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On call: a valuable training experience for senior house officers?

  • Rhiannon Callaghan (a1), Gabra Hanna (a2), Nick Brown (a3) and Christopher Vassilas (a2)

Abstract

Aims and Method

To describe the experiences of psychiatric senior house officers (SHOs) of being on call. A survey of SHOs on three on-call rotas across south Birmingham was conducted to investigate their opinions about on-call work and to consider how time on call is spent.

Results

SHOs in psychiatry gain a broad range of experience out of hours on a traditional on-call rota. On-call periods were valued as a learning experience and 63% of SHOs were confident in their decision-making while on call. However, on-call work was often viewed as isolating, and not all SHOs felt that they were working as part of a team when on call.

Clinical Implications

As changes to working patterns are introduced, for example in order to implement the European Working Time Directive, care must be taken to retain the positive aspects of current on-call systems. Such changes should be seen as an opportunity to improve working lives so that SHOs feel less isolated when providing out-of-hours cover.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

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On call: a valuable training experience for senior house officers?

  • Rhiannon Callaghan (a1), Gabra Hanna (a2), Nick Brown (a3) and Christopher Vassilas (a2)

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On call: a valuable training experience for senior house officers?

  • Rhiannon Callaghan (a1), Gabra Hanna (a2), Nick Brown (a3) and Christopher Vassilas (a2)
Submit a response

eLetters

Recent changes to SHO on call duties

Oliver G White, SHO in Psychiatry
28 April 2005

Dear Editor,

In their recent paper Callaghan et al (Psychiatric Bulletin, February2005) showed that in general senior house officers (SHOs) in psychiatry valued on-call periods as a learning experience. However, the European Working Time Directive (EWTD) regulations regarding hours worked and rest requirements are now well and truly upon us and this has caused concern regarding the training of SHOs in other specialties (Mayor, 2005).

In Nottingham, SHOs in psychiatry previously worked a high intensity shift pattern that was non-compliant regarding EWTD regulations. Measuresimplemented to ensure compliance included the appointment of psychiatric nurses to work specifically at night as the first point of call for anyonereferring to the psychiatric SHO. Initially SHOs were involved with the majority of the assessments but over time the nursing team’s experience has increased and they are now proficient in managing almost all of the referrals independently. As a consequence, SHOs are now finding that their participation in acute decision-making, risk assessment and devisingmanagement plans has reduced significantly.

The implementation of specialist nurses into the role traditionally fulfilled by SHOs should not act as a barrier to training. Additional measures need to be introduced to ensure SHOs remain exposed to acute psychiatric cases. Possibilities include nursing teams providing a directtraining role and a more comprehensive trainee’s logbook where emergency cases seen are recorded. This would also be a step towards workplace-placed assessment for doctors in training which is emphasised in Modernising Medical Careers (DoH, 2002).

Yours faithfully,

Dr Oliver WhiteSHO in psychiatryQueen’s Medical CentreNottingham.

REFERENCES:Callaghan, R., Hanna, G., Brown, N. & Vassilas, C. (2005) On call: a valuable training experience for senior house officers? Psychiatric Bulletin 29, 59-61.

Department of Health (2002) Unfinished business proposals for Reformof Senior House Officer Grade. A Paper for Consultation. London: Department of Health

Mayor, S. (2005) UK surgeons report that EU directive has cut training time BMJ, 330, 499.
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