“Fatigue is a major factor in doctors making errors. Mistakes could be incorrectly writing up a note in a patient’s medical chart,missing something in a clinical examination or a radiology finding,” Dr Sanjay Hettige,co-chair of the committee,said. “It could also be taking longer in doing something which could affect patient care.”
Dr Ho said pressure during the Delta wave increased fears about making a mistake with personal protective equipment,noting concerns that if a PPE error is made “we could transmit the virus to someone else or bring COVID-19 home”.
Dr Hettige said the results shine a spotlight on the burnout from working longer hours.
“While it’s not good for the doctors,it’s also not good for patients. Junior doctors are at the coalface of the public health system. If they are under strain then patients can have poorer outcomes.”
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Sixty per cent of doctors surveyed said they worked more than five hours overtime in a two-week period,compared to 49 per cent the previous year,which Dr Hettige says could be partly attributed to thousands of medical staff being furloughed throughout the Delta wave.
The findings come as up to 24,000 junior doctors could form part of a class action,launched almost a year ago by Law firms Maurice Blackburn and Hayden Stephens&Associates to recover tens of millions of dollars in unpaid wages from NSW Health.
“These results regarding overtime are entirely consistent with what our clients have told us. Working excessive unpaid hours is a problem which has only been exacerbated by the pandemic,” lawyer Hayden Stephens said.
Almost three-quarters of un-rostered overtime was paid,a significant improvement on 2019 when 63 per cent was paid.
“But there’s still a long way to go with improving gender-based outcomes,” Dr Ho said,noting about 35 per cent of female doctors reported discrimination at work,compared to a quarter of their male counterparts.
One-quarter of women claimed all their overtime,compared to 36 per cent of their male colleagues.
“I often think doctors-in-training are just looking for things like fresh food being made available after hours,somewhere they can rest or sleep,access to Wi-Fi,a few more computers in the common rooms. Sometimes it’s relatively small improvements that make the biggest difference to our lives,” Dr Ho said.
Dr Hettige noted the individual grades for each hospital showed some improvements,but more oversight from NSW Health “is needed in terms of practical things they are doing to improve workplace culture”.
Hornsby Hospital received an overall A-grade,which includes measures such as behaviours,rostering and facilities. Sixteen hospitals,including Liverpool,St George and St Vincent’s,scored an overall B grade and fifteen hospitals including Westmead,Orange and Nepean scored an overall C. Concord was the only hospital to receive an overall D grade,with the lowest scores in rostering,overtime,behaviours,sick leave and facilities.
Dr Ho noted positive findings for overall wellbeing and morale:63 per cent of doctors-in-training feel valued by their hospital,while three-quarters would recommend their hospital to other doctors.
“Systemic change in hospitals takes a long time,there are deep cultural views that can take a long time to see improvements,” she said.
In 2017,the state government launched its $3 millionJunior Medical Officer Wellbeing and Support Plan including a dedicated support line offering specialised confidential counselling,and a “performing under pressure” course.
A NSW Health spokesperson said progress had been made on the 10 initiatives contained in the plan,including new safe work hours standards,which states there is a 14-hour maximum for consecutive rostered hours and 10-hour minimum break between shift periods.
This is the fifth year the AMA has run the survey,with this year’s conducted from July 23 to September 3. There were 1747 respondents,including interns and residents,from 35 hospitals across the state.
NSW recorded 159 new cases on the day the survey launched and more than 1500 new cases on the last day results were gathered.
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