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Dr Josie Cheetham is chair of the BMA’s Welsh Junior Doctors Committee and is a trainee in Acute Care Common Stem (Anaesthetics) in Aneurin Bevan University Health Board.
It has been six months since I had the privilege of taking up the chairperson position, working alongside colleagues on the Welsh Junior Doctors’ Committee. I am immensely proud to represent a diverse group of conscientious and committed individuals. In this blog, I want to talk about wellbeing and fatigue, interrelated topics of great importance.
We find ourselves emerging from a period that has received much media coverage under the coined phrase ‘winter pressures’. However, service delivery pressures remain high, day after day, year-round. As an Acute Care Common Stem (ACCS) trainee, working in Acute Medicine over much of the winter and then more recently in Emergency Medicine, my working days are filled with reminders of the dedication and altruism demonstrated by my colleagues in all specialities. The firm determination to deliver the highest quality patient care despite service demands (and even snow drifts!) is incredible.
As junior doctors, we are crucial to our patients, to our clinical teams and to the NHS, but we must remember that we are human. We know that reliable access to food and water, adequate rest and the length and quality of sleep have a sizable impact on mental health, cognitive function and overall morbidity. We, and those who organise our training and employment/working environments, owe it to our patients, ourselves, our families and our colleagues to remember that all these factors and needs apply to us too. We are not invincible, and should not be expected to work as such, nor expect our colleagues to do so. I am very aware that I am only as effective as the team I work in.
Fatigue from normal working days and the additional effects of being on-call, do not finish when you hand over or switch off your bleep; you are still a tired doctor on your journey home, during the adjustment period between overnight and day shifts, during rest periods. You cannot work or train effectively while overly fatigued. Having to tolerate unmanageable levels of fatigue not only affects patient safety but also affects the quality of our training opportunities and how we learn, having effects on the doctors we can be tomorrow. We are entitled to safeguards such as breaks and time-limited shifts: they are built into our contracts, and are essential and must not be disregarded in the face of increasing workplace pressures and rota gaps.
We are all stretched and trying to meet the needs of patients, colleagues and training programmes, but it’s so important that we make time to look after ourselves outside of working hours and that we are enabled to care for our own basic needs during working hours. We have long careers ahead of us where we can support, heal and comfort many people. Prioritising our own wellbeing is crucial. We can be the drivers of a change in culture if we work together as one profession.
Read more about the BMA’s work on fatigue and sleep deprivation here.