Junior doctor Died on Call In hospital

drzhivago

I know a lot of docs read these posts
I was wondering had any of you heard of a junior doctor who died on call in a hospital in the North east recently

sad story but seems to be very quiet why would this not have made the news
Could it have had anything to do with his long working hours

Will there be an investigation of his work schema, workload etc

I heard he was a non national doctor so he may not have nay family here or anyone asking these questions on his behalf now

Jane5

I had heard of this as well. Many docs have suffered cardiac events in their 20s and 30s in Ireland as a direct result of workiong extended shifts-NOT long weekly hours for any non medics reading, but extended shifts, ie. shifts that go on for longer than 30 hours straight and up to 60 something with no sleep or meals.
I have personally known of several docs who suffered arrhythmias requiring treatment, one in his late 20s who developed a.fib after 56 hours on duty and was warfarinised. One who dropped dead, two who committed suicide and another who died in bed, all in their twenties. There have been many, many RTAs involving docs post call and some have been serious or fatal.

Svalbard

Jane5 wrote: »

I had heard of this as well. Many docs have suffered cardiac events in their 20s and 30s in Ireland as a direct result of workiong extended shifts-NOT long weekly hours for any non medics reading, but extended shifts, ie. shifts that go on for longer than 30 hours straight and up to 60 something with no sleep or meals.
I have personally known of several docs who suffered arrhythmias requiring treatment, one in his late 20s who developed a.fib after 56 hours on duty and was warfarinised. One who dropped dead, two who committed suicide and another who died in bed, all in their twenties. There have been many, many RTAs involving docs post call and some have been serious or fatal.

I have heard of similar stories.
A friend started to develop SVT (an irregular heart beat) while on call. It happened a few times, always when she had been working more hours straight than non-medics could comprehend as feasible. She had to keep working, of course!
She never had it before.
Between cardiac arrhythmias, RTAs, depression, exhaustion and forcing ill and heavily pregnant doctors to work inhumane hours we deserve our current pay & entitlements and danger pay at least!!

drzhivago

Svalbard wrote: »

I have heard of similar stories.
A friend started to develop SVT (an irregular heart beat) while on call. It happened a few times, always when she had been working more hours straight than non-medics could comprehend as feasible. She had to keep working, of course!
She never had it before.
Between cardiac arrhythmias, RTAs, depression, exhaustion and forcing ill and heavily pregnant doctors to work inhumane hours we deserve our current pay & entitlements and danger pay at least!!

am more concerned here because the chap may no have family or relatives here and that he may have died anonymously

The only concern in the hospital is likely to be who will do his on call work now he cant

Valmont

holy moly I never knew doctors had it so bad. Do the long shifts not contravene labour or union laws?

tallaght01

Valmont wrote: »

holy moly I never knew doctors had it so bad. Do the long shifts not contravene labour or union laws?

Yep, it contravenes the European Working Time Directive, but the government just pays the fine for breaking the rules every year, as far as I know.

Cheaper than paying to train more docs, I guess.

Capt'n Midnight

it's not a temporary problem either , it's being going on as long as I can remember

in the past Junior Doctors got less pay for "overtime" than normal time so the incentive was to work them as hard as possible

I'm pretty sure if they got the same overtime rates as other workers the hospitals would be able to take on more of them as it would be cheaper.

of course there are times when people in the health service need to work long hours because there more patients etc. , but that time is shouldn't be from before they were born till some distant time in the future

Has there ever been a formal study of number of people who have been mistreated because a Doctor was physically incapable of being as alert as one would have a right to expect ?
How do these statics compare to the North where I assume doctors only have to work 56 hours a week with an 11 hour break in every 24 hours ?

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1174715

BMJ. 1999 June 26
The country's junior doctors were furious after the recent decision by the European Union to defer the implementation of a 48 hour working week for 13 years. They currently work an official week of 65 hours but regularly work 100 hours or more, including non-stop shifts of 72 hours

:mad::mad:

drzhivago

tallaght01 wrote: »

Yep, it contravenes the European Working Time Directive, but the government just pays the fine for breaking the rules every year, as far as I know.

Cheaper than paying to train more docs, I guess.

There have been no fines yet from Europe

Docs on ground reluctant to take their employers to court

Law broken every day by almost every doc on multiple sections

If the law was enforced hospitals would have to close and the employers use this as reverse spin pressure among the other staff too " you dont want to be responsible for all these people losing their jobs do you" was a quote I particularly remember

Wont hire more docs, anti government policy
They actually want to reduce junior docs and employ consultants, in short term that will mean even longer hours of the juniors until they get enough consultants, catch 22 gain

EXAMPLE

Small hospital 40 junior docs, 8 consultants, do you really think they are going to swing teh ratio the other way round and have 40 consultants, I doubt it. If you live near a small hospital get a deal with someone who has a helicopter if you want to get to a hospital in a hurry

Svalbard

drzhivago wrote: »

The only concern in the hospital is likely to be who will do his on call work now he cant

You know it. I bet Medical Manpower contacted the team to tell them they have no rights to compassionate leave to attend their colleagues funeral and that no locum would be provided.

Valmont wrote: »

holy moly I never knew doctors had it so bad. Do the long shifts not contravene labour or union laws?

Yes. Calling it slave labour is not too much of a stretch.

localhothead

jesus christ - this is incredible - seriously -

is a banded together show of strenght not going to help ?

youve got to do something - your people are dying because of it - holy fcuk !

drzhivago

localhothead wrote: »

jesus christ - this is incredible - seriously -

is a banded together show of strenght not going to help ?

youve got to do something - your people are dying because of it - holy fcuk !

Nope
People have been getting sick and dying for a while
No one really cares

went to a funeral at the weekend 42 yr old doc, died in UK, sudden death, nothing suspicious, but she served many years here too before she left

On a different note The numbers of suicides in the last 10 years is well above average for an age matched population, the number of marriage break ups and the rate of cardiac disease

For a supposedly intelligent group we are not doing ourselves justice

luckat

That's what unions are for...

Apart from anything else, from the patients' point of view it would be much better to have two doctors working 40 hours each than one doctor working 80 hours.

Valmont

Surely something could be done? Maybe this explains why a doctor missed a 5 inch crack on my skull looking at an X-ray just like Dr. Hibert in the Simpsons. Seriously though these hours must affect both patients and doctors alike. I have a new found respect for doctors knowing the conditions they work in.

DrIndy

The reason i was happy to stick things out so far is I'm a Type A personality and a workaholic - i genuinely love my job.

But my personal life is very curtailed in balance compared to everyone else - these things i am sure will become more important as the years go by.

luckat

DrIndy wrote: »

The reason i was happy to stick things out so far is I'm a Type A personality and a workaholic - i genuinely love my job.

But my personal life is very curtailed in balance compared to everyone else - these things i am sure will become more important as the years go by.

If the years go by.

tallaght01

Valmont wrote: »

Surely something could be done? Maybe this explains why a doctor missed a 5 inch crack on my skull looking at an X-ray just like Dr. Hibert in the Simpsons. Seriously though these hours must affect both patients and doctors alike. I have a new found respect for doctors knowing the conditions they work in.

Do people still use skull xrays for fractures? Load of me arse. Maybe they're better in adults?

localhothead wrote: »

jesus christ - this is incredible - seriously -

is a banded together show of strenght not going to help ?

youve got to do something - your people are dying because of it - holy fcuk !

Mate, all kinds of things are happening because of it.

I really hate to say it, but Irish docs are being pussies. They're allowing the HSE to jack off on them from above, and all you hear is "my career will suffer if I speak out".

I think there will be a lot of embarrassed docs in a few years who will squirm when they're telling their grandkids about the slave conditions they worked in. Little Timmy will say "what did you do about it, grandad? Did you guys stick it to the man? Did you rock the foundations of government with widespread civil disobedience?".

"No, I didn't want to get in trouble, so i said nothing".

Honestly, what point is there in being so protective of a career that regularly makes you work 56 hours on the trot, and might kill you???!!!!

Svalbard

tallaght01 wrote: »

Do people still use skull xrays for fractures? Load of me arse. Maybe they're better in adults?



Mate, all kinds of things are happening because of it.

I really hate to say it, but Irish docs are being pussies. They're allowing the HSE to jack off on them from above, and all you hear is "my career will suffer if I speak out".

I think there will be a lot of embarrassed docs in a few years who will squirm when they're telling their grandkids about the slave conditions they worked in. Little Timmy will say "what did you do about it, grandad? Did you guys stick it to the man? Did you rock the foundations of government with widespread civil disobedience?".

"No, I didn't want to get in trouble, so i said nothing".

Honestly, what point is there in being so protective of a career that regularly makes you work 56 hours on the trot, and might kill you???!!!!

Location Australia, eh? Must be nice.

nesf

drzhivago wrote: »

On a different note The numbers of suicides in the last 10 years is well above average for an age matched population, the number of marriage break ups and the rate of cardiac disease

Pfft, Bipolar: Higher suicide rate, none of the money...

tallaght01

I trained in the UK and never worked in Ireland. But if I did, I wouldn't be able to keep quiet about what's happening.

GuanYin

nesf wrote: »

Pfft, Bipolar: Higher suicide rate, none of the money...

Actually, I've worked in departments with two residents who have taken their lives due to stress/upset.

Here the incidence of depression in MD population sis high and they don't do nearly enough about it

nesf

GuanYin wrote: »

Actually, I've worked in departments with two residents who have taken their lives due to stress/upset.

Here the incidence of depression in MD population sis high and they don't do nearly enough about it

High stress + any underlying mental health problem no matter how small = bad stuff.

Svalbard

tallaght01 wrote: »

I trained in the UK and never worked in Ireland. But if I did, I wouldn't be able to keep quiet about what's happening.

Ah ha............

So your take on Irish docs is based on what exactly?

tallaght01

The fact that they work slave labour hours and conditions AND accept it.

Svalbard

tallaght01 wrote: »

The fact that they work slave labour hours and conditions AND accept it.

I'm just going to take a few deep breaths here, before I say something I might regret. You are a mod, after all.

tallaght01

Svalbard wrote: »

I'm just going to take a few deep breaths here, before I say something I might regret. You are a mod, after all.

Say what you need to say. Don't worry about no mod stuff.

sam34

fight!!! fight!!! fight!!!

/gets popcorn and front row seat

nesf

tallaght01 wrote: »

Say what you need to say. Don't worry about no mod stuff.

Eh, I'd guess that his point would be that you're talking a lot of trash about Irish doctors despite never working in a hospital here and not having any first hand experience of the system.

Which is a fair point considering you're pretty much insulting them for not subscribing to your viewpoint on this. A moderator of a forum shouldn't be calling most of its denizens pussies and such imho.

tallaght01

Well, it's my opinion.
I never stop people expressing their on here, and being a mod has nothing to do with it.

I happen to think that a group of well educated, articulate, middle class doctors should just refuse to be treated the way they are.

I don't need to work in the Irish health service to know that people are dying, and people are depressed, and people are working 56 hour shifts.

I've worked 24 hour shifts, and I really don't know how getting a bit more practice at being miserable would change that opinion, or make it more valid.

You don't have to be in a system to know it's wrong.

I'm just fascinated by the fact that so many Irish NCHDs are so angry, but at the same time they're also so passive.

drzhivago

tallaght01 wrote: »

I've worked 24 hour shifts, and I really don't know how getting a bit more practice at being miserable would change that opinion, or make it more valid.

You don't have to be in a system to know it's wrong.

I'm just fascinated by the fact that so many Irish NCHDs are so angry, but at the same time they're also so passive.

Raise head get shot
Rise two heads get shot
Raise multiple heads - HSE comes with machine gun

Reminscent of Arlo Guthrie here

"and if your in a situation like that there's only one thing you can do and that's walk into the shrink wherever you are ,just walk in say "Shrink, You can get anything you want, at Alice's restaurant.". And walk out. You know, if one person, just one person does it they may think he's really sick and
they won't take him. And if two people, two people do it, in harmony,
they may think they're both ******s and they won't take either of them.
And three people do it, three, can you imagine, three people walking in
singin a bar of Alice's Restaurant and walking out. They may think it's an
organization. And can you, can you imagine fifty people a day,I said
fifty people a day walking in singin a bar of Alice's Restaurant and
walking out. And friends they may thinks it's a movement. "

Thats what we need a movement

no matter how fast the HSE gun they wont cope with a movement of people out of the system

nesf

tallaght01 wrote: »

I don't need to work in the Irish health service to know that people are dying, and people are depressed, and people are working 56 hour shifts.

But having not worked in it you might be unaware of the politics and union crap for ages gone by that have resulted in this system and why it's been so hard to change. The answer varies according to which doctor I chat to about this, the older doctors (consultants) lay the blame at the feet of the IMO and decisions it made many years ago (don't know the exact details and know nothing of IMO internal politics and history myself so can't judge this myself), other younger ones tend to blame the HSE or a combination of the two.

It's very hard to know the whole story when you're outside a system as opaque as the Irish Health Service regardless of whether you're a medical professional or not, the UK system and history is very different. I can't judge these claims and just hold the position that the system is a mess and hesitate in apportioning the blame to any one group tbh.

drzhivago

nesf wrote: »

But having not worked in it you might be unaware of the politics and union crap for ages gone by that have resulted in this system and why it's been so hard to change. The answer varies according to which doctor I chat to about this, the older doctors (consultants) lay the blame at the feet of the IMO and decisions it made many years ago (don't know the exact details and know nothing of IMO internal politics and history myself so can't judge this myself), other younger ones tend to blame the HSE or a combination of the two.

It's very hard to know the whole story when you're outside a system as opaque as the Irish Health Service regardless of whether you're a medical professional or not, the UK system and history is very different. I can't judge these claims and just hold the position that the system is a mess and hesitate in apportioning the blame to any one group tbh.

Not sure how the older consultanst can lay the blame at the IMO they didnt create the working hours the hospitals and the consultanst did

Any union only as strong as members so if members of union not willing to back the union they have small hand to negotiate with and lack the "NUTS" as the common poker parlance refers

I know a lot about IMO politics, HSE politics, DOHC politics and blame is firmly with DOHC on this

They have known for years hours could not come down until they made a startegic decision on what hospitals would eb 24 hour on call and what wouldnt

The decision has been awaited for more than 20 years and it has been bottle don every occasion so the only way to staff these hospitals was to flood them with Junior docs, Irish docs wouldnt go there so they trowelled the world to find docs in india and Pakisatn. i Think in 2001 they had an overseas visitation of a few weeks to recruit more.

They never went to irish medical schools to find out why so many were leaving, possibly because they had no remedy

They went to countries and offered them jobs ina supposed 1st world Health service, some were amaxed to land here and find hospitals smaller than the wards they were used to back home

They stay now for economic reasons not because the standard of training or healthcare is so high

But if they leave in large numbers the smaller hspitals will fall

www.pgmdb.ie

and check the NCHD census it will tell a lot about who staffs what hospitals

drzhivago

nesf wrote: »

High stress + any underlying mental health problem no matter how small = bad stuff.

worse
show any evidence of mental health problem and referred to medical council

catch 22

Hence the suicides

nesf

drzhivago wrote: »

worse
show any evidence of mental health problem and referred to medical council

catch 22

Hence the suicides

As someone with bipolar I wouldn't want anyone with it working as a doctor. To dangerous for both them and their patients. I am very, very glad that I didn't get it into my head to be a doctor when I was younger and unaware that I had mental health difficulties. Though my episodes got bad enough early enough that I wouldn't have made it out of university without it being spotted I think.

Catch 22, but the reality is that the stress levels of doctors makes it a really bad environment for anyone with mental health difficulties. Ditto for some cardiac problems.

tech77

RIP that poor doctor.
FWIW a girl in my class died suddenly as well a few years ago (while working AFAIK).
Never actually found out what exactly happened to her tbh.
But i seem to remember someone saying it was an arrhythmia as well.

merrionsq

You never hear anything serious in the media about junior doctors working hours. Your more likely to hear a consultant talking about their conditions. Surely the IMO is responsible for not doing more about this issue?

On a smaller point, looking at the amount of docs here who brag about the long shifts they've done, I don't see much impetus to do something about. One joker even says he's happy working unhealthy hours since he's a(scientific proven?) type-A personality.

tallaght01

I don't know the exact set up in the mater, or beaumont, or sligo general or wherever.

But, through here, the blog and working with the Irish who leave and come here to Oz, I've been in contact with a lot of Irish NCHDs and a few IMO people.

I don't think the situation is drastically different to that in the UK. In fact, I think the Irish govt has learned some of it's art from the Labour administration across the water.

Whenever we complained about conditions, Tony Blair, and whatever cronie was in the dept of health at the time, played on the fact that we were supposedly well off middle class punters with very little to worry about. They overexaggerated our salary and underplayed our hours.
They did the same with the consultants.

Sound familiar?

Nesf, i hear the same thing over an dover again from Irish docs. "I hate my job, but I'm afraid to speak up". Not "I hate my job, but because of some of the intricacies inherent in Irish labour laws, there is really no hope for change".

In nearly every case, the fear has been about their reference, and their future employability.

I think that's pussy-ish. I can accept not everyone will agree. But I don't think I have to be on the inside to see what's right and what's wrong.

I do wonder about how proud the NCHDs will be when they tell their grandkids about this part of their career.

I think the IMO can't represent people effectively if they don't complain.

If everyone complains, and everyone shows they're serious about doing something, then change has to happen.

I don't need to be working in a Bangladeshi sweatshop to know it's wrong. I now it's very wrong how irish NCHDs are treated.

But I think they have to grow some rock hard balls, mobilise, and do something.

That's my opinion. I'm sorry if it's not popular. But you can only let fear dominate for so long.

Svalbard

I suppose my main problem with your opinion, tallaght, is you are on the outside looking in. You seem to think talking to some Irish docs (who have gone to Australia) and being on boards.ie a lot (!) qualifies you to dismiss all the doctors in Ireland as "pussies".

I have never worked in Australia, so correct me if I'm wrong, but they have a much better working environment and training than here. I'm interested to know if you took any role in bringing that about during your career.

Also the inference that if you were here, you would do something about it, something that no-one here is doing it would seem. What makes you so bloody superior to the 4,500 NCHDs currently working in Ireland and the generations that have gone before them? Perhaps you should come here and sort our problems out for us, since you have a unique and superior perspective that apparently myself and my coleagues lack.

drkpower

Svalbard wrote: »

I suppose my main problem with your opinion, tallaght, is you are on the outside looking in. You seem to think talking to some Irish docs (who have gone to Australia) and being on boards.ie a lot (!) qualifies you to dismiss all the doctors in Ireland as "pussies".

I have never worked in Australia, so correct me if I'm wrong, but they have a much better working environment and training than here. I'm interested to know if you took any role in bringing that about during your career.

Also the inference that if you were here, you would do something about it, something that no-one here is doing it would seem. What makes you so bloody superior to the 4,500 NCHDs currently working in Ireland and the generations that have gone before them? Perhaps you should come here and sort our problems out for us, since you have a unique and superior perspective that apparently myself and my coleagues lack.

I dont know why you are giving th guy such a hard time. NCHDs working in Ireland, with a few exceptions, are, in the vernacular, "pussies". That may be a little perjorative but I think it gets the point across.

Most are afraid to act for one primary reason: They believe that if they do so, it will reflect poorly on them and thus affect their future career prospects. There is a certain amount of truth in this fear, of course, but not as much as people think.

As a former NCHD, I can say I was one of those pussies too. I tried more than most; I was on a Hospital NCHD committee, I fought to get the IMO to take its finger out of its ass but I didnt complain to the people who could do the most good - consultants. Afraid they would think i couldnt hack it, afraid they would see me as a truble-maker, just afraid I suppose - I thought i would just struggle through, one day become a consultant and then everything would be grand. And then irony of ironies, I left the profession...... But that is the general attitude out there and unfortunately things do not seem to be changing.

Jane5

We ARE pussies! tallaght01 is 100% right. In NZ and Oz docs actually laughed at us for taking the crap we took, and told us we were stupid to take it. And I bloody well agree with them.
The consultants are behind us. I don't know why anyone is afraid from that point of view. In the IMT, the IMN and even the Irish Times consultants have written in about how unjust this new wave of cutbacks is, and how hard we work, and how badly our training will be compromised by the cuts in funding it. No one need fear for their references.

Incidentally, you are ENTITLED by law to a fair reference from your employer, in writing, and if there is anything on it you disagree with or that might affect your ability to gain further employment, you are ENTITLED to question it and inquire as to why you weren't informed that your performance was not up to snuff while you were doing the job.
If you don't get a satisfactory response, you are entitled to a variety of legal actions and regulatory body advice. Not that anyone will need this info, but there it is.

The IMO is dealing with it this time though. Fair play. And everyone is pissed off enough that this time, the fear is GONE. But we have nothing to fear from consultants. They were NCHDs once, and care about our training and conditions. The perception that they don't is not valid.