In the Doctor’s green room…
The medical profession is no easy trick. Eight years of medical studies, followed by three years of being a resident doctor, and still no guarantee of a job. To add to this, resident doctors work twice as much as consulting doctors or senior doctors. The Harvard Work Hours, Health and Safety group performed a study targeting 2,700 resident doctors in their first year of post-graduate residency. This study revealed that the doctors had to work for more than 80 hours a week, barely having any time to eat or sleep. The situation of Indian Resident doctors is similar, if not worse, with increased workload, decreasing nutrition and unhygienic residential hostels.
1. Workload:
Working continuously for 24 hours or more can cause doctors to lose concentration and make mistakes while at work. A lapse in concentration results in 64% of injuries while excessive fatigue results in 31% of the injuries that doctors are exposed to. Moreover, continuous lack of sleep and food causes burnouts in as many as 90% resident doctors and depression in 35% doctors.
Doctors in Delhi went on a strike in July 2015 to demand shorter work hours.
In government hospitals, as many as 500–700 patients are admitted every day, which are divided amongst 4–5 resident doctors. Dealing with 100 patients every day in addition to any emergency cases that may arise is too much of a workload on resident doctors. Moreover, the doctors are under constant pressure to handle so much responsibility since their degree is under constant danger. These doctors have to seldom work continuously for 48 hours without getting any break. Such stressful shifts lead to emotional breakdowns and depression. Moreover, the doctors find no time to study for their exams, which they are supposed to do simultaneously.
2. Nutrition:
Because of working continuously and having no breaks between shifts, doctors have irregular food intake. Many doctors have expressed that they survive an entire day of stressful conditions on only a couple of glucose biscuit packets, a few bananas and water. Since their shifts go on for long hours, doctors miss out on a proper lunch or dinner. They only have time to gobble up small portions of food to begin working again, which is not healthy, since doctors need energy to be able to focus well on work.
Resident doctors are the ones most affected by the patient load at hospitals.
3. Infrastructure of hostels:
When it comes to accommodation of resident doctors, the hostels that the government hospitals provide are no good. Doctors in Mumbai, Delhi and Pune have many times complained of the insufficiency of hostels for resident doctors. Moreover, the condition of the rooms is not up to expectations. The rooms are typically shared by at least 4–6 doctors. Most of the residential facilities are old and lack proper infrastructure.
About 56 doctors in Mumbai’s government hospitals were diagnosed with tuberculosis, two of whom died in 2013.
It is because of these reasons that doctors get exposed to multiple diseases, get depressed and lose touch with their personal lives.
While the number of incoming patients certainly cannot be controlled, the number of patients per doctor at a given point of time should be restricted or managed well. More doctors can be assigned patient duty to ease the workload. The presence of senior doctors and consultants should be made compulsory to provide assistance and support to resident doctors. It would bode well if doctors had sufficient lunch and dinner breaks at appropriate times to ensure proper nutrition for themselves. The requirement of improving infrastructure and hygiene of the hostels lies in the hands of the government and hospital authorities.
Sources:
India Medical Times- And they are called the backbone of the medical system. http://www.indiamedicaltimes.com/2014/04/26/and-they-are-called-the-backbone-of-medical-system-the-plight-of-resident-doctors-in-india/
The Indian Express- How inhumanly long work hours are killing young doctors, literally.
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