>I am of the opinion that no SHO should work more than an 8 hour shift as
>like me they go bonkers.
--> Not convinced of the necessity of the 8-hour limit. Many benefits to
having some flexibility in this, especially in order to allow more days off
by lengthening shifts, fewer weekend shifts, etc. One needs to employ other
methods for keeping SHOs from going bonkers, e.g. having them spend parts of
a shift in one area of department & other parts elsewhere. Also, consider
the value of more useful breaks than the minimum prescribed. An example I
have seen work well on a weekend:
SHO 1: 8am - 10pm (2 hour break from 1pm to 3pm, 1 hour break from 7-8pm)
i.e. 14 hours on site, 11 hours working
SHO 2: 1pm - 1am (1 hour break 5-6pm, 1 hour break 9-10pm) i.e. 12 hours on
site, 10 hours working
SHO 3: 9pm - 8am (1 hour break midnight-1am) i.e. 11 hours on site, 10 hours
working
With some other aspects not mentioned here, although 31 hours' work were
provided, SHOs seemed to feel these were very comfortable!
Big issue is to consider meal-times and how anti-social shifts are.
Personally, I use to work on a rota where I was quite happy to give up a
4pm-midnight shift and do the 8am-8pm shift instead, because I could still
go out at 8pm, which was nice to look forward to as I worked, while I tended
not to make any good use of the daytime before a 4pm start!
There are many other possible innovations and many are improved by the
"users" themselves - just let them try things out...
>I also feel we should have 2 SHO's on all night.
--> Well, you know your workload... But you can't get these 2 out of a 6-doc
team!
>Could I have some advice from other departments about how they manage
>similar problems?
--> My logic and experience tells me you'll need 8 SHOs to man 24/7, but
this is with just ONE for most of the midnight to am stretch. So you're
probably looking for 10 on the rota. Your patient load suggests you'll need
that many anyway (depending on how many are new vs. repeat visits)
>Over here they have 2 registrars a resident (SHO) and an intern on
>overnight.
--> BTW, Danny, if you also had SpRs or other grades, you could create times
when they take over care in the department and create a "replacement" for
the SHO who would otherwise be needed, i.e. they will have to provide some
service as a part of their role.
>12 hour shifts definitely turn people insane
--> Come on guys. We all did and many on this planet still do those. We have
also seen people go "ineffective" at 8 hours. There's more here than just
numbers and duration - it depends on morale, training, how many on at same
time, VISIBLE SENIOR SHOP-FLOOR SUPPORT and many other "tricks" to make
longer shifts effective.
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