>Certainly seems like an opportunity in my patch, Matt, to move towards a
>24-hour middle grade presence. We've already established that a
significa>nt
>proportion of our "breaches" occur after midnight, and it looks like much>
of
>our recent increase in attendances occur out of hours too.
>
>Adrian Fogarty
When you say 'middle grade', Adrian, do I hear the echo 'staff grade'?
Certainly seems that the registrars are less and less likely to have any
commitment beyond 5, or at best, 10pm.
Don't forget these staff grades will, if foolish enough to stick around
under current conditions, reach their 40s and 50s and be no more willing to
commit to this 24 hour cover than you are. I don't need to point out that
A&E with a 90% plus clinical commitment is hard, hard yards. It isn't
sustainable simply to shove the lion's share onto a small group of people
indefinitely. A 50:50 commitment is far more realistic, be it teaching,
research or one of the many other channels available. It is very easy in
A&E to lose perspective; I rarely go home feeling I have achieved anything,
and I suspect this is true for a significant proportion of middle graders,
and it fuels their egress from the specialty.
In GP people come back, you have an ongoing relationship and you see that
you are doing some good. Here, being dismissed as a whinger and a fool by
GP colleagues (I can forward the emails, if you want) it is harder to find
daily rewards, and difficult to know what to do.
I enjoyed the tale of the radiologist - today I had to ask a surcical SHO1
to arrange an IVP for a man with renal colic, as radiology won't accept the
form if signed by me.
Keep smiling! (even if it's a fixed grin)
Fiona.
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