Hospital Dr News

Cultural change around doctors’ night shift working is needed, says AAGBI

A new three-point plan has been proposed to address the culture surrounding doctor fatigue in hospitals.

The Association of Anaesthetists of Great Britain and Ireland (AAGBI) wants to tackle the problem of excessive fatigue with night shift working, which is known to impair decision making.

The AAGBI says tiredness at the end of night shifts is of particular concern, with tragic reports of doctors who have died in car accidents, having fallen asleep at the wheel on their commute home.

Research suggests that 85% of trainee anaesthetists are at high risk of burnout, with fatigue being a risk factor for this.

According to the AAGBI, a junior doctor in an acute hospital specialty, such as anaesthesia, will work over a year’s worth of hospital night shifts in the first ten 10 years of their career.

Consultants also work resident night shifts, and are subject to commonly interrupted nights’ sleep when they are on call.

The Association is calling on all anaesthetic departments and hospitals to provide rest facilities, and points to the examples of other industries with a responsibility for public safety, such as pilots or HGV drivers, where rest breaks are mandatory.

It calls on the government to:

  1. Support publication of a national survey about junior doctor fatigue, covering accessibility of hospital rest facilities, commuting after working night shifts and the impact of fatigue on physical and psychological health.
  2. Roll out of a fatigue education programme informing doctors and their managers about fatigue and how they can reduce its risks.
  3. Define the standards for adequate rest facilities and cultural attitudes towards rest in hospitals.

Dr Emma Plunkett, chair of the Group of Anaesthetists in Training (GAT) Committee at AAGBI, said it’s time for healthcare professions and NHS managers to acknowledge that working at night is not the same as working in the day, and that for the sake of patient safety, steps must be taken by all parties to manage night working safely.

Limiting working hours is a positive step to reduce fatigue, she says, but it cannot overcome the powerful biological drive that requires humans to sleep at night.

Unfortunately, as working patterns changed, many hospitals removed staff rest rooms that provided facilities for staff to take an important restorative nap during a quiet moment at night.

There must be “a change the culture around fatigue” she added.

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