# 006 ... 256

Monday 08:00am - Tuesday 18:00pm = 34hrs
Wednesday 08:00am - Thursday 18:00pm = 34hrs
Friday 08:00am - Monday 18:00pm = 82hrs
Tuesday 08:00am - Wednesday 18:00pm = 34hrs
Thursday 08:00am - Friday 18:00pm = 34hrs

This was a normal 2 week for interns doing a 1:2 roster in the hospital I worked at for the first two years post-graduation from medical school ... that is 218 hours worked per fortnight on a normal rotating shift. And that's assuming one actually could walk away from the job at 18:00pm on your rostered "night off" AND assuming your consultant didn't drag you in for an early ward round to start the day ... a 36 hour "day" was not uncommon. We were paid at a "normal hourly rate" for the first 120hrs per fortnight, then paid "time and a quarter" for "overtime hours" and nothing for hours worked that were not on the roster.

Insane? ... damn right it was!

We thought we were in heaven when worked a 1:3 roster so we worked only every third night overnight ... with the dreaded weekend shift only every third weekend.

We changed jobs every three months ... only one of those rotations was the 1:3 medical ward job.

Why such an insane weekend system?

You see, this was a small rural hospital that, in order to attract new medical graduates, offered a "country weekend". If you had a city job, your "weekend off" started at 13:00pm on Saturday (again, if you were lucky enough to actually get away on time) so you NEVER had a full weekend off. Most country hospitals started their weekend off at 18:00pm Fridays ... but the consequence was that those left behind to work the weekend started their job normal time 08:00am Friday morning and didn't finish until 18:00pm Monday ... 82 hours later!!

The hospital administration also claimed it could not allow us to have more than two weeks off each year, despite the fact we were entitled to six weeks holiday (our "award" gave us four "normal" weeks leave plus additional for all the "public holidays" and weekends we were required to work).

We worked very long hours.

I remember one fortnight's timesheet I signed off on 256hrs ... it was a change over of jobs and I got the short straw and managed to work two "weekends" in a row. Just to save you the calculation, there are only 336 hours in a fortnight. The "normal" working fortnight for "real people" was 76 hours.

We grabbed sleep when we could, we ate when we could, (desperately, and unhealthily fast in case we got interrupted - and we not infrequently were), we toileted when we could no longer hold on and we worked constantly ... and we made mistakes.

I grieve that I probably made many mistakes, and not all I became aware of. I hope I learned from my mistakes ... we all made mistakes, some that may have resulted in the premature death of the patients in our care, certainly some that added to the already profound level of stress we all felt, and many that added to our own work load and that of our colleagues.

The stress taught us how to consume alcohol, a lot of alcohol - we didn't have much else to spend our hard earned money on.

The lack of sleep strained relationships.

The lack of sleep also took the life of one our colleagues. She was heading back to the city (two hours drive away) for her weekend off ... in the failing light and no doubt, with overwhelming fatigue, she missed a corner and drove herself off the road.

It was this year that our state Health Minister decreed that the normal working week for hospital-employed doctors was to become 48 hours replacing the 60 hours. It didn't immediately reduce our hours, but we were paid a little more for what we did. Slowly that extra wages cost ate a hole in hospital budgets so over the next few years, the rostered hours for hospital doctors were gradually reduced to reduce costs.

This eventually made life for young hospital doctors a little more bearable, at least for when they had the time off.

I wonder if it made life harder for those left behind to do the work.

Our older colleagues would say that we lost our experience when our working hours were reduced.

I would ask - what experience did we lose that was worth more than the life gained and the iatrogenesis prevented?