The sound of junior doctors cracking under the strain

IRISH LIVES:It is 9am on Wednesday, and Anthony O’Connor, a medical registrar at St James’s Hospital in Dublin, is beginning his oncall shift by reviewing his inpatient files.

Towards midday he transfers to the emergency department, where he will remain on duty until 9am the following morning. There are treatment plans to draw up, lumbar punctures to commission and chest X-rays to order.

“There’s a lot of decision-making involved. You have to be nimble on your feet. Some of the elderly patients have stories to tell and you do your best to lend an ear, but there’s always the pressure to move on to the next patient,” he says.

An average of 25 patients come into the emergency each night, many with serious conditions. O’Connor, whose specialities are gastro-intestinal and general medicine, supervises his senior house officers’ work and is often called in by colleagues for advice on their patients.

There’s time for a cup of coffee but not much more, and even when his stint in emergency is up there are ward rounds to complete and more tests to order for patients. By the time he heads home he has clocked up 28 straight hours at work.

His other working days follow more regular hours but in an average week O’Connor reckons he puts in 65 hours at work and another 12 at home. That’s before study for exams and writing articles for medical publications.

Long hours and large doses of stress: it was ever thus for non-consultant hospital doctors (NCHD). Successive governments have promised the European Commission they would take steps to ensure Ireland conformed to the European working time directive, which limits the working week to 48 hours, but this aim has never been realised.

However, the current crop of junior doctors has decided enough is enough, or, more precisely, “24 hours is enough”. It started with a heartfelt column by O’Connor in the Medical Independent, in which he recalled his mental health challenges and the stresses of the job. Since then, a flood of NCHDs has taken to the airwaves and the internet to offload their anger at the working conditions they endure.

What distinguishes the current campaign is the palpable anguish among junior doctors, the unmistakable sound of people cracking under the strain.

“I qualified 10 years ago and have worked like a slave because of the HSE,” one doctor told The Irish Times. “I work on average 95 to 100 hours every week and occasionally up to 108 hours. The HSE have refused to pay me overtime and my colleagues too.

“During these 36-hour shifts there is no bed, no sleep, no time to eat and no time to wash or clean oneself. It is relentless and ruthless and every second of every day people are dying because of mistakes.”