Doctors face similar exhaustion across Tasman

By GREG ANSLEY

CANBERRA - The alarm would have jarred Nicholas Barrett from sleep at 5.30 am today.

By 7am he would have been taking over from night staff in the intensive care unit (ICU) at a large Sydney teaching hospital, preparing for a day divided frantically between the unit, wards and emergency admissions.

His working day will end at 7 pm tonight, after 12 gruelling hours with sandwiches and coffee on the run.

And these are the good times: outside the structured hours of the ICU, life can get really crazy.

Dr Barrett is a 27-year-old junior doctor, three years out of university. For the first couple of years he and his colleagues can expect to earn between $A35,000 ($44,000) and $A40,000 a year.

During a rare break from work, he wonders at the number of New Zealanders heading across the Tasman, most of whom return within a couple of years.

"The grass may appear greener, but I suspect it's probably just as brown."

For Dr Barrett and his colleagues, the battle to end 32-hour shifts, redesign rosters and ease a crushing workload has taken on new urgency through a safe-hours campaign by the Australian Medical Association.

Research by Coopers and Lybrand for the association tells the story: 40 per cent of junior doctors work more than 60 hours a week, 15 per cent more than 70, and 5 per cent more than 80.

For the first couple of years, says Dr Barrett, junior doctors are relatively protected, with 14-hour maximum days.

After that the pressure really starts. Most registrars, especially surgical, are on call throughout the night after a normal working day.

Thirty-two to 36-hour shifts are still quite common, says Dr Barrett, and the risk, to both patients and doctors, is high.

"After 18 hours of being awake and working you have an equivalent in terms of poor thought processes and poor eye-hand coordination of a blood-alcohol level of 0.05," he says.

"I think after 24 hours it's about the same as a blood-alcohol level of 0.1, so if someone's not allowed to drive I find it difficult to believe they're expected to operate."

Several of his friends have had car accidents on the way home.

And Dr Barrett has a caution for the apparent appeal of a salary in Australian dollars: In Sydney $A40,000 doesn't even cover your costs.