Page105 - Week 01 - Wednesday, 2 December 2020
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This is happening right now. The maximum shift length is 14 hours. The maximum number of rostered hours per fortnight, excluding on-calls, is 112 hours, yet we know people have worked 150 hours.
Clause 19.18 is:
A Medical Officer will have two days free from any duty following the end of night shift duties to ensure adequate rest time and to minimise sleep deprivation which occurs on night shift. Where operationally possible the number of days free from ordinary duty should equal the number of consecutive night shifts worked
The review also found, in its section on workplace culture, the following: fewer than half of the basic physician trainees interviewed who completed the survey would recommend the ACT physician training program to a junior colleague. Lack of a regular forum for senior or junior medical staff to have their concerns heard was a problem. There was an overwhelming sense that clinical staff do not feel valued by the system.
Common themes commented on included poor exam results, repeated exam failures and good people failing exams. Trainees often reported witnessing senior clinician conflict. Currently there is no culture of mentorship at the hospitals. The labelled mentor program operates more as a long case supervisor rather than a true mentor role. And currently there is no culture of teaching at the hospitals. Trainees report service provision roles, with minimal teaching on the run reported on most rotations. There is a lack of team building, community or social events.
Surveys are completed on incivility. However, there is no feedback to trainees that any action was taken to address the issue raised. This is not acceptable. Trainees report no good system processes for addressing bullying and harassment complaints by junior staff. Several examples were raised during the discussions that had all been reported to consultants within the health service with no obvious action taken and no feedback to the trainee or support mechanisms put in place.
It is clear from the high rates of survey returns by junior staff and good turnout to face-to-face interviews by medical and administrative staff that there is an interest and a keenness to make improvements to the workplace at all levels if given the opportunity and vision. Positive role modelling was observed in the actions or support of Dr Ashwin Swaminathan and Natalie Monkivitch at the MESO as part of the findings of the report. Not only is there clearly an issue with burnout and exhaustion but the ever-present issue of the poor culture in the hospital is also apparent.
I attended the Canberra Hospital ED a couple of nights ago with a friend of mine who was in medical need. She waited a while and then was looked after by a junior doctor. He was kind and professional. At the end of the visit I asked him if things have improved at all for the junior doctors since the report we are dealing with here came down earlier this year.
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