4 Oct 2016

Doctors to strike over 'unsafe' rosters and hours

From Checkpoint, 5:15 pm on 4 October 2016

Junior doctors who voted to go on strike say they have no choice, because the exhaustion caused by long working hours is putting patient safety at risk.

More than 3000 junior doctors at all 20 DHBs will strike for two days from 18 October, after negotiations over their work hours broke down. The New Zealand Resident Doctors Association wants the maximum number of days worked in a row cut from 12 to 10, and the number of night shifts reduced from seven to four.

Roster patterns have included working shifts as long as 15 hours over 12 consecutive days, with three overnight shifts in the middle.

Dr Helen Saywell told Checkpoint with John Campbell that the fatigue that hit after a week of consecutive overnight shifts should be of concern to everybody involved.

"As far as I can see the DHBs, the general public, the doctors, the nurses who are picking up the pieces after us if we are struggling - everyone has a vested interest at having us at our best and everyone has a vested interest in us being able to provide the best for the patients, and I think that's really important."

After her first run of seven night shifts in a row, she fell asleep on the job at 3am, and was so "bone-tired'" that she didn't wake up when her pager went off, Dr Saywell said.

"It wasn't an urgent problem, everything was fine in terms of it didn't change the patient's outcome, but it was very scary. That page could have been about anything.

"And it also made me question how I could possibly be making safe judgment calls if I was literally hanging onto consciousness by my fingernails, which is why we want to change from seven nights in a row to split nights, with four nights as the maximum and some decent recovery time, so when we come back to work we are sharp and we are doing a good job."

Dr Richard Chen told Checkpoint he was currently working 12 days straight, with two 15-hours shifts in the middle - roughly 115 hours of medical care between "weekends".

He voted to strike because he became apathetic in the final days of that stretch, Dr Chen said.

"I don't have a good sense of how I am doing from an emotional and clinical view.

"I feel I don't give the patients my absolute best, when I can do that when I first start my shift, on day one to day five. On day 11, day 12, I just feel there's no way that can be sustained."

The dispute was never about the pay, he said.

"I think the DHBs somewhere along the line have introduced that argument, whereas our argument was simply about the hours.

"Money can never solve this issue."

A third doctor, who did not want to be named, said she knew junior doctors had long faced long and irregular hours, but it was tougher than expected, leaving her "really exhausted, mentally fatigued and often a bit nauseated".

"I'm really passionate about medicine and being able to do my job is in some ways worth it, but the thing that I worry about is the safety of the patients. I do worry about the safety of the people I'm trying to help."

A spokesperson for the DHBs, Julie Patterson, said earlier today that the system that saw doctors work 12 days in a row had been in place since the '80s, with doctors working Monday to Friday, then working the weekend, followed by anther Monday to Friday stint.

She said DHBs were happy to work towards breaking the 12 days up.

"The issue that we've got as DHBs is the union is expecting that when the junior doctors have days off during the week either side of that weekend, that they will continue to get paid for the days that they have off."

She said that was not fair and reasonable, and the offer given by DHBs that the union yesterday turned down would have given doctors the best conditions in the world.

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