by My name is Brian Connelly. I’m 67 and retired. I don’t have any particular expertise in blogging but I do have a story to tell. I would also like you to support my campaign to make junior doctors’ working hours safe.
My daughter Lauren began work as a junior doctor in August 2011 at Inverclyde Royal Hospital in Greenock. She died in a road traffic accident on Saturday 17th September, 10 days before her 24th birthday, driving home after a 12-hour nightshift. After conducting their investigations, police told us they believed she may have fallen asleep while driving home. Thankfully, no-one else was involved or injured in the accident.
During her short career as a junior doctor, Lauren had become increasingly tired. Her shift rota contained periods when she worked for 10 and 12 days in succession, working in excess of 100 hours each time. This without a weekend or full day rest between shifts. Before starting nightshift on Friday, she had already worked Monday to Thursday dayshifts, 9 to 5. She was scheduled to work 7 continuous nightshifts and would have worked 117.5 hours on 12 days without a full day’s break had she completed this run of shifts.
I cannot prove it but I firmly believe that a contributory factor towards her death was fatigue caused by the hours she worked as a junior doctor.
I started to investigate further into junior doctors’ working hours and soon discovered that Lauren’s experience was shared by other junior doctors, that the hours they work cause too many to experience tiredness when at work and puts their safety and their patients in danger. Governments and the NHS in Scotland and the rest of the UK know this but have not taken effective preventative measures to eliminate the chronic fatigue many medics suffer from. The 1998 Working Time Directive, a health and safety law, passed to protect workers by limiting the hours they are permitted to work to 48 for each 7 days, has been rendered ineffective by statistical manipulation and has ignored the reality of the actual hours junior doctors work and the fatigue the legislation should protect them from.
I decided to campaign to reduce the number of hours and the number of consecutive days which junior doctors work. The changes I’ve argued for are as follows:-
- Junior doctors should not work more than 48 hours in any 5-day period
- Working periods should be followed by 2 days off
- Actual working hours should be recorded.
Junior doctors are not supermen or superwomen despite the heroic efforts we ask of them and they actually perform. They are as susceptible to the effects of fatigue as the next person. There is no good reason why they should have to work the excessive number of hours they do or to experience the fatigue which results.
Health care in Scotland is a devolved matter and is the responsibility of the Scottish Government so I’ve met with Alex Salmond, when he was First Minister, and Cabinet Secretaries responsible for Health and have argued my case for reform. To their credit, they have made some improvements and have given their commitment to introduce others. I will continue to exert as much pressure as I can until the required changes are made.
The problem of tired and overworked doctors is not confined to Scotland, it’s UK-wide. I’m determined to achieve my objectives and ask that everyone who reads this to join my campaign. Write to MP, your MSP in Scotland, Assembly Member in Wales, and MLA in Northern Ireland and put pressure on them to make junior doctors’ working hours safe.
We must not allow Lauren’s experience to be repeated. We must not reward the commitment and dedication of our junior doctors with exhaustion. We must take better care of those who work so hard to take care of us.
We must end the national scandal of overworked and chronically fatigued junior doctors – NOW!
If you support my campaign, please raise this issue with your MP/MSP/Assembly Member/MLA. You can use the attached template letter to write, or use its contents in an email.
You can find their contact details here: www.theyworkforyou.com
Please feel free to comment below.
Save Doctors Lives 
Hi Brian just read your Blog it’s pretty powerful and I’m appalled at the way we treat our Junior Doctors. I sincerely hope you achieve your objective it beggars belief that any other profession would not be subjected to these unreasonable working hours.
And I would lend my support.
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Thanks, Emma. I’ve put another post up. Please read it and the attachment. I’d be grateful for your support, as many people as I can get, in fact. Please distribute. Spread the word. Get as many people writing as you can. Thanks
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Hi Brian,
Very powerful reading and who could argue what you are asking for would not be of immense benefit to doctors and patients alike and surely the powers that be must see sense and find a way to implement the changes as soon as possible. Numerous other workers with nothing like the pressures and demands faced by our doctors aren’t expected to work in these conditions and in reality we would all want the best care and attention from those looking after our loved ones, doctors are only human and although capable of delivering miracles they have no chance to do so whilst running on empty. We expect so much of them and they always try to deliver and should be afforded the conditions to allow them to do so for all our sakes. Lauren will always remain in our hearts and hopefully through her horrific loss the changes will emerge to prevent such a tragedy occurring again and sooner rather than later. You have my full support in any way possible.
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This is a fantastic cause and it’s just heartbreaking that such a terrible thing had to happen for Brian to achieve so much. Keep going, and know you have support from all over the UK.
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Brian won his arguments 5 years ago. the Scottish parliament and NHS hierarchy must be pressed from all quarters but particularly patients and the general public to implement the changes they know are required. 5 years is disgracefully too long
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My daughter is an F2,and I have been worrying about her working hours since she qualified ; she also leads a very busy social life.
I ask her to rest more and work fewer hours,but I’m told neither is possible because of that which must be done and because of her dedication,which appears to be common to the majority junior doctors.
In this day and age it strikes me as absurd that anyone should be at risk through exhaustion caused by their profession. Our politicians appear unable to address the situation which,when they are told of it,does not appear to come as a shock.They must therefore be fully aware of the position,and are prepared to allow it to continue.Shameful !
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Hi Brian,
I am a junior doctor and I have had to work 12 day stretches multiple times in the last 4 years as have all of my doctor friends. I have also had terrifying drives back after night shifts. There are on call rooms at my hospital but have to be pre booked and the accommodation office doesn’t open til 10am which is an hour after you’ve already left to drive and there’s no guarantee of a room. Thanks for your support of all junior doctors. I know all of our parents appreciate it. I’d be happy to be involved in a similar campaign in the North West if you want to get in touch.
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Please get back to me on brianconnelly1@hotmail.co.uk and head the email Rosie from NW – I’ve been deluged with notifications of views on the blog so this will help me identify it.
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I am so sorry for your loss. I too am the mother of a first year junior doctor (F1) and am appalled by how junior doctors are treated. It starts with them effectively working unpaid in their last year of medical school, continues to (in England, it might be different in Scotland) not being able to choose to work near their support networks of friends and family (hospital allocation is largely a lottery), have no ability to work part time (just not allowed. End of). My daughter struggled to get a flat to rent as the NHS were unable to produce a contract or confirmation that she had a permanent post (she has still not yet had a contract) so she could not pass landlord referencing (this is common amongst junior doctors) and there is a very limited ability to choose holiday (it can only Co-incide with standard day rostering) making it hard to ever go away with friends or family. She started her first shifts on nights earlier this month, but was also rostered to go to induction during the daytimes too! Now that the new contract mandates being paid for compulsory training, it seems that there is a tendency to make vital training “strongly recommended” so that whilst you would be negligent to go, those hours do not count as `’work” for the WTD or for pay. The NHS is a monopsony – there is only the one potential employer for junior doctors, private work only being legal once you are a consultant. This is how the bad practice has been allowed to proliferate. The junior doctors have NOWHERE else to work unless they bin 6 years training and a life time’s vocation. The governments should be ashamed of themselves for allowing this situation. Recently, there was a letter in the Times reminding senior doctors to buy F1s lunch as they would not get paid until the end of the month and often could not afford to eat (assuming they could find time). I fully support your campaign., and once again sympathise with your heartbreaking loss. I am so sorry.
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Thank you for this campaign. My daughter is at medical school and although we are so very proud I have always had concerns. You have so eloquently explained them. I have worried about her being so tired that she makes a mistake that she will never be able to recover from. The pressures on these wonderful young people, who lets face it, already put enough pressure on themselves, are as you know only too well – dangerous! I am so very sorry and sad for your loss. Please know that your sharing will affect others and many of us are profoundly grateful. I have never written to my MP before but have done so today and will be looking for more ways to support your campaign.
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Hi Brian,
As the mother of a doctor who has just started her F2 year I fully support your campaign.
I feel so frustrated with the lack of care and support our young doctors receive.
It seems that we barely acknowledge they have basic human needs like eating, drinking, sleeping and even having time to go to the toilet let alone offering care and support for all the traumatic things they may come across.
I am so sorry about what happened to your daughter. My heart goes out to you and I will do anything I can to help this cause.
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I am the mother of a junior doctor (4 years qualified) and its disgraceful how overworked these dedicated young people are. The long hours and shifts (five day shifts follwed immediately by 3 long day shifts) is shocking not to mention the blocks of long night shifts. On top of all this, there is study for exams to be done as well. I have worried about my daughter driving long motorway drives home after night shifts and have the same system as you had, ringing before she leaves. She is often exhausted and lacking in fresh air or exercise as its work work work and study continually. Occasionally her days off consisted of her being in bed with a migraine and sickness but then she would be up again for the next shift. What other profession would this be allowed to happen? If you can do something to reduce the long hours of junior doctors, then that will be so worthwhile. I am so saddened by the heartbreaking loss of your dear dedicated daughter. She deserved better. They all deserve better.
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Thank you for sharing your sad story and being so brave highlighting these issues since Lauren’s accident. I too am the mother of a junior doctor and throughout F1 and F2 and then for the next 2 years I was worried so many times about my daughter. As you describe, the way they calculate the hours worked does not take into account the way their hours are spread. She was permanently shattered, whilst dealing with hugely emotional issues. Many times she missed friends’ weddings and family get together’s and then had days off when no-one was around and at too short notice to plan anything. Getting holiday when she wanted was an issue too, because it can only be booked once on the relevant rotation, so she was never sure she could commit to a holiday. She did lose a couple that she had booked, including her best friends hen do which she had organised! She really resented all this eventually and I was worried about her mental state. She loved being a hospital doctor, but after these 4 years it was clear things had to change, so she did GP training (which was 2 more years in the hospital first) and she is now a GP which she loves. These hours are long and stressful, but it was those long night shifts, without enough recovery time, and the whole rota system that made the hospital intolerable for her.
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I’m so sorry for your lost. I’m seeing the exact same problem in Singapore. My loved one is a registrar now but I don’t see how it is getting better after the terrible junior years. Ever since she has became registrar a few months ago, she has been assigned for multiple presentation/teaching. Everything has to be delivered in a week time. On top of that, she still has to run her clinics, go to wards and see patients, coach junior doctors, read research papers and work on a research topic. What’s more, she still has to be on call! She is burning out very terribly. Worse, she is not seeing an end to it. The system here has the maximum working hours but the problem is most of the time the doctors cannot finish all the assigned duty within the maximum hours. They are still expected to deliver it. If a doctor clock more than the maximum hour a week, the poor doctor will be penalized by the boss. This system is just crazy. On the surface, it seems like it is protecting the doctors, but it is just driving the doctors nuts. It is not solving the root problem. They need to reduce the workload of a doctor as well! I hope to have similar movement here as well.
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Have just read your story – I am going to protest at the BMA – its the senior consultants at BMA who are responsible for this. My very best to you and your family
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I remember when I was a resident in the US. I was once forced to work 68 hours without sleep, which was inhuman. The long shift started at 7am on a Monday. I was on call that night and the next night after that. When my daily shift started on Wednesday 7am after the consecutive call nights, I had been awake working at the hospital for 48h straight. At the end of that day at 5pm, my 58th hour without sleep, I had to drive back home. Almost killed myself driving, being so incredibly tired. But I finally made it home in one piece and jumped into my bed. At that exact moment, the phone rang and it was my chief resident asking me why I was not at the hospital as I was apparently on call again. I told him I had been awake for 58 hours straight and there was no way I could be on call again. He told me to drive back to the hospital as I was required to do the shift. I took my car again, and drove back to the hospital after more than 58h without sleep. The drive back went smoothly, luckily. I then started my third night in a row on call. At 3am in the morning, my body collapsed in a waiting room out of extreme exhaustion. I had been forcibly awake for 68h straight. They found me a few hours later at 7am and woke me up. I immediately looked at my pager to see how many calls I had missed while I had collapsed. Fortunately there were none. Had I missed any calls, I could have been fired. This is what practicing medicine in the US is like.
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Dear Mr Brian, Very sorry to hear about Lauren. I am a Senior Consultant in Medicine and the pain of junior doctors I expressed in my way in a poem called: Post Call Zombies:
Post Call Zombies!
With droopy eyelids, walking with us like a machine,
This young Doc is attending the rounds in a dream.
He has been ‘On’ since previous morning when bright,
He was on call, up and about, didn’t sleep the whole night.
He now answers in monosyllables, understands little,
Miss-spells and miss-reads, is even slow to twitter.
His eyes are red, legs frail, brain very hot,
A little more and he will either shout or just drop.
This is not the first or the last time, that he knows is his fate,
It happens every third or fourth day and he can’t escape.
It takes two days to recover; he can then see the next date,
He’s wedded to the ‘Duty Rota’ for his career’s sake.
Seniors won’t help him for they have been through it all,
Since nobody helped them then, why now bother at all.
This is the eternal cycle through which all Docs must pass,
Like it or not, you have no choice, Alas!
Long hours prey on young Doc’s health and take their toll,
They also make him thick skinned and insensitive to others call.
He may learn avoidance techniques, not respond to some calls,
Someone definitely suffers from this mismanagement of ‘Calls.’
Now they’ve realized that our clients- the patients- do suffer,
If the doctor on call is not well-rested and doesn’t appear fresher!
If the nurses, pilots, factory workers have eight hour shifts,
Is the doctor super human to give quality in 36 hour shifts?
Now somehow though late, the wisdom has dawned, (1)
A shift of longer than 13 hours for doctors is banned. (2)
After the shift, for 11 hours they must rest and not work, (3)
The quality of care will improve as 56 hours a week, law works. (4)
Young people have been deserting Medicine as a career for long,
They may now be brought back happily, they may sing a song.
We work for the good of the patient; we don’t want any harm,
Let’s have more doctors- dedicated to serve and charm!
References:
1) Rory Watson. On-call time in health centers must be seen as working time.
BMJ 2000, Oct. 14, 321, 918.
2) NHS is not ready for a 48 hour working week. Rhona MacDonald.
BMJ 2002, 25 May; 324: 1235
3) Trusts are ill prepared for 58 hours a week for Junior Doctors. Katherine Burke.
BMJ 2004, Feb 28; 328: 484.
4) Debashis Singh. Quarter of hospitals not ready to comply with working time directive.
BMJ 2004, May 1; 328: 1034
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