Patient safety is also workplace safety

Rosalind McDougall wrote in The Age on 26 July 2010 about the excessive and dangerous workloads of junior doctors in Australia. Similar articles have appeared elsewhere in the world for years but the hazard persists. Part of the reason for the hazard’s persistence is evident in the article if one considers the hazard as a workplace hazard rather than a patient safety hazard or a matter of customer service.

McDougall states the impact of excessive workloads for doctors:

“While most hospitals now have policies advocating ”safe hours”, the reality is many junior doctors work shifts that fail to meet the guidelines.”

“Numerous studies (as well as commonsense) indicate that doctors’ technical skills are compromised when they work too long.”

“While certainly not universal, some practices make it almost impossible for junior doctors to work safe hours.”

Where is the OHS regulator?  Is workers’ compensation for stress, fatigue or psychosocial hazards ever invoked by junior doctors? Are there OHS guidelines for the safe operation or design of hospitals and emergency wards?

There are very good reasons for inaction on the issue by the doctors themselves.  McDougall reports exploitation (my word) of junior doctors as an entrenched cultural phenomenon in the profession and the health sector.  Her argument is that the cultural practice puts patient lives at risk due to the potential misjudgments of junior doctors.  An alternate position is that a lack of commitment to the genuine application of OHS principles and legislative requirements by all levels of the Australian health sector are putting the lives of patients AND doctors at risk.

OHS legislative obligations have the potential to break the cycle of cultural exploitation.  What is required is a willingness by OHS regulators to act on the research evidence and undertake a summit on the issue with a broad range of stakeholders.  Hospitals need to start making cases that illustrate that under-resourcing is leading to an “inevitable” exploitation of junior doctors.  Doctors need to feel that they are able to exercise their OHS obligation to look after their own health and the health and safety of others without criticism.  Medical associations should not only research the issue but call on other associations to campaign on the unsafe and unhealthy (and arguably illegal) work practices being imposed on doctors.

Medical associations are not quiet on the issue but it takes a brave person at the beginning of any career to potentially threaten that career by refusing to sacrifice their own health for the good of the employer.  People need much more overt assistance in feeling that they can exercise their OHS obligations without penalty.  This must come from OHS stakeholders in the health sector, OHS professionals from outside that sector and the community generally who should not ignore the health needs of the people who help to save our lives.

Kevin Jones

reservoir, victoria, australia

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