Call for safe working hours for junior doctors
This petition had 7,311 supporters
South African interns and community service doctors are working continuous shifts, often up to 36 hours, with no or little rest. The result is an increase in medical errors which can harm or lead to the death of patients. Their superiors offer them no alternative working arrangement.
Many studies have been done to show that if doctors work more than 16 hours continuously, they become a danger to themselves and their patients. One that stands out is where a tired doctor was compared to a drunk doctor:
“...after 24 hours of sustained wakefulness cognitive psychomotor performance decreased to a level equivalent to the performance deficit observed at a blood alcohol concentration of roughly 0.10 %[double the South African legal driving limit] .” -D. Dawson and K. Reid, Nature 388: 235, 1997.
Despite critical shortages of doctors, basic safety standards should be applied. You would not trust an exhausted pilot to fly your plane. You would not trust an exhausted bus driver to drive on the road. Why should exhausted doctors place patients at risk? Exhausted staff are a danger to their patients and themselves.
June 2016 update:
This petition was started in 2014 and received widespread media attention and support, see here
In June 2016, Ilne Markwat, a newly qualified junior doctor who was one of our classmates, passed away in a motor vehicle accident while driving home after a call. This tragedy could have been avoided if South Africa regulated the working hours of junior doctors in a safer way.
What has been the progress of the campaign thus far?
- The petition was handed over to the HPCSA’s internship committee in April 2016, who committed to providing urgent feedback.
- The call for shortening the maximum continuous duration of the shift was accepted at the 2015 JUSASA AGM.
- The petition was handed over to the Western Cape Minister of Health, Prof Nomafrench Mbombo, in February 2016, who committed to providing feedback.
Why the focus on the HPCSA?
The 2013 edition of the HPCSA Handbook on Internship Training states that continuous service worked by interns should not exceed 30 hours. We strongly contest this recommendation. There is ample evidence that working continuous shifts beyond 16 hours leads to cognitive impairment and poor decision-making, as well as increasing risk of harm to both patient and practitioner. Fatigued doctors are at a significantly increased risk of being involved in motor vehicle accidents and sustaining needle-stick injuries.
Our petition to the HPCSA has not resulted in tangible results. We are appealing to Minister Motsoaledi to publicly support our cause.
We are also asking for your help, whether you are a junior doctor, medical student, consultant, friend of family member or member of the public at the receiving end of medical care:
1. Support the call for an immediate 24 hour cap to all shifts, with further review and reduction to 16 hours in future.
2. Please share this petition widely.
3. Follow this campaign’s progress on our Facebook group www.facebook.com/SafeWorkingHours
4. Contact your local healthcare facility. We will provide templates for letters on our Facebook group soon.
5. Tweet your thoughts and progress using #safeworkinghours
If there ever was a time to join forces and push for change, it is now. It is only through pressure from within and outside the medical profession simultaneously, that this archaic practice can be stopped.
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