Post on Politics.ie. Great description of an NCHD's experience

take everything

This was posted in the Strike thread on Politics.ie health forum.

Great description of NCHD working conditions. Really felt for the guy reading it
Fcuking scandal what this country has done to such well-intentioned, highly-educated people.
Ugh.

Anyway, this is it:

Lets just clear some things up...
There are no hospitals in ireland that are fully EWTD compliant for all docs. That means 13 hour shifts max per day with 48 hours max per day.

The solution currently being touted by the hse is, 24 hour max shifts, with no cap on weekly hours. considerable difference from actual ewtd

Galway is touted as being compliant, but my friends there work 60 hour weeks average too. They just dont do the 24 hour shifts or 36 hour shifts like we do...

The average working week that James Reilly says doctors work is based on the hours *payed* to doctors. I've not been payed overtime in 10 weeks now, so my 90 hour weeks have magically become 39 on their calculator. So his 52 hours average, is fantasy really. There isnt a single doc in my hospital under 60 hours. Some over 80. Average. Its horrific...


If anyone wants to know the horrors of 36 hours, then just ask. Can you imagine getting a phone call/bleep every 5 mins or less for about 20 hours to come and do jobs and review patients? Only 2 doctors to cover 200 beds. Jobs ranging from charting cerumol ear drops at 5am to a guy vomiting up blood, anaphylaxis, heart attacks. Things we may or may not be able to handle. Jobs that we may call our senior and he may tell us he cant come cause he has 3 other dying patients to see first...

It is hell on earth

And thats just over half your shift. Then you have to recall every single detail about your inpatient list for your consultants convienence as he cant use a computer and doesnt know the patients. Then go assist in theatre, or clinic if you're lucky. Worse go battle other teams or radiology to get them review your patients or get your scans done. Write in 30 charts etc etc

There is no teaching. good job my phone has good battery, cause i google a hell of a lot these days.

The worst part is when your inpatient list breaches north of 30, sometimes 40 patients. Very rarely 50. With only me, the reg and 2xuseless import sho's to care. You want to help. Ordinarily you could sort out the gallbladders, pancreatitis easily. Give optimum care. But with only 4 mins or less with each patient you forget to order chest physio, optimise analgesia and fluid management and antibiotics. And they get infections, kidney damage from dehydration etc...

The hse are 'proposing' to fix this.But the truth be told they cant. They need efficiencies and better rostering. True. But they need 30% more doctors from all levels. And there isnt a chance in hell they can get them. They cant even fill consultancies on the last contract. How can they do it now? How can they entice good registrars back? Its impossible.

The HSE can promise the sun moon and stars right now, and maybe even mean it... But they cannot deliver. They've destroyed themselves on the world market that no one will work here.

30% more docs will fix this. But they will not come
What will happen is the same scraping of doctors will cover even more burnt toast, just jiggled around a bit. Instead of there being 2 docs covering 200 beds for 24 hours and then they go onto their day job for another 12, there will be 1 doc covering 200 beds for 20 hours and then another comes in for 20 hours. Or something ridiculous like that. Its obscene and is already resulting in deaths. It will get worse unless they get more docs in. Make no mistake, men and women are dying in our hospitals every night and weekend from too few staff. Simple things that an extra pair of eyes wouldnt miss...

And last point. About the strike causing patient harm. Absolutely not. Today each hospital had a full quota of consultants on site. And they had no clinics (public or private)or elective theatres to go to. Each consultant is worth 2 registrars, 5 sho's and 6 interns. The hospitals had more quality docs on site today than they probably will tomorrow. Today the health system actually ran (a little bit) as it should. Consultant lead & *delivered* service.

I hope this gets resolved, but all i foresee are broken promises...
I just hope i do well on my canadian exams.

I'm sure he/she won't mind it being re-posted but it really hit home.

MrCreosote

Great post! (original is here http://www.politics.ie/forum/health-social-affairs/215141-junior-doctors-strike-looks-likely-19.html just cos it hasn't transferred well). Sad to see that nothing whatsoever has changed in the 14 odd years since I graduated.

I've kind of kept out of the strike thing because it doesn't directly affect me and I think some of the reason it has happened is a bit of dick-swinging by the IMO as they try to regain relevance after the McNeice scandal. But it's great to see it happen nonetheless.

Why not an all-out strike though? The consultants can pick up the slack like in strikes overseas. Screw the "ethical problem" (or emotional blackmailing by politicians/management)- it's clear that the death rate dropped significantly in all doctors' strikes studied overseas.

his_dudeness

There is apparently some agreement between HSE and the health sector unions about ensuring a level of care - there was always the (however remote) small chance that consultants and nurses would refuse to cross the picket.

What a sight that would have been

RobFowl

OP that's pretty much unreadable the way it's been transferred!

take everything

RobFowl wrote: »

OP that's pretty much unreadable the way it's been transferred!

Yeah sorry.
Just edited there.

RobFowl

Cheers, I find cutting and pasting form some sites seems to make them go a bit haywire too.

ThatDrGuy

That is a great post. Really sums it up. I remember a few years ago the medical admin in the hospital I worked drew up an EWTD compliant roster for the hospital interns. It had one intern covering the whole hospital (usually four). When this was pointed out to be madness they said it wasn't their problem - they had done the rosters as requested. If the doctors refused them, it was them standing in the way of EWTD compliance and their fault.

Icemancometh

ThatDrGuy wrote: »

That is a great post. Really sums it up. I remember a few years ago the medical admin in the hospital I worked drew up an EWTD compliant roster for the hospital interns. It had one intern covering the whole hospital (usually four). When this was pointed out to be madness they said it wasn't their problem - they had done the rosters as requested. If the doctors refused them, it was them standing in the way of EWTD compliance and their fault.

Admin's attitude in a nutshell.

Frito

ThatDrGuy wrote: »

That is a great post. Really sums it up. I remember a few years ago the medical admin in the hospital I worked drew up an EWTD compliant roster for the hospital interns. It had one intern covering the whole hospital (usually four). When this was pointed out to be madness they said it wasn't their problem - they had done the rosters as requested. If the doctors refused them, it was them standing in the way of EWTD compliance and their fault.

It's ridiculous, but the depths of HR indifference never ceases to amaze me. Are hospitals not required to risk assess intern:patient ratio as they are required to with nurses?

ThatDrGuy

Hahha Risk assess. Where would you start ?! With the ortho reg who is operating after a Sat- Monday on call ? With the intern drawing up a heparin bolus without a shagging clue what he is doing ? With the SHO in A and E googling Bipap settings? In my new job I had to attend a chemical awareness training session. There were people there from HR - the chemical they were exposed to was Tipp-Ex!. I remember being covered in doxarubicin from a catheter without a clue what to do about it. Took a shower, hoped for the best and completed my weekend on call. No one gives the remotest sh1te about medical personal enough to risk access them or their patients for anything.

Malmedicine

his_dudeness wrote: »

There is apparently some agreement between HSE and the health sector unions about ensuring a level of care - there was always the (however remote) small chance that consultants and nurses would refuse to cross the picket.

What a sight that would have been

HA! I would just have loved if the other NCHD's in my hospital didn't cross the picket. All surgical and ortho NCHD's crossed . A few medical interns crossed, most med SHO's didn't . Most of my fellow med regs crossed. Few others in paeds, obs and anaesthetics also crossed. Oh and the med students crossed . WTF of all the ungrateful shower, I know they don't work but some are even members of the union albeit student membership .

Its just disheartening and after the strike I really feel antipathy towards them, even more so when it went around that they were getting the on call team to do their ward work - " Cannulas etc"

Those that showed up were fantastic and really great support from the public and GP's.

caroline1111

HA! I would just have loved if the other NCHD's in my hospital didn't cross the picket. All surgical and ortho NCHD's crossed . A few medical interns crossed, most med SHO's didn't . Most of my fellow med regs crossed. Few others in paeds, obs and anaesthetics also crossed. Oh and the med students crossed . WTF of all the ungrateful shower, I know they don't work but some are even members of the union albeit student membership .

TCD med students didn't cross anyways

his_dudeness

Malmedicine wrote: »

Oh and the med students crossed . WTF of all the ungrateful shower, I know they don't work but some are even members of the union albeit student membership .

FWIW, the students couldn't join the picket regardless of membership, not being employed by HSE. Med schools should've made a unified statement in support and withdrawn the students for the day.

Oddly, one of our Med Manpower staff refused to cross the picket.......(the irony was obviously lost on her)

Abby19

Malmedicine wrote: »

Oh and the med students crossed . WTF of all the ungrateful shower, I know they don't work but some are even members of the union albeit student membership .

caroline1111 wrote: »

TCD med students didn't cross anyways

I don't know about other colleges but Trinity sent out this email the day before the strike.

'We have received confirmation that the NCHD industrial action by the IMO is going ahead tomorrow - Tuesday 8th October.

The School has made the decision that students on rotations in clinical sites that are affected should NOT attend on that day as they cannot be on the wards.'

take everything

anyone know what's happening this week?

RobFowl

take everything wrote: »

anyone know what's happening this week?

Talks resuming tomorrow afaik and we'll see soon after.

polydactyl

RCSI also asked that students did not cross the picket and if they had lectures they had to attend but were to stay off the wards. Where the hell do you work that so many crossed? I happened to be in four hospitals that day and no NCHDs crossed. I am going to guess Limerick.