I have been a doctor for 8 years, which is a very satisfying career but this year I broke… and by broken, I mean shattered into a million pieces. For the last four years I have been working as Plastic & Reconstructive surgery registrar, with a focus on hand surgery. As part of this role, we are “on call” which means that for 24 hours you are at the beck-and-call of the hospital.
Earlier this year I was working on rotation at Hospital X. Every fortnight I worked 12 days, and got 2 off. Of the 12 days I worked, I was on call for 10… that’s 240 hours of being on stand-by just in case anyone in the hospital might need me. Even after going home, my phone is still on overnight just in case a doctor or nurse in the hospital may need some phone advice, refer a patient, or less commonly, for me to return to the hospital to review a patient whom they are concerned about. Most nights I would receive phone calls until midnight, and a few times a week I’d get woken up by a call in the middle of the night. 3am seemed to be the most popular time.
Some nights were so busy, that whilst I was parking my car in my underground carpark on the occasions that I did make it home or whilst taking a quick shower I would miss 3 phone calls. I remember there was one time I was on a call and during that one call 4 calls were also coming in at the same time. I would get calls every 5 minutes sometimes. I felt like I was getting “phone raped” by the sheer volume of calls, especially those that weren’t particularly necessary or could have waited till I was at work the next day.
The days were long. My longest day was 20 hours long. There was a little boy whose finger tip got amputated, which is a time-critical emergency that I finished operating on at around 10:30pm. As I was getting changed out of my scrubs to go home, I got a phone call about another hand injury. The emergency doctor was happy for me to see the patient the next morning but I thought I might as well review the patient as I was still physically in the hospital.
This man was a labourer who cut three of his fingers on his dominant hand. One of his fingers was pale, which made me concerned about the arteries to that finger. I rang my boss about this urgent case but he did not come in to help me with this complex operation… so it was just me to fix this man’s fingers. He cut through several structures (tendons, nerves, etc.) in his three fingers and it took me until 3am to repair all of the damage under a microscope.
I was too tired to drive home (and what would be the point? It would take me nearly an hour to drive home, I’d sleep for maybe an hour, and then have to drive back at 6.30am). As I often did, I slept on a random chair in the doctors’ office that night. My next day was 16 hours long and I was not allowed to take a break. Days like this continued for several months… it’s no surprise that my sleep was (and still is) completely ruined.
I’ve had post-traumatic symptoms.. I think I can hear my phone ringing when it’s not, and I get anxiety when I see a call from “No Caller ID” (as the hospital would always call from a blocked number). Needless to say, this workload was completely unsustainable and despite myself and 6 other doctors (including the Head of Surgery) requesting my department to revise the on-call roster, nothing changed and I eventually physically could not function and resigned in June this year from this job. More about this in another post!
Anyone who does night shift work or on-call, I hear you. I will also be writing another article soon on signs of burnout to look out for. I was aware of some of my signs, but unfortunately that didn’t matter because my hospital did not care. It’s very sad when the very people who work tirelessly to look after others don’t get looked after by their own workplace.