Junior Doctors - Will the contracts have any effect?
As you all probably know I'm a second year nursing student and currently on my fourth placement. In the last 4 weeks I've worked on two junior doctor strike days; one was a full walkout including emergency care, and one was a 'half strike' (emergency care unaffected).
I think the easiest way to sum up how the strikes affected patient care - they didn't. Patients were still seen by a doctor in the ward round, there were still emergency admissions and emergency surgery. There were even some routine operations! Shock horror - the NHS didn't fall apart. When the junior doctors walk out, all of the consultants come into work, as oppose to just one or two on a normal day. All of the nurse specialists come into work, as oppose to just one or two. And in my current hospital we have military doctors step in to help. It is effectively all hands on deck to maintain patient care. This can be done for a couple of days here and then to cover the strikes, but it stretches staff too far to do it regularly. The new junior doctor contracts would mean this level of staff stretching would become the norm.
This video explains what the contract changes are and what they will actually mean - https://www.youtube.com/watch?v=T9891vEmUzw
As a student nurse I've seen a lot of acutely unwell and dying patients, but there will always be one I can't shake. A young man came into A&E after falling over at home. He had been drinking and taking drugs, he was only semi-responsive; seemingly improving but still some concern to staff. He became completely unresponsive, taken into resus and intubated (put to sleep with anaesthetic and put on a ventilator via a breathing tube). When stable he went for a CT scan of his head. He'd had a stroke, but I'd seen many stroke patients and this guy was different. He had a clot blocking a main artery feeding the brain. This was now 5 hours since the fall at home, for any stroke patient to be given a clot-busting drug it must be given within 4 hours, so this treatment wasn't an option. His only option was a surgical embolectomy, where the clot is surgically removed; a risky but potentially life saving surgery. Now this is where we hit a wall, no hospital in the UK will do this surgery outside of 6am to 10pm, they do not have the staff, equipment or theatre available or ready. It was midnight Monday night, this man would have to wait another 6 hours to have the embolectomy, but that would leave him outside of the time window an embolectomy has to be done in. He had no hope. This is the only time I have not seen a 24/7 NHS, and a patient suffered as a direct result.
However, making sure the junior doctors work longer hours wouldn't have saved this man alone. For his operation he needed an anaesthetist, an operating department practitioner, at least two scrub nurses, a consultant and a specialist surgical registrar (NB a registrar is a junior doctor). All of those people, plus the recovery staff, the cleaners, the porters and god knows how many more people, would have to be there. Just targeting the junior doctors is not going to create the 24/7 NHS Jeremy Hunt wants, or even the 24/7 NHS we, as a population, need right now.
If we ignore the fact the new contract won't change anything, it discriminates against women, and a loophole may mean hospitals don't even have to enforce it!
More food for thought -
Heidi Alexander vs Jeremy Hunt on this week's strikes
The dispute explained by the BBC
Poole Question Time fast forward to 10:10, a junior doctor debunks the '11,000 die at the weekends'
I think the easiest way to sum up how the strikes affected patient care - they didn't. Patients were still seen by a doctor in the ward round, there were still emergency admissions and emergency surgery. There were even some routine operations! Shock horror - the NHS didn't fall apart. When the junior doctors walk out, all of the consultants come into work, as oppose to just one or two on a normal day. All of the nurse specialists come into work, as oppose to just one or two. And in my current hospital we have military doctors step in to help. It is effectively all hands on deck to maintain patient care. This can be done for a couple of days here and then to cover the strikes, but it stretches staff too far to do it regularly. The new junior doctor contracts would mean this level of staff stretching would become the norm.
This video explains what the contract changes are and what they will actually mean - https://www.youtube.com/watch?v=T9891vEmUzw
As a student nurse I've seen a lot of acutely unwell and dying patients, but there will always be one I can't shake. A young man came into A&E after falling over at home. He had been drinking and taking drugs, he was only semi-responsive; seemingly improving but still some concern to staff. He became completely unresponsive, taken into resus and intubated (put to sleep with anaesthetic and put on a ventilator via a breathing tube). When stable he went for a CT scan of his head. He'd had a stroke, but I'd seen many stroke patients and this guy was different. He had a clot blocking a main artery feeding the brain. This was now 5 hours since the fall at home, for any stroke patient to be given a clot-busting drug it must be given within 4 hours, so this treatment wasn't an option. His only option was a surgical embolectomy, where the clot is surgically removed; a risky but potentially life saving surgery. Now this is where we hit a wall, no hospital in the UK will do this surgery outside of 6am to 10pm, they do not have the staff, equipment or theatre available or ready. It was midnight Monday night, this man would have to wait another 6 hours to have the embolectomy, but that would leave him outside of the time window an embolectomy has to be done in. He had no hope. This is the only time I have not seen a 24/7 NHS, and a patient suffered as a direct result.
However, making sure the junior doctors work longer hours wouldn't have saved this man alone. For his operation he needed an anaesthetist, an operating department practitioner, at least two scrub nurses, a consultant and a specialist surgical registrar (NB a registrar is a junior doctor). All of those people, plus the recovery staff, the cleaners, the porters and god knows how many more people, would have to be there. Just targeting the junior doctors is not going to create the 24/7 NHS Jeremy Hunt wants, or even the 24/7 NHS we, as a population, need right now.
If we ignore the fact the new contract won't change anything, it discriminates against women, and a loophole may mean hospitals don't even have to enforce it!
More food for thought -
Heidi Alexander vs Jeremy Hunt on this week's strikes
The dispute explained by the BBC
Poole Question Time fast forward to 10:10, a junior doctor debunks the '11,000 die at the weekends'
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