Just two junior doctors were left responsible for the care of 436 patients overnight at a hospital in Plymouth, a report has revealed.
A doctor raised concerns anonymously after being asked to leave their day job in a breast surgery in order to take the night shift at Derriford hospital, calling it a “very unsafe shift”.
“There would otherwise only be a single SHO looking after all of the medical patients in the hospital”
At 11am, the doctor who later raised the concerns was pulled from their day job in order to be able to provide medical cover for the hospital night shift.
Also working in the medical assessment unit that night was a doctor, two senior house officers and a house officer. However, the junior doctor pulled from their day job and one other senior house officer (SHO) were then made responsible for 436 patients – as well as carrying the crash bleep, which covered the entire hospital.
The report said:
Told on the phone that the deputy medical director had talked to my consultant and said I must do this, as there would otherwise only be a single SHO (senior house officer) looking after all of the medical patients in the hospital.
After discussion with my consultant we reluctantly agreed that the best measure from a patient safety perspective would be for me to attend this shift, despite it being unsafe and bad for my personal training/development.
Unfortunately, I did not manage much sleep before coming in for the night due to the short notice.
Between myself and the other SHO on ward cover we were responsible for the care of 436 patients between the two of us, while carrying the crash bleep which covers the whole hospital.
The report concluded:
(We) want it to be noted while having done our best; this was a very unsafe shift from the patient perspective.
Difficulties recruiting junior doctors
Normal practice would see three doctors covering the night shift, rather than two.
The deputy medical director for Plymouth Hospitals NHS Trust, Dr Peter Rowe, said that such incidents happened “rarely”.
He also said that the two junior doctors were not responsible for any ‘acutely unwell’ patients, and no new admissions.
However, he admitted that the hospital had experienced difficulties recruiting junior doctors. With 68 current vacancies, it is a concerning possibility that these incidents are going to become more common.
Of course, two out of three is not good and that’s why this was reported as an exception but it’s not the generality, and it’s not the whole hospital. It’s important to realise that.
These two individuals were working hard, and they were working harder than usual because only two of three of them were present, but they were supported by the greater doctors and everyone was aware of this was the position on that particular night.
These two junior doctors were working under such huge responsibility, one with a lack of sleep due to short notice and after being pulled from a day time position.
Under those circumstances, this ‘exception’ certainly doesn’t seem as ‘supported’ as the medical director insists, and the junior doctor who raised the concerns clearly feels differently.
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