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+ 18 — THE WEEKEND AUSTRALIAN APRIL 23-24, 2005 — 18
Health
The death of a young girl in a Queensland
hospital has raised awareness of the safety
threat posed by doctors’ long working
hours. Jane Lyons reports
G
EOFF Dob clearly remem-
bers the exhaustion of his
first six months as a junior
doctor: expected to work 128
hours a week and 36-hour shifts, the
darkest hours were those before
dawn when coffee seemed to be the
only thing that would get him
through the night.
And even after this initial training
period there was very little respite as Dr
Dob and his colleagues continued to work
80-100 hours a week.
Now 56 and a senior consultant at the
intensive care unit at the Royal Perth
Hospital, Dob says these hours may
sound medieval but it was common
practice when he started in 1973 — and
not much has changed since.
The Queensland branch of the Aus-
tralian Medical Association is currently
undertaking an audit of doctors’ hours in
their state, and has found that many
doctors, both senior and junior, are still
working dangerously long hours.
Forty-one per cent of the doctors
surveyed have fallen into the high-risk
category, with 80-plus-hour weeks, shifts
of 14 hours or more, at least three night
shifts and no days off. Fifty-six per cent
have fallen into the significant risk
category, having worked 60-hour weeks,
with two night shifts, three days on-call
and only one day off.
The audit was in response to a recent
case against a junior doctor found guilty
by the Health Practitioners Tribunal last
December of unsatisfactory professional
conduct . In 2002 Andrew Doneman, who
was a second-year resident at Queens-
land’s Caloundra hospital, was in the 20th
hour of a 24-hour shift when he made the
decision to send home a 10-year-old girl
who had come into the hospital after
falling out of her bed and hitting her
head. The girl subsequently worsened,
was brought back to the hospital and
later died.
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RISK FACTORS
■ Are doctors regularly scheduled to work
more than 10-hour shifts?
■ Do doctors work more than 14
consecutive hours in any one period
(including overtime and recalls) at least
twice a week?
■ Is the minimum rest between scheduled
work less than 10 hours?
■ Are the total hours worked in a seven-
day period more than 70 hours (including
overtime and recalls)?
■ Is the minimum non-work time in a
seven day period less than 88 hours?
■ Is there less than a 24-hour break free of
work in a seven-day period?
Extract from the AMA’s National Code of Practice —
Hours of Work, Shiftwork and Rostering for Hospital
Doctors (AMA, 1999)
But despite finding against Doneman,
the tribunal’s report made strong men-
tion of fatigue as a contributing factor.
‘‘One does not need medical evidence to
know that anyone who is in the 20th hour INSIDE:
of a continuous duty must have reduced
capacity to assess the situation when it
presents itself,’’ it said.
‘‘If this tragedy leads to nothing else, it
MILKING IT
should lead to the abolition of such
brutally long shift hours, which must in
Do kids’ bones
itself reduce the standard for care avail-
able to patients.’’ Too many hours common: But hospital administrators won’t admit it, says the AMA’s David Hewett Picture: Patrick Hamilton need dairy?
The Queensland Government last
month asked the state’s Medical Board to hours threaten standards of patient care. dated industrial agreements have al- sword for the public and media’’.
Despite a 10-year Safe Hours Cam- lowed rostered on-call hours to extend Sue Page, president of the Rural Doc-
decide a safe working hours benchmark for
doctors after being criticised over the death.
The move was welcomed by the AMA,
paign by the AMA and the development
of a Safe Hours Code, Dr Hewett says this
agreed shift lengths, creating unsafe
hours such as those experienced by
tors’ Association of Australia, says poor
rostering practices contribute to the loss
DEMENTIA
but the standard could take two years to
implement — and it is understood work is
case has underlined the fact that there is
still more work to be done on the issue of
Doneman.
He argues that the Doneman case
of rural doctors in an industry that is
already understaffed. EPIDEMIC
‘‘The biggest single reason why doctors
yet to begin on drafting the new standard.
David Hewett, chairman of the Aus-
tralian Medical Association’s Council of
junior and senior doctors’ hours.
‘‘Twenty-four-hour shifts are much
more common than (hospital) adminis-
highlights the need to shift more of the
responsibility back on to the institutions
that are creating the unsafe rosters,
leave the area is related to workplace
issues that are possibly fixable, and of
Carers prepare to
Doctors in Training, couldn’t agree more
with the tribunal’s concultion that long
trators like to admit,’’ he says.
According to Hewett, vague and out-
rather than focusing solely on the indi-
vidual doctors, ‘‘who must fall on their
those the biggest single reason is tight
Continued next page
lobby politicians
Hills Mallee Souther n
Regional
Eastern Health
Health
Ser vice
Inc
Maroondah Hospital
ED Registrar PGY3+
Make a Difference
MANAGER, CLINICAL ENGINEERING
CLINICAL ASSET ADVISORY SERVICE Ref: MS11679 Join ACT Health.
ADVERTISING SALES OFFICES $75, 616 (MAS2) Junior Medical Officer PGY2/3
Sydney: Duties: The Manager, Clinical Engineering is accountable Ref: MS11680
Dusan Stamenkovic to the General Manager, Hills Mallee Southern Region for Department of Emergency Medicine
tel > 02 9288 3679 the operation of the Clinical Asset Advisory Service, a Maroondah Hospital is seeking Medical Officers in the Emergency department
business unit within the Hills Mallee Southern Regional Applicants should note that Duty Statements, Selection Criteria and Application Packages
to fill vacancies. Both positions are to commence in May 2005.
Adelaide: Health Services. including Referee Report Proformas are available on the Department’s website at
The New Emergency Department was opened in March 2005 and sees http://www.health.act.gov.au/employment
Norma Pedicini The Clinical Asset Advisory Service is a statewide, self- approximately 40,000 patients a year. There are 29 cubicles with state-of-the-
tel > 08 8206 2760 funding clinical engineering service provider. The art equipment, 12-bed short stay ward, 4 paediatric cubicles and 4 paediatric THE CANBERRA HOSPITAL
Brisbane: department’s principle role is the contracted management of short stay beds. The positions are well supervised by enthusiastic 9 EFT FACEM
the clinical engineering equipment used in regional hospitals consultants and Paediatricians. SURGICAL SERVICES
Samantha Andrew
tel > 07 3666 7422
for treatment, monitoring and therapy of patients. Additional There is an excellent education program locally, integrated with the very CARDIAC SURGERY
the department also provides some contracted and fee-for- successful Eastern Health ACEM training program. Protected training time is
Canberra:
James Beatty
service clinical engineering services to other government
non-regional hospitals and health services as well as private
also given for resident staff. The position is for a 6-12 month post with the
possibility of an extension. Clinical Perfusionist
tel > 02 6248 5888
health providers. Registration with the Medical Practitioners Board of Victoria is essential. Health Professional Grade 4
The Manager’s key responsibilities are: Enquiries: Dr Peter Archer, Director of Emergency Services 9871 3150 or Dr Greg
Janet Slade Mele, Clinical Director 9871 3550.
$69,899 - $75,367
• the ongoing provision of services in accordance with
tel > 02 6248 5888 Please apply on line: www.easternhealth.org.au or written applications quoting Canberra (PN. 28742 Expected Vacancy)
the recommendations and requirements of Australian
the position reference number to :
Hobart: Standards at a service level sufficient to meet hospital Applications are invited from suitably qualified Clinical Perfusionists to fill an expected full-time
accreditation requirements
Mary Hatchard, HMO Manager
Chris Barry Medical Administration, Maroondah Hospital vacancy in the Cardiac Surgery Department at The Canberra Hospital.
tel > 03 6234 8588 • the planning and implementation of management and P.O Box 135, Ringwood East VIC 3135. The Cardiac Surgery Department has one operating theatre, with a case load of 330 adult Cardiac
Melbourne: operational strategies that will benefit the service provision or email: Mary.Hatchard@maroondah.org.au procedures per year. The successful applicant will share this case load with another full-time Clinical
and equipment facilities of Regional Health Units Perfusionist, rotating the on-call commitments, week on-week off.
Angela Wayling Applications close Friday 6 May, 2005.
• the development asset and risk management strategies
tel > 03 9292 2349
Gavin Carns • the marketing of the Departments service capabilities to Angliss Hospital Eligibility/other requirements: Qualification Diploma with the Australian Board of Cardiovascular
Perfusion with a current certification.
support the departments financial viability
tel > 03 9292 2323
• the financial management the business operations of the
General Medicine Registrar/HMO3+ A minimum 5 years experience in managing Cardiopulmonary Bypass and its associate equipment.
Newcastle: Commencing end May or February 2006 The ability to manage Cardiopulmonary Bypass and various Perfusion procedures independently,
Department on behalf of the Hills Mallee Southern Regional under the direction of the Cardiac Surgeon. Experience in working in regional Cardiac Units
Rosemary Crick Health Service Ref: HH11684
Angliss Hospital is a 200 bed Hospital located in the foothills of the Dandenong desirable.
tel > 02 4982 6900 Essential Qualifications: Degree, Diploma or equivalent from a Ranges, in Melbourne’s eastern suburbs. A new Emergency Department with
recognised tertiary institution combined with extensive Selection documentation may be obtained from www.health.act.gov.au/employment
Perth: co-located short stay and High Dependency and Coronary Care Unit opened in
industrial experience at a senior level relevant to the position. 2005. There are currently three general physicians each supported by a registrar Contact Officer: Kaye Collins (02) 6244 3096
Stephanie Watson
Special Conditions: Regular intrastate travel involving and resident. Physicians contribute to the education of junior staff. There are Applicants must quote the above position number when applying.
tel > 08 9326 8298 excellent links with the local GPs who support inpatient care.
overnight accommodation. Regular out of hours work may be
Bookings: Applications Close: 5 May 2005
required. A current SA driver’s licence and willingness to The position will suit a basic trainee in medicine, emergency medicine or general
tel > 1300 307 287 drive health service vehicles is essential. practice seeking additional general medicine experience. The post is accredited Applications to be addressed to:
for Basic Training with RACP - General Medical Registrar term.
Job and Person Specifications are available from: Peter Senn, The Recruitment Officer
Manager, Clinical Asset Advisory Service, ph (08) 8443 3111 Qualification: Registration with the Medical Practitioners Board of Victoria.
ACT Health
or 0408 244 828 or by e-mail, senn.peter@saugov.sa.gov.au Enquiries: Dr Harvey Lander, Director of Medical Services 9764 6105 or to Dr PO Box 11
Martin Walter, Head of Medicine 9764 6110.
Enquiries and Applications to: Peter Senn, Manager, Clinical Woden ACT 2606
hmaBlaze 092856
Asset Advisory Service, Building 3, 26 Stirling Street, Closing Date: 13 May 2005
or tch.recruitment@act.gov.au
Thebarton SA 5031, ph (08) 8443 3111 or 0408 244 828. Apply on-line at www.easternhealth.org.au or written applications to Martin
Please forward an original application plus three copies and Smith, HMO Manager, Angliss Hospital, 39 Albert Street, Ferntree Gully 3156 or
include the name, address and contact number of three current email martin.smith@angliss.org.au.
work referees. Applicants are required to
CLADSE000106
address the job and person specification
hmaA005954
in their application.
Applications Close:
6 May 2005 at 5.00pm
www.easternhealth.org.au