Questions for doctors - I've just read This Will Hurt

[banoffipies]

I am seriously shocked by the hours that the author had to work, as well as by the working conditions in general: understaffing, inadequate support, having to arrange cover for his own sick leave, having to cancel holidays, not getting time to eat at work etc.

If you are, or have been, a junior doctor, I'd be interested to know - has your experience of it been the same as his? I realize the NHS is under particularly high pressure at the moment, so would be interested to hear your experiences of what it was like before the pandemic as well as now.

I'm puzzled by the hours. I don't doubt that the author is telling the truth, but friends who are doctors don't seem to work, or to have worked, such insane hours. I wonder whether the author was particularly unlucky with the hospitals where he worked, or whether obs and gynae is especially bad for hours?

Also: thank you so much for the work you do!!

ummmm I'm now a consultant. Whilst I am no longer sitting on the ground in a car park crying with exhaustion at 4am whilst 7 months pregnant, I can assure I do a hell of a lot more than taking the occassional phonecall. Our department is currently missing 9 senior medical staff in vacant posts that we can't recruit to. I always start work before my allocated time and usually end up staying late and then doing work from home in the evenings trying to catch up. I am being faced with high risk dangerous situaitons on a dialy basis and we strugle to provide even a basic level of care for patinets at times due to lack of resources. My day is spent running from one thing to the next none stop, and yes I still rarely get time to eat lunch! Yes, I will agree I earn a good salary, but the stress and demands of the job are horrendous. And I've never played around of golf in my life!

oh, and as for being treated like God -
I have been shouted at, sworn at , and spat at regularly, I have had death threats and been physically assualted. I have had patients and carers berate me about lack of services whilst sobbing down the phone or in front of me, depserate to get help for their loved ones. We are continually having resources stripped from us, no longer have proper desk pace, poor IT infrasystem, wifi that only works 40% of the time and had all our admin support taken away systemtaically over the past 5 years.
Certainly doesnt make me feel particualrly God like!

My experience was not as bad as some of these. We were still exempt from the working time directive in 2000/2001 when I qualified and weeks of 84hrs on the rota were frequent. We did have 5hrs of protected sleep in each 24hr period thanks to previous generations of junior doctors raising awareness. But I was still so tired that I slept through a crash bleep and wrote a patients name as 'Diamorphine Williams' on the drug chart. God knows what errors I made that weren't picked up.

I am not a doctor but used to be involved in the junior doctor's training and they would regularly only be able to do the mandatory training if they came straight from a night shift then went back and done another night shift straight after and this training could be a week long.
Yes this isn't allowed but if they didn't they ended up not being signed off and would need to repeat the year so everyone pretended they didn't know this was going on.

I have just come over from the 2023 Medicine applicants thread and this is such a disputing thread to read. Lots of extraordinary commitment and resilience shown by posters who have managed to survive the appalling treatment they have received.

It is just extraordinary that such bad management seems to run through the system, but it could be that good young managers leave because they hate the environment and have easily transferable skills. Some of that was reflected on in Question Time last night - yes, the pay is rubbish, but so much more is also unacceptable. Actually the money is easier to fix than the management.

Another bit of unbelievable hospital management. A friend who used to be a paramedic told me that where we are, the waits for people to be admitted from an ambulance have been so bad that someone started their shift taking over care of a patient waiting in a queue from another paramedic. At the end of a 12 hour shift they were still there, looking after that same patient, who they handed on to someone else. There was talk about putting some beds in a room so that one paramedic could look after several people waiting to be admitted, but they didn't have enough beds. That is mind-blowing to me - they had the space and could not get some beds for the space to free up 6 ambulances. It is Dickensian incompetence!

dispiriting thread, not disputing!

As I understand it, hours now are much improved. But, 30 years ago, junior doctors could work up to 124 hours a week. You could be resident on call from 9am Saturday until 5pm Monday, and probably no day off until following weekend. On call rota was 1 in 3, which meant at least another 1 in 3 was spent sleeping. On call was also paid at one-third of normal pay rate which meant that a houseman was paid less per hour than a porter. It was brutal, so no wonder marriages broke up! We toughed it out, but I always had to accept that husband's career came first. I also got used to doing lots of things on my own, which was a pretty good life lesson, to be fair.

its not just 'beds' a bed is shorthand for an equipped room with oxygen, suction, arrest bells , toileting facilities etc. and a hospital bed - about £5000 each is a specialized piece of equipment. one paramedic should not be minding six critically ill patients without support from a member of staff with access to hospital computer systems.

Oh, and consultants are not treated like God, and still work incredibly long hours. Don't believe the lazy stereotypes!

its not just 'beds' a bed is shorthand for an equipped room with oxygen, suction, arrest bells , toileting facilities etc. and a hospital bed - about £5000 each is a specialized piece of equipment. one paramedic should not be minding six critically ill patients without support from a member of staff with access to hospital computer systems.

He was talking about the same equipment as they have to care for a patient in the ambulance, so would not include arrest bells, toilet facilities etc. I assume it depends on what is wrong with the patients in the ambulances, but if the super urgent ones are admitted, you are left with the ones who don't need quite so much care to be transferred to a bedded paramedic-covered room. You can not NEED 2 paramedics and an ambulance for someone who has been triaged as not unwell enough to be seen within 12 hours. This is no reflection on doctors, just a window on the waste/frustration due to dreadful management who could ease some aspects of a bad situation.