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I’m incredibly fortunate to have some of the nicest people I could wish for as my colleagues; I have seen them develop, mature and grow over many years. They are a rich cosmopolitan bunch. They are diverse, they care about what they do and each other, they are a constant in an uncertain NHS world. They are our SAS doctors. The epitome of sustainability and stability, they are a long-sighted investment in the future of our NHS.
It was 3.30am, frosty, and I was really hoping for a quiet night. I had a very experienced SAS doctor on call, which helped of course. But that’s not how it works in obstetrics. I knew about the emergency c/section already, so when the call came to attend theatre immediately, I knew it was a question of needing extra hands. When a uterus doesn’t want to contract after delivery, it bleeds, rapidly and profusely. Given that the circulation to the uterus increases to 750ml / minute in pregnancy, and the blood volume increases to around six litres, that’s exsanguination in under 10 minutes, unless our drugs or manual compression of the uterus work. This compression can be maintained with sutures. Time is of the essence because maternal clotting becomes abnormal rapidly in the presence of such bleeding and it takes more than one skilled pair of hands in such circumstances. There was no panic though. Logically and calmly, we worked through the problems as they arose. All was well (and the woman kept her uterus - and has had another baby since).
I have more examples where working as a team with our SAS doctors has avoided a drama in a crisis and many occasions where I have learned from them - aortic compression in major hemorrhage, scanning, cervical balloons for induction of labour, the latest laparoscopic techniques. We have flattened our hierarchy and our patients have benefitted as a consequence.
SAS doctors scaffold our NHS hospitals and have become much valued professionals, but wider recognition often seems to lag behind. Despite a SAS Charter defining roles and expectations, many SAS doctors struggle to gain appropriate recognition and equal access to training or personal development opportunities. This is short-sighted by line managers and the wider service; it is both disappointing and heart-breaking to hear repeated and on-going stories of bullying and discrimination. Our duty as consultants is to stand up for, and support, this essential group of doctors, to take the time to know them as people, and to understand their needs and aspirations.
At labour ward handover this week, we comprised of three consultants and six SAS doctors discussing two patients with complex presentations. The discussion was lively, everyone chipped in with ideas and experiences from past patients across several continents. It was educational, exciting and fun; demonstrating why we each went into medicine as we trundled through rarities and stories enthusiastically. These SAS doctors have seen us through some tough and dark times, but they light up our department and I am certain this is the case for many more around the country. Let’s celebrate these unsung heroes of our NHS.
Dr Banfield is the chair of BMA’s Welsh consultants committee.
You can find out more about the BMA's UK-wide SAS doctor campaign, here and read the Welsh charter, here.
The scaffold needs a lot of support. If the support is not given, the building will fall.
The SAS Charter needs to be implemented.
Many thanks for your support
Thanks you can speak for department... Where I work it's a joke... Happy to share my experience... Jayadeep
Has always been a great supporter .well done Phil for highlighting it again , admire your work and support
I think we can do better, it's different in different hospitals
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