Over-tired junior doctors ‘inevitably’ make mistakes during shifts, says registrar

The first 28 hours of a 36-hour-shift were “okay”, junior doctor Dr Grainne O’Kane said yesterday. “Adrenaline and a sort of euphoria get you through, but after that you are utterly exhausted. It’s difficult to focus and by the end you are just broken.”

Dr O’Kane, an oncology registrar at the Mater hospital in Dublin and also chairwoman of the hospital’s non-consultant hospital doctor (NCHD) committee, said it went against doctors’ instinct to leave their posts but they had been forced, in their own interests and their patients’ safety, to strike.

Over-tired junior doctors “inevitably” made mistakes during shifts, she said. She recalled making a “minor prescribing” mistake herself during a 36-hour shift some years ago. “It was not serious and there were no repercussions but I felt enormous guilt as a doctor. I really felt I had failed, but mistakes are inevitable on 36-hour shifts.”

She said she regularly worked 120-hour weeks. “I’m 31, and for 13 years I have been pushing myself to be the best doctor I can possibly be. You put your life on hold for a decade. I have missed weddings, funerals, family occasions. As a junior doctor your family suffers, your friendships suffer, it’s very difficult to have relationships, but you do it because you want to be the best doctor you can be.”

Intense
Dr Ger O'Connor, specialist registrar in emergency medicine at the hospital, said the average 36-hour shift was "more intense, more complex" than it was 10 years ago, making rest periods almost impossible to take. He said he was nearly finished his time as a junior doctor and so the marathon shifts were coming to an end for him. He was out on the picket in support of his younger colleagues, he said.

“Today medicine is more complex and so care is more complex. A higher proportion of patients are older. When I started in training you might have been able to take a two-hour nap during a 36-hour shift but that is impossible now. So this is about doctor safety and patient safety,” he said.

“We do feel the hours are illegal. No one except Minister Reilly and the HSE would argue with that. The Government had been promising to do something about this for a decade and it is with a heavy heart that we are doing this.

“We have a very strong ethical commitment to our patients, so it is heartening that there have been patients and their families coming to us on the picket this morning to wish us well.”

Public support
Dr David Brinkman, a surgical NCHD on the picket line outside Cork University Hospital (CUH), said public support for the stoppage was very encouraging with many passing motorists honking their horns in support.

Dr Zara Fonseca-Kelly, an NHCD in obstetrics and gynaecology at CUH, said: “Ultimately nobody standing out here today wants to be on a picket line – we want to be inside doing our jobs but it’s come to the point where we don’t feel we can provide safe patient care with the hours we are being asked to work.”

Among those lending support was Dr Pooja Sarkar from Cork, who graduated from UCC in 2011 and worked for six months at CUH until she decided to leave to work in Birmingham. “I started working in the UK on September 4th. The conditions are phenomenal: we work 13-hour shifts, I’m not rostered for more than seven days in a row, I get time off in lieu, I go home on my nights off and I have never done anything more than 13 hours since I started.”