scholarly journals On call: a valuable training experience for senior house officers?

2005 ◽  
Vol 29 (2) ◽  
pp. 59-61 ◽  
Author(s):  
Rhiannon Callaghan ◽  
Gabra Hanna ◽  
Nick Brown ◽  
Christopher Vassilas
Keyword(s):  
Decision Making ◽  
Learning Experience ◽  
European Working Time Directive ◽  
Clinical Implications ◽  
Training Experience ◽  
Out Of Hours ◽  
Improve Working ◽  
Working Lives ◽  
European Working ◽  
Working Time Directive

Aims and MethodTo describe the experiences of psychiatric senior house officers (SHOs) of being on call. A survey of SHOs on three on-call rotas across south Birmingham was conducted to investigate their opinions about on-call work and to consider how time on call is spent.ResultsSHOs in psychiatry gain a broad range of experience out of hours on a traditional on-call rota. On-call periods were valued as a learning experience and 63% of SHOs were confident in their decision-making while on call. However, on-call work was often viewed as isolating, and not all SHOs felt that they were working as part of a team when on call.Clinical ImplicationsAs changes to working patterns are introduced, for example in order to implement the European Working Time Directive, care must be taken to retain the positive aspects of current on-call systems. Such changes should be seen as an opportunity to improve working lives so that SHOs feel less isolated when providing out-of-hours cover.

scholarly journals The EWTD: friend or foe to quality patient care?

2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent
Keyword(s):  
Patient Care ◽  
Medical Staff ◽  
Junior Doctor ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Quality Patient Care ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.

scholarly journals Surgical training and EWTD – can it be done?

2007 ◽  
Vol 89 (6) ◽  
pp. 206-209 ◽  
Author(s):  
WH Allum ◽  
NI Markham
Keyword(s):  
Surgical Training ◽  
Working Time ◽  
European Working Time Directive ◽  
Training And Education ◽  
Out Of Hours ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
Postgraduate Surgical Training

The introduction of the European Working Time Directive (EWTD) has created specific and predictable pressures on surgical training and education. In many hospitals the emphasis has been on ensuring a safe service, particularly out of hours. This has been to the detriment of training opportunities. The changes inherent in Modernising Medical Careers with the introduction of progressive training will further limit the amount of time for postgraduate surgical training to a total of six or seven years.

Out-of-hours cover in oral and maxillofacial surgery

2008 ◽  
Vol 90 (8) ◽  
pp. 282-283
Author(s):  
G Reddy-Kolanu ◽  
M Ethunandan ◽  
R Anand ◽  
V Ilankovan
Keyword(s):  
Medical Staff ◽  
Maxillofacial Surgery ◽  
Working Time ◽  
European Working Time Directive ◽  
Oral And Maxillofacial Surgery ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Dental Pathology ◽  
European Working ◽  
Working Time Directive

The European Working Time Directive (EWTD) has required all departments to re think staffing arrangements to provide out-of-hours ser vices. Large departments with man y junior doctors can continue to have oral and maxillofacial surgery (OMFS) SHOs covering the out-of-hours ser vice without exceeding the constraints of EWTD. For smaller departments the choice has been either to close the on-call service and centralise it in a larger department or to have a specialty cross-cover arrangement. The problems of cross-cover might be more apparent in OMFS than in other hospital specialties due to other medical staff possessing a negligible knowledge of dental pathology.

BAUS Section of Endourology Guidelines for Acute Management of First Presentation of Renal/Ureteric Lithiasis

2009 ◽  
Vol 2 (3) ◽  
pp. 134-136 ◽  
Author(s):  
Bo Parys ◽  
Sam McClinton ◽  
Graham M. Watson ◽  
Kenneth M. Anson ◽  
Neil Burgess ◽  
...  
Keyword(s):  
Emergency Management ◽  
Working Time ◽  
European Working Time Directive ◽  
Acute Management ◽  
Quality Service ◽  
Out Of Hours ◽  
European Working ◽  
Working Time Directive ◽  
Urological Emergencies

The European Working Time Directive (EWTD) poses challenges for out of hours management of the acute urological patient. With the introduction of the “Hospital at Night” team or cross specialty cover, there may be limited onsite urological experience out of hours. One of the commonest urological emergencies is acute stone colic. For the on call team to provide a safe and quality service, the BAUS Section of Endourology has produced guidelines for the emergency management of urolithiasis.

scholarly journals Psychiatry at night: experience of the senior house officer

2006 ◽  
Vol 30 (9) ◽  
pp. 329-333 ◽  
Author(s):  
Jules Mason ◽  
Tina Irani ◽  
Garyfallia Fountoulaki ◽  
Sylvia Warwick ◽  
Jane da Roza Davis ◽  
...  
Keyword(s):  
Service Provision ◽  
House Officer ◽  
Adverse Impact ◽  
Clinical Implications ◽  
Senior House Officer ◽  
Training Experience ◽  
Prospective Data ◽  
Out Of Hours ◽  
Senior Nurse ◽  
Working Time Directive

Aims and MethodWe gathered detailed prospective data for first on-call activity of senior house officers (SHOs) in order to help plan changes in service provision so that SHOs in psychiatry complied with the Working Time Directive and to determine whether service changes affected training experience while on call. The incumbent SHOs designed a simple form to monitor on-call activity in West Berkshire.ResultsAdmissions and assessments make up a quarter of calls but three-quarters of the work. An overnight crisis service reduced the number of assessments made by SHOs out of hours by 68%. Screening of calls by a senior nurse reduced the number of calls about in-patients by 60% on weekday nights. Between 73% and 100% of calls about in-patients after midnight were for assessment of patients in seclusion and rapid tranquillisation.Clinical ImplicationsThis survey helped to plan service delivery and to monitor the training of SHOs during on call. Screening of calls by a senior nurse, alternatives to seclusion and nurse-led prescribing for rapid tranquillisation would have the largest impact on the work generated by in-patients. The overnight crisis service reduced the number of assessments, but might have an adverse impact on training.

scholarly journals A qualitative investigation of Foundation Year 2 doctors’ views on the European Working Time Directive

2015 ◽  
Vol 29 (3) ◽  
pp. 367-380 ◽  
Author(s):  
Myanna Duncan ◽  
Cheryl Haslam
Keyword(s):  
Time Management ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Working Time ◽  
European Working Time Directive ◽  
Semistructured Interview ◽  
Out Of Hours ◽  
Content Type ◽  
European Working ◽  
Working Time Directive

Purpose – The purpose of this paper is to examine the personal views and experiences of Foundation Year 2 doctors operating under the European Working Time Directive (EWTD). Design/methodology/approach – In total, 36 Foundation Year 2 doctors from a single UK-based Deanery participated in this semistructured interview study. Findings – Findings indicated that Foundation doctors typically welcomed a regulation of working hours, but reported frustration at the manner in which the Directive had been implemented. Participants reported concerns at reducing hours by removing out-of-hours working in order to meet EWTD requirements. Out-of-hours shifts were highly valued owing to their increased opportunities for autonomous clinical decision making. By contrast, day-shifts were regarded as heavily administrative in nature and were perceived as service provision. Foundation doctors discussed the unique nature of the out-of-hours working period which appeared to provide specific learning opportunities as doctors draw on time management and prioritisation skills. Originality/value – Given the challenges the EWTD presents, careful rota planning is essential. First, the authors would encourage the restructuring of day-shift work to provide a greater emphasis on hands-on skills experience in a supportive, supervised environment. Second, where possible, Foundation doctors might benefit from the opportunity to engage in some out-of-hours working, such as with multi-professional “Hospital at Night” teams. Third, the authors would encourage junior doctor involvement in rota design and planning which may increase their perceived autonomy and therefore buy-in of working practices.

scholarly journals Service innovation: psychiatrists on call – the community at night

2007 ◽  
Vol 31 (2) ◽  
pp. 65-67
Author(s):  
Laurence Mynors-Wallis ◽  
Denise Cope
Keyword(s):  
Medical Care ◽  
New Deal ◽  
Health Professionals ◽  
Service Innovation ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
European Working ◽  
Working Time Directive ◽  
The New Deal

There have been significant changes in the provision of medical care in hospitals at night. The initial catalyst for this was the New Deal for Junior Doctors but more recently the European Working Time Directive requiring doctors' hours to be reduced to 56 in 2002 and to 48 by 2009. The reduced availability of junior doctors in hospitals at night has had a range of implications, including the necessity to train other health professionals to do work previously undertaken by doctors and a reduction in the number of specialist doctors available out of hours. The expectation is that staff in the hospital at night will be equipped to deal appropriately and safely with emergency work across specialties, rather than each specialty covering their own patients.

Covering ENT out of hours: how confident are senior house officers?

2006 ◽  
Vol 120 (7) ◽  
pp. 587-590 ◽  
Author(s):  
S J Davis ◽  
S McDonald
Keyword(s):  
Patient Management ◽  
Telephone Survey ◽  
Working Time ◽  
European Working Time Directive ◽  
Middle Grade ◽  
Out Of Hours ◽  
Call Structure ◽  
European Working ◽  
Working Time Directive

Background: The implementation of the European working time directive has led to an increase in cross-speciality out-of-hours cover. This survey illustrates ENT out-of-hours cover arrangements and assesses the implications for senior house officers (SHOs) responsible for managing emergencies.Methods: A telephone survey of 100 ENT departments was conducted, asking the on-call SHO about departmental structure, on-call rota design, their previous ENT experience, access to SHO training and their confidence in managing emergencies.Results: 44 per cent of departments used only ENT SHOs on the on-call rota. 73 per cent always had an ENT middle grade on call. In 60 per cent of hospitals, the ENT consultant was sometimes on call with only a non-ENT SHO. At the time of the study, 5 per cent of SHOs had no ENT experience, no access to training, were not confident in managing simple emergencies and were on-call without middle-grade cover.Conclusion: The current junior on-call structure for ENT has implications for patient management.

scholarly journals EWTD: maintaining the pressure

2009 ◽  
Vol 91 (8) ◽  
pp. 258-259 ◽  
Author(s):  
John Black
Keyword(s):  
Medical Association ◽  
Working Time ◽  
European Working Time Directive ◽  
News Item ◽  
Junior Doctors ◽  
Public Concern ◽  
European Working ◽  
Working Time Directive ◽  
First Time ◽  
Radio Programme

The ill-judged introduction of the 48-hour week demanded by the European Working Time Directive (EWTD) was the first news item on every television and radio programme on Saturday 1 August, indicating just how successful the College has been in raising public concern. It was encouraging that the British Medical Association (BMA) speakers were for the first time expressing serious anxiety, largely about the effects on training and about pressure being put on junior doctors to falsify their hours returns. All conversions to the cause are welcome, however late in the day. It is disappointing that the BMA is not yet stressing the dangers to patients, which they are surely hearing about from their members working in the acute specialties.

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