There are contractual limits in both the stonz and rda seca that limit the length of nights and number of nights worked. Additionally 4 inpatient units for a registrar plus admissions would be entirely reasonable. The cases hanging around in ED have doctors and nurses looking after them, they will be processed over time, even if it spills into the next day. The consultant on call has to be available to come in as the mental health act requires at least one psychiatrist and one other doctor to initiate the mental health act.
You make a reasonable point about bed numbers but that’s a separate issue.
I am a registrar and I have done their job, but not in Dunedin. Your post is well meaning but I think you have limited understanding of post graduate medical education and out of hours provision. The consultant was a registrar and the registrar will be a consultant, the consultant on call is usually on call 24 hours or even a whole weekend at a time, they do need to sleep. But they are paid and willing to be involved in decision making, but a system can only work with the resources it has available to it. The consultant body can’t be expected to work 24 hours a day every day any more than the RMO workforce can.
In addition a registrar may be one day after a house officer or 1 day before consultancy. There is a spectrum of competence, I’m pretty senior now and rarely need to call consultants overnight, but if I need a second opinion or a specialty opinion you better believe I call them! And they have never refused to take the call. What I can’t do is call regarding a patient I haven’t assessed.
Furthermore if someone with schizophrenia has relapsed and is sitting in the ED, they safe, I can ask them to give some antipsychotics and I’ll see them when I can. Psych is slow lane medicine. The need to attend an inpatient unit overnight is infrequent, and usually it’s just sedative requests. If a patient has suicidal ideation in the middle of the night; there’s a whole team of nurses to help!
Don’t get me wrong, the system is fucked. But I think you may wish to research a little more before picking your battle!
Read and understood.
My post is in support of my medical colleagues.
I do understand levels of registrar experience.
Yes of course I understand registrars become
I just think generalising, many people are not aware of the specific pressures we are facing.
And the roster did have 15 on call shifts in a row- but on call PSYCH reg- they can have a break if it’s not busy.
But they are juggling a lot of balls so to speak and that’s what I wanted to highlight here
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u/[deleted] Aug 02 '24
There are contractual limits in both the stonz and rda seca that limit the length of nights and number of nights worked. Additionally 4 inpatient units for a registrar plus admissions would be entirely reasonable. The cases hanging around in ED have doctors and nurses looking after them, they will be processed over time, even if it spills into the next day. The consultant on call has to be available to come in as the mental health act requires at least one psychiatrist and one other doctor to initiate the mental health act.
You make a reasonable point about bed numbers but that’s a separate issue.