Over half of anaesthetic trainees have had car crash or near miss after night shift, survey finds

Authors: Abi Rimmer 

Publication date:  07 Jul 2017


Over half (57%) of anaesthetic trainees have experienced a crash or near miss when driving home after a night shift, a survey conducted by the Association of Anaesthetists of Great Britain and Ireland has found.

The study, published in Anaesthesia, outlined the findings of the survey, which received 2170 responses from UK anaesthetic trainees.[1]

Most (84%) of the respondents said that they had felt too tired to drive home after a night shift, and 57% said that they had experienced a crash or near miss in doing so.

Respondents talked about falling asleep at the wheel and about being woken by rumble strips on the road, the paper said. “Adverse events were not only reported by motor vehicle users. There were also multiple reports of such events amongst walkers and cyclists,” it said.

The survey found that only a third (32%) of trainees were aware of the existence of rest facilities in hospitals where they could sleep after a night shift, and just 17% had ever used such a room to sleep. The reasons given by trainees for not using rest facilities included “just wanting to get home” or the unsuitability and lack of accessibility of facilities.

Laura McClelland, a coauthor of the study, said, “We want rest facilities made available to people not only while they’re working on their shift but also for an unlimited period between shifts, because a lot of the issues that arise post-shift stem from the fact that people don’t know if facilities are available, they don’t know where they are, how to access them.”

She added, “By making rest facilities the norm, encouraging people to use them and making them an attractive option for them will gently, over time, shift the culture.”

A 10th of respondents also said that they had to pay for on-call rest rooms, the survey found. “We’ve seen prices of up to £70,” McClelland said, “which, understandably, people don’t want to pay. The calibre of the accommodation is not usually very high.”

The survey also found that trainees were prevented from resting during their shifts by other members of staff. In free text comments, some respondents cited examples of nurses objecting to doctors resting on shift and, in some instances, intentionally disturbing them, the study said.

“Nursing staff are not meant to sleep on their shift. Many do, but it depends on the local policy, and they are far less supported and will often face disciplinary action if they are caught sleeping,” McClelland said. “So, with that attitude towards nursing staff, it does put pressure on us. The expectation of nursing staff is sometimes that we [trainees] mustn’t rest.”

The Association of Anaesthetists of Great Britain and Ireland has established a “Fatigue Group” with the Group of Anaesthetists in Training and the Royal College of Anaesthetists, the paper said. It will look at establishing a “traffic light” grading system for rest facilities, at attitudes towards fatigue in hospitals, and at encouraging anaesthetists to advocate change.

McClelland said, “We’ve developed a set of standards which will be rolled out in the next couple of months. Even though it’s not official guidance, it’s the best that we have been able to come up with, and we hope that trusts will adopt these suggestions and work towards creating some official guidance in the future.”

References

  1. McClelland L, Holland J, Lomas J-P, Redfern N, Plunkett E. A national survey of the effects of fatigue on trainees in anaesthesia in the UK. Anaesthesia  2017;(Jul). [Link] [Link] .

Abi Rimmer BMJ Careers

 arimmer@bmj.com

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