' Doctors tell of fatigue errors '


TIRED doctors working long and erractic hours are putting patient safety at risk,
research has found. Four out of 10 doctors had made a fatigue-related medical
error over a six-month period, a Massey University study of 1366 junior doctors found.
Twice as many doctors scored as excessively sleepy on a standard test compared
with the general population; nearly half (42 per cent) reported having fallen asleep
at the wheel driving home from work and most said work patterns caused problems
in their personal life.

Lead researcher and director of the university's Sleep/ Wake Research Centre Philippa
Gander said the results were worrying. " The reported levels of sleepiness, fatigue
related clincial error, and problems outside work caused by work patterns are all of concern,
for the safety and wellbeing of doctors and patients."
Professor Gander said a high number of night hours or unstable work patterns made it more
difficult to plan proper sleep.
Resident Doctors Association spokeswoman Deborah Powell said a lot of work had already
been done to limit junior doctors' working hours but more improvement was needed.
" The way we are working at the moment is not acceptable. There are health and safety risks to
employees and risks to patients. District health boards can't ignore that. "
A reduction in hours and roster re-organisation would help, she said.
Two North Island health boards have been trialling alternative rosters that reduce
night shifts from seven to four consecutive shifts and limit doctors to a 10-day stint
without a break, instead of the current 12. Both have been successful and the union would
push to introduce them nationwide, Dr Powell said.
She did not believe more doctors would have to be trained to work the extra hours.
The gaps could be filled by retaining some of the 20-25 percent who took their skills
District Health Boards New Zealand spokeswoman Margot Mains said Health Boards were
aware of the problem and had been working to find solutions. A resident medical officer working party was set up in January, with representatives from District Health Boards, senior and junior doctors. As well as reviewing the whole system, the group would look at a national role out of the alternative rosters, she said. The problem of junior doctor fatigue was not unique to New Zealand and significant progress had been made here compared with other countries, she said.

© 2005 The Dominion Post, Fairfax New Zealand