14 hour shift in medicine FML (1 Viewer)

strawberrye

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Lol who does the weekend shifts in private hospitals? Oh I forgot also JMOs. Good luck trying to do 15 cannulas, rewriting 30 med charts/reviewing medications, admitting 3 patients, supervising 3 CT scans, 10 venepunctures, placing 20 fluid orders whilst checking patients electrolytes, chasing results and scans, reviewing 5 patients etc. and the list goes on. I actually worked 15 hours but no one puts in overtime for 1-2 hours and sometimes more than that.

Wait you have no idea about the system and you are making a comment what a joke. LOL you try interpret an ECG to the level of an advanced cardiology trainee OH wait YOU CAN'T. I'm not talking about STEMIs, NSTEMIs, Hypertrophy, Heart blocks I'm talking about acute on chronic changes and what they mean in the context of the patient's situation.

Typical law student, talks shit about another field when they have no idea. Enjoy your 70+ hour work week if you want to make a decent lawyer.
Whilst I do not want to derail this thread, and I can understand your potential annoyance at an uneducated response, I think it is not fair to make a stereotype on law students, most law students that I know of actually don't talk 'shit about another field when they have no idea". Whilst we appreciate your hardworking nature and the hectic lifestyle that you are having right now, I would greatly appreciate it if you don't devalue or stereotype other professions through your word choice.
 

nerdasdasd

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Destined for the reject pathway = GP career. Good luck bulk billing and earn only a $100K in the suburbs.
Maybe people like bulk billing and don't mind earning 100k?

That isn't that bad of a salary, and there's more to a career / profession than money
 

Medman

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Destined for the reject pathway = GP career. Good luck bulk billing and earn only a $100K in the suburbs.
4pm-12pm = 8 hour shift?

I've read his other threads typical troll has nothing better to do with his life. What a sad sad person. I would feel sorry for him but not really. I do apologise for making that assumption about law students but I'm just going by the general population stereotype and yes it is wrong.

Thanks patpatpat for the advice appreciate it. Yeh I realised how little I actually know even regards to simple things such as replacing electrolytes as you never truly get that practice as a medical student. Also I would like to point out as a medical student you don't really understand the dosages and the different brand names with different doses make it even harder. Still trying to wrap my head around the standard doses for common medications but hopefully will catch on soon. They said starting off on relief is difficult and that is definitely true. I also try to ask as many questions to everyone, experienced and good nurses know a heck of a lot.
 
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enoilgam

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lol i swear half your posts are about discouraging people to study med
It isnt discouraging, but more about being realistic. What medman has said is nothing new to me personally, because Ive long known about how tough medicine could be. But a lot of people cant see past the prestige of medicine and are shocked at the reality.

To be honest, I read stuff like this and find it quite concerning that doctors are allowed to work these hours. Pilots, air traffic controllers and even construction workers have regulations in place which prevent them from working excess hours for safety reasons. There are even regulations in place for nurses when it comes to their shifts. So I cannot understand why Doctors are allowed to work these hours, especially given the high level of life and death responsibility involved.
 

bangladesh

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It isnt discouraging, but more about being realistic. What medman has said is nothing new to me personally, because Ive long known about how tough medicine could be. But a lot of people cant see past the prestige of medicine and are shocked at the reality.

To be honest, I read stuff like this and find it quite concerning that doctors are allowed to work these hours. Pilots, air traffic controllers and even construction workers have regulations in place which prevent them from working excess hours for safety reasons. There are even regulations in place for nurses when it comes to their shifts. So I cannot understand why Doctors are allowed to work these hours, especially given the high level of life and death responsibility involved.
I disagree with your first part. We all know(and get told again in medschool) about the hours and the working conditions we'll have to cope with so having a little cry about it is a bit stupid because it is what it is. And I say all his posts are discouraging because he keeps raving on and on about how hard it is to get a job after graduation and get into competitive specialities. Again, there are reasons why some specialties are extremely competitive and not once has he talked about the fact that a lot of specialties are actually UNDERSUBSCRIBED and aren't very competitive.
 

Schmeag

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I disagree with your first part. We all know(and get told again in medschool) about the hours and the working conditions we'll have to cope with so having a little cry about it is a bit stupid because it is what it is. And I say all his posts are discouraging because he keeps raving on and on about how hard it is to get a job after graduation and get into competitive specialities. Again, there are reasons why some specialties are extremely competitive and not once has he talked about the fact that a lot of specialties are actually UNDERSUBSCRIBED and aren't very competitive.
The official working hours for a junior medical officer in Australia aren't too bad. You might go over if you are in surgery, but cover doctors should be there to take up the slack (they may give you **** for handing them work but that's why they are there, as long as you've put in effort during your shift). I don't think doctors at a junior level necessarily have it worse than other health professions. A theatre tech the other day was complaining about a 14hr shift and there are plenty of non-medical staff who have to do evening or night duty.

There are some undersubscribed specialties, but I wouldn't say a lot. Which ones were made to be aware were undersubscribed?
 

bangladesh

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The official working hours for a junior medical officer in Australia aren't too bad. You might go over if you are in surgery, but cover doctors should be there to take up the slack (they may give you **** for handing them work but that's why they are there, as long as you've put in effort during your shift). I don't think doctors at a junior level necessarily have it worse than other health professions. A theatre tech the other day was complaining about a 14hr shift and there are plenty of non-medical staff who have to do evening or night duty.

There are some undersubscribed specialties, but I wouldn't say a lot. Which ones were made to be aware were undersubscribed?
ye very true. But as an intern, you need to be ready for super long shifts and it's a part of the job.
 

Kiraken

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Wait till ur a surg reg lol

Dem hours
 

patpatpat

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To be honest, I read stuff like this and find it quite concerning that doctors are allowed to work these hours. Pilots, air traffic controllers and even construction workers have regulations in place which prevent them from working excess hours for safety reasons.
I've never had any trouble working a long shift, and I cannot think of anyone I've worked with whose struggled (and this includes mature aged students). People get tired as the day goes on, but if you are a competent doctor then you won't let it compromise patient safety. The reason why people struggle is because of how busy the shift gets, not because of its length.

There are plenty of regulations on junior doctors just as there are on other industries. In my previous hospital we were only allowed to do 2 rostered overtime shifts per week if we had a ward job. Just remember that pilots, construction workers will still do long shifts. Unfortunately it is the nature of rostering (finishing at 11pm and starting at 6am three days in a row) and the amount of unrostered overtime that causes issues.

And the hours increase as you go up the scale. An orthopedic registrar on-call over a weekend in a busy hospital will start work at 7:30am on a Friday morning and finish work at 4:30pm the next Monday, and during that entire time may only have a few hours sleep because of the amount of work they have to do.

Again, there are reasons why some specialties are extremely competitive and not once has he talked about the fact that a lot of specialties are actually UNDERSUBSCRIBED and aren't very competitive.
What are these specialties you speak of??? Looking through the AMC list of recognised specialties, I can think of psychiatry (becoming increasingly difficult), rehab, public health (what do they even do), sexual health and maybe palliative care.

That many GP programs are oversubscribed should give you an idea that the situation is as bad as people make it out to be, and it's not getting better because this is what the government wants (forces more people to join ACRRM and become a country GP, which is where they need doctors).

The official working hours for a junior medical officer in Australia aren't too bad. You might go over if you are in surgery, but cover doctors should be there to take up the slack (they may give you **** for handing them work but that's why they are there, as long as you've put in effort during your shift). I don't think doctors at a junior level necessarily have it worse than other health professions. A theatre tech the other day was complaining about a 14hr shift and there are plenty of non-medical staff who have to do evening or night duty.
With respect I disagree with two things.

Depending on your rotation it is very easy to work a large amount of unrostered overtime if you are doing your job right. After hours doctors are there to deal with things that arise when the day team isn't there, they should not be caught up with med charts and cannulas that the day teams were too lazy to do. It can be forgiven if you are working 1-2 hours over and are too tired to do a med chart, it is a poor reflection on you if you leave on time with a number of jobs outstanding, especially if they are clinical reviews. And surgery is far from having the busiest jobs, try a rural medical rotation or a metro oncology/haematology job.

On the whole doctors do have it harder than other health professionals in hospitals, but we have the greatest payoff at the end. Nurses may have shiftwork which includes evening and night shifts, but they are limited to 80 hours/fortnight (unlike doctors who are 80 hours/fortnight plus rostered overtime) and have the option to work extra overtime if they wish but are protected by their award if they choose not to (unlike doctors who are compelled to). They also have protected breaks, unlike JMOs who may do 10 hours straight without a toilet break on a busy shift.

Physiotherapists, speech pathologists and the like do have weekend work, but they are either compensated by a day off during the week, or are on a roster which provides a lot less overtime than JMOs. Theatre nurses and radiologists on call have a number of arrangements which benefit them if they get called in (time off, significant penalty rates). And to top it all off, doctors (including interns) have clinical responsibility for patients which they review.

That's not to denigrate the other health professions, who work extremely hard and, on a case by case basis, may outdo their intern/RMO. But a realistic picture needs to be presented to people considering medicine, and it is not a bed of roses.
 

Dupain

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4pm-12pm = 8 hour shift?

I've read his other threads typical troll has nothing better to do with his life. What a sad sad person. I would feel sorry for him but not really. I do apologise for making that assumption about law students but I'm just going by the general population stereotype and yes it is wrong.

Thanks patpatpat for the advice appreciate it. Yeh I realised how little I actually know even regards to simple things such as replacing electrolytes as you never truly get that practice as a medical student. Also I would like to point out as a medical student you don't really understand the dosages and the different brand names with different doses make it even harder. Still trying to wrap my head around the standard doses for common medications but hopefully will catch on soon. They said starting off on relief is difficult and that is definitely true. I also try to ask as many questions to everyone, experienced and good nurses know a heck of a lot.
4pm - 12 am shift is 8 hours, not 4pm to 12pm. Shit you are dumb.
 

Havox

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I think I hit nearly 70 working hours last week in 5 days with 1 rostered overtime shifting and making up the rest going overboard with unrostered. It's not so much the length of time that was exhausting but the amount of stuff that built up during the day including getting paged repeatedly both for good reasons and bad ones (45 in a single day...wut...?). I still love my job but I don't think last week was representative of a normal working week, even at a hospital that was busy by reputation on a team that was considered busy for that hospital. 14 hour days as a standalone aren't too bad, as long as you don't need to do them back to back.
 

Schmeag

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With respect I disagree with two things.

Depending on your rotation it is very easy to work a large amount of unrostered overtime if you are doing your job right. After hours doctors are there to deal with things that arise when the day team isn't there, they should not be caught up with med charts and cannulas that the day teams were too lazy to do. It can be forgiven if you are working 1-2 hours over and are too tired to do a med chart, it is a poor reflection on you if you leave on time with a number of jobs outstanding, especially if they are clinical reviews. And surgery is far from having the busiest jobs, try a rural medical rotation or a metro oncology/haematology job.

On the whole doctors do have it harder than other health professionals in hospitals, but we have the greatest payoff at the end. Nurses may have shiftwork which includes evening and night shifts, but they are limited to 80 hours/fortnight (unlike doctors who are 80 hours/fortnight plus rostered overtime) and have the option to work extra overtime if they wish but are protected by their award if they choose not to (unlike doctors who are compelled to). They also have protected breaks, unlike JMOs who may do 10 hours straight without a toilet break on a busy shift.

Physiotherapists, speech pathologists and the like do have weekend work, but they are either compensated by a day off during the week, or are on a roster which provides a lot less overtime than JMOs. Theatre nurses and radiologists on call have a number of arrangements which benefit them if they get called in (time off, significant penalty rates). And to top it all off, doctors (including interns) have clinical responsibility for patients which they review.

That's not to denigrate the other health professions, who work extremely hard and, on a case by case basis, may outdo their intern/RMO. But a realistic picture needs to be presented to people considering medicine, and it is not a bed of roses.
Nothing is a bed of roses except an actual bed of roses. Medicine is a job and I feel as though other career pathways might have something similar (I have no proof).

As with anything, I think there is variation in personal experience. I have done a whole rotation of a metro onc/haem cover job, and I would have to say it was in hindsight one of the most lifestyle-friendly rotations I've had. However, the home teams and onc/haem/other regs were very good/supportive and did not consistently stay back late (they would have late days, of course). The weekends were busy, but palatable. I will admit that I have not had the (dubious?) luxury of working as a medical registrar in a rural hospital, but in my post I referred to the hours working as a junior medical officer.

As a member of a home team, I am not for the "leave at 5pm and not a minute later" mentality, but neither am I of the "stay until 10pm until absolutely everyone is sorted" mentality--I know of both types and it is a personality thing. Also, I know of those covering residents who will write passive-aggressive STAT orders instead of doing a rewrite. Does it effect a patients' clinical care? Its hard to say--the most important thing is a good handover, to trust your covering residents and a tacit awareness that we are not able to survive being alert for 24/7; in fact, it is bad for the patient. The home team and the covering team just need to be considerate of each others needs. Everyone needs to looks after themselves and their colleagues.

Once an admitting medical registrar reviewed all his patients' stories until 3am even though he had finished at 10pm so he could present well to the consultant on the 8am ward round! Many doctors may stay back to prepare discharge summaries for early morning discharges. However, if the home team is asked to review a patient at 4:30pm and they finish at 5pm, this is a job that I would (if I start at 4:30pm) happily do and encourage the home team to get on with their administrative things for the rest of their shifts while I cover the clinical aspects: I do not think poorly of the home team if I need to do this, as this is the whole concept of a covering doctor. Rewriting medical charts and resiting IVs is a courtesy and not compulsory (it is nice to remind the home teams once in a while, especially interns who have yet to experience the absolutely joy of a cover shift!). In my experience resident-type jobs are generally not too bad. I've found night ED shifts to be the busiest due to the constant adrenaline (getting to the eating part can be quite hard), but still not terrible. I don't really notice after a while.

I think an important point patpatpat brings up is that the ultimate responsibility lies with the doctor, and I feel that this separates us from the rest of the healthcare profession. We might not have scheduled tea breaks, so its a case of prioritising. Healthcare is evolving, with expanding roles of other healthcare professionals, nurses and allied health are becoming more clinically experienced and are become more involved or are expanding into many roles considered to be a doctors' realm. However, the doctor is the one most accountable.
 

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Just spoke to a usyd grad interning in Prince Alfred atm. Seems to be fairly good. But he did say some orthopedics hours get pretty high. He has a finance background so was good to see both sides finally.

Will be rekt if I have to go rural to get jobs.
 

enoilgam

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Just spoke to a usyd grad interning in Prince Alfred atm. Seems to be fairly good. But he did say some orthopedics hours get pretty high. He has a finance background so was good to see both sides finally.

Will be rekt if I have to go rural to get jobs.
Wait, rish are you going into Medicine?
 

Medman

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Just spoke to a usyd grad interning in Prince Alfred atm. Seems to be fairly good. But he did say some orthopedics hours get pretty high. He has a finance background so was good to see both sides finally.

Will be rekt if I have to go rural to get jobs.
Is his name Andrew? He's a nice guy and a close friend. He's really passionate so that's a plus.

I disagree with your first part. We all know(and get told again in medschool) about the hours and the working conditions we'll have to cope with so having a little cry about it is a bit stupid because it is what it is. And I say all his posts are discouraging because he keeps raving on and on about how hard it is to get a job after graduation and get into competitive specialities. Again, there are reasons why some specialties are extremely competitive and not once has he talked about the fact that a lot of specialties are actually UNDERSUBSCRIBED and aren't very competitive.
I'm a realistic kind of person and I'm not super competitive. Therefore, I find it pretty hard to distinguish one self from others who are pursuing a other activities to put on their CV. If you put in the effort you will reap the benefits however the effort one needs now is certainly much more than before. I'm not saying the hours in medicine are bad, they are not as terrible as IB but with medicine it's not just work you have all these other commitments such as ongoing study, presentations, research which will definitely affect the "hours committed to medicine" which is a lot higher than just purely working.

There's a reason why specialties are undersubscribed. Palliative care, rehab medicine, drug and alcohol medicine, psychiatry, maxillofacial surgery, medical administration, clinical genetics etc. Not many people want to do these specialties because they are their own world and are slightly different to normal medicine as we all know it. Please refer to a Government website I have linked to understand the context of how competitive the environment is right now. You can only imagine once you graduate in 5 years time how even more competitive it will become given that there isn't any plans to build new hospitals. There is talk about expansion and Blacktown Hospital will expand to the size of Westmead but how many people deep down inside truly would not mind Blacktown? Not many I can tell you that despite the fact that medicine should not be about us but the patients.

http://www.health.nsw.gov.au/careers/Pages/career-planning.aspx

If you have ever seen me with a patient you would realise I have great manners, approach and communication skills which are much better than some consultants. I know I won't be a crap doctor but I also want to look out for my own interests and pass on a realistic message to students. When I was a student everyone I spoke to just said medicine is great, no one actually went to describe anything else which is unrealistic. This is what we call in medicine an informed choice. People need to see both sides and make a decision themselves. I would like to reiterate medicine is definitely rewarding, a patient kissed my hand after I just put in a cannula and I saw her get wheeled out of hospital yesterday, it was extremely gratifying. On the alternative side you have patients who do not listen to a word you say and continually bounce back to hospital every few weeks after you've spent so much time caring for them which frustrates you. This is the REAL WORLD. Not all patients will appreciate your help but a majority will.

I think I hit nearly 70 working hours last week in 5 days with 1 rostered overtime shifting and making up the rest going overboard with unrostered. It's not so much the length of time that was exhausting but the amount of stuff that built up during the day including getting paged repeatedly both for good reasons and bad ones (45 in a single day...wut...?). I still love my job but I don't think last week was representative of a normal working week, even at a hospital that was busy by reputation on a team that was considered busy for that hospital. 14 hour days as a standalone aren't too bad, as long as you don't need to do them back to back.
70 hours is not glamorous considering they only pay us for 43 hours of rostered work so if you don't claim unrostered overtime you are being paid about ~$22 per hour. Does your hospital pay you a meal allowance if you work past 7pm? We had an issue with the hospital not honouring that part of our award which could come to an extra $27 per day worked past 7pm which adds up. Legally it should be paid and a few hospitals I know pay the meal allowance.

Tell me about the built up of work load. I was running on adrenaline for the whole 14 hours. I don't think I would volunteer for weekend shifts at this stage given the lack of experience but I hope in time it will get better. I also hate the fact that trying to finding a vein on a difficult patient and failing to cannulate really sets you back so much!
 
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Kiraken

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Blacktown hospital isn't a bad environment at all tbh

Only reason i wouldn't go there is if i wanted to go into a specialty that wasn't available there like neurosurgery.

Also there are plans to build a new public hospital in Rouse Hill too which should be done by the early 2020s if not late this decade
 

Medman

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Blacktown hospital isn't a bad environment at all tbh

Only reason i wouldn't go there is if i wanted to go into a specialty that wasn't available there like neurosurgery.

Also there are plans to build a new public hospital in Rouse Hill too which should be done by the early 2020s if not late this decade
Yeh it's not terrible but I have a progressive mindset and it really annoys me that little things could be done to improve efficiency but they don't happen.
Neurosurgery good luck with that I've heard it's insanely hard to get in. I think Blacktown is heading in the direction where all major specialities will be incorporated at some point in time. Jobs here for you in the future. I haven't heard anything about Rouse Hill but that is good news!

One of my friends originally wanted to do it and decided to do a PHD at med school as it will help him get in but he's having second thoughts on medicine.
 

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