----- Original Message -----
From: "Craig Ellis"
Subject: Re: SHO BAND 2A ROTA
> Adrian and Phil,
> It wasnt a dig at the staffing structure, I understand the
"way it is". I still dont think working 14 hours in a high intensity
environment is good for learning, patient care or the SHO's themselves. Even
if relatively well supported. I agree that the best place to learn EM is on
the shop floor. It would be a disaster to have trainees only working 1/3
clinical. But performance declines with time - there is plenty of literature
around on it (mostly anaesthetic, but some Aust and US ED data) - in ICU/ED
environments 12 hr shifts are usually considered the max safe length, with
10 or 8 being the ideal. Putting a doctor, mostly 12 months out of med
school, on 14 hours shifts in ED is just not on IMO - although I do
understand the financial problems with increased staffing.
Oh I fully agree Craig, we've just gotta improve our balance, that's what I
mean; a few more registrars dedicated to clinical care rather than endless
courses, and a little less reliance on first year SHOs would go a long way
to redressing the balance.
> Craig (who currently works in a 65K department, with 26 SHO's, 9 middle
grades and 7 FTE consultants, where every single patient is reviewed or
discussed with a middle grade or above - so finds it very hard to comprehend
the UK system sometimes)
See what I mean about decades behind...
> P.S Adrian, Sorry about the grammer and spelling - Im pretty c#$p at both.
All is forgiven Craig!