk index for shiftworkers.
Website update: The Doctors' working hours section has now been updated to take account of the new flexible training pay system.
News
Rotating shift work may raise heart disease risk (Reuters)
British junior doctors in demand as Australia struggles to fill health service vacancies (Scotsman)
BMA Annual Representative Meeting: “Black hole” is opening up for 11 500 junior doctors (BMJ)
icWales reports on problems facing Wales in meeting the 48 hour target. (Also see the BBC report.)
The Sydney Morning Herald reports on the stress suffered by junior doctors and what can be done to address it.
Good doctors, safer patients: Proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patientsA report by the Chief Medical Officer. (Department of Health)
Editorial, response and letters on the regulation and revalidation of doctors (BMJ Career Focus)
Technology
Doctors test out RFID technology for handovers (E-Health Insider)
E-Health Insider also looks at optimising the radiologist's workload in view of PACS and RIS.
Research and reports
A Scottish National Prospective Study of airway management skills in new-start SHOs (BJA)
Laboratory and field studies of naps and caffeine as practical countermeasures for sleep-wake problems associated with night work. (Sleep) Concludes that naps plus caffeine improve performance and alertness on the night shift.
A Warwick University study has concluded that "More work needs to be done on effectively communicating the aims of the foundation programme to medical students and trainees" (BMJCF).
Women at greater risk from working long hours (ESRC)
Shiftwork: what health care managers need to know (Health Care Management)
When policy meets physiology: the challenge of reducing resident work hours (Clin Orthop Relat Res)
The impact of the 80-hour resident workweek on surgical residents and attending surgeons (Ann Surg)
Influence of a 30-min break on divided attention and working memory in resident anaesthetists on daily routine (BJA) This study found no clear effect of rest breaks on cognitive function during daytime work.
Post-call cognitive function and satisfaction in medical students on different call schedules: A prospective observational pilot study. (Am J Obstet Gynecol)
Adverse Events Secondary to Mistakes, Excessive Work Hours, and Sleep Deprivation (letter, JAMA)
A number of letters on Resident Hours in the Pursuit of Better Health Care (JAMA)
Tips for doctors
How to teach communication skills (BMJCF)
How to get the best out of your house officer (BMJCF). Notes that "Derogatory terms such as house monkey should be avoided".
Writing clinical records on a consultant ward round (BMJCF)
Tips on surviving in a bottleneck specialty (BMJCF)
The Royal College of Surgeons has published a policy statement on Safe Shift Working for Surgeons in Training. The RCS also has a useful EWTD page with updates and recommendations on implementing the 2009 requirements for surgeons in training.
The BMA JDC and Academy of Medical Royal Colleges have released a position statement on on call rooms which recommends that on call rooms should be retained and ideally at least two hours rest provided on a night shift (as per Murray et al's proposal in the BMJ), but that as a minimum "quiet resting areas" should be provided and EWTD/New Deal breaks enforced.
The HSE has also revised its fatigue/risk index for shiftworkers.
Website update: The Doctors' working hours section has now been updated to take account of the new flexible training pay system.
News
Rotating shift work may raise heart disease risk (Reuters)
British junior doctors in demand as Australia struggles to fill health service vacancies (Scotsman)
BMA Annual Representative Meeting: “Black hole” is opening up for 11 500 junior doctors (BMJ)
icWales reports on problems facing Wales in meeting the 48 hour target. (Also see the BBC report.)
The Sydney Morning Herald reports on the stress suffered by junior doctors and what can be done to address it.
Good doctors, safer patients: Proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patientsA report by the Chief Medical Officer. (Department of Health)
Editorial, response and letters on the regulation and revalidation of doctors (BMJ Career Focus)
Technology
Doctors test out RFID technology for handovers (E-Health Insider)
E-Health Insider also looks at optimising the radiologist's workload in view of PACS and RIS.
Research and reports
A Scottish National Prospective Study of airway management skills in new-start SHOs (BJA)
Laboratory and field studies of naps and caffeine as practical countermeasures for sleep-wake problems associated with night work. (Sleep) Concludes that naps plus caffeine improve performance and alertness on the night shift.
A Warwick University study has concluded that "More work needs to be done on effectively communicating the aims of the foundation programme to medical students and trainees" (BMJCF).
Women at greater risk from working long hours (ESRC)
Shiftwork: what health care managers need to know (Health Care Management)
When policy meets physiology: the challenge of reducing resident work hours (Clin Orthop Relat Res)
The impact of the 80-hour resident workweek on surgical residents and attending surgeons (Ann Surg)
Influence of a 30-min break on divided attention and working memory in resident anaesthetists on daily routine (BJA) This study found no clear effect of rest breaks on cognitive function during daytime work.
Post-call cognitive function and satisfaction in medical students on different call schedules: A prospective observational pilot study. (Am J Obstet Gynecol)
Adverse Events Secondary to Mistakes, Excessive Work Hours, and Sleep Deprivation (letter, JAMA)
A number of letters on Resident Hours in the Pursuit of Better Health Care (JAMA)
Tips for doctors
How to teach communication skills (BMJCF)
How to get the best out of your house officer (BMJCF). Notes that "Derogatory terms such as house monkey should be avoided".
Writing clinical records on a consultant ward round (BMJCF)
Tips on surviving in a bottleneck specialty (BMJCF)
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.
