50 hours a week and more – hospital patient care: The doctor
is probably overtired violations of the labour law are more often the rule than the exception – what is the work of inspectors around. That the doctors, more and more administrative tasks will have to spend, exacerbated the Problem. Robert Mayer1 Kommentar1Intensive layer services, and then still a lot of administrative work: the upper and the interns are up to their limits and beyond, demanded.Photo:
a Good half of the top doctors and assistant doctors has seen in the last two years that patients were in danger because the treating doctors were tired. Between 2013 and 2019 have increased, such “Almost-errors”, with potentially fatal consequences for the patient. The proportion of upper – and interns is, the witnesses of such events had risen in this period from 38 to 52 percent.
“This result has me scared, really,” says Jana Siroka, President of the Association of Swiss assistant and senior physicians and doctors (VSAO) in Zurich. To the light, he came in the recent members survey conducted by the Association.
From the survey, the reason for the Fatigue to the hospital doctors will be seen: the long hours of work, not to go in many places, only on the contractual provisions, but also against the labour law.
At the Limit
“With colleagues, I have found time and again that they couldn’t focus out of sheer exhaustion on their work,” says Siroka, who has recently been working as a senior physician in the Basel arlesheim clinic. “But there is no one who could fill in. And not to say “today” that goes on in a hospital.”
According to the survey, which referred to the last year, did not correspond to the working times of 62 per cent of respondents to the statutory provisions. In compliance with the law, they were only 23 percent of the participating VSAO members, for the Rest of this was not clearly determined.
“In a number of hospitals there is a fear culture. “This goes so far that assistance had to clock out doctors and then continue to work.”
Jana Siroka, President of the VSAO Zurich
Striking is also: Every second Respondent worked in 2019, longer than the legally permissible maximum working hours are 50 hours per week. 69 percent said they worked longer than the contract time specified. In fact, the number of people Affected is likely to be even greater, because, on average, two and a half weekly hours of work were not reported by the respondents at all.
How come? “In some hospitals, a fear culture,” says Siroka. “This goes so far that assistance had to clock out doctors and then continue to work.” The hospital lines, the Zurich VSAO-President, were under increasing pressure to comply with the legal requirements – what is the often limited resources difficult. Thus, this pressure will reach “here and there, from the top down,” she says.
Not a celebration evening after the end of the shift
The hospitals places the Problem with the labour law, which had to be a little flexible. “This flexibility would be important to the working hours of assistant and senior physicians in the clinical reality,” stresses Anne-Geneviève Bütikofer, Director of H+, the Association of private and public hospitals. To not belong to this reality, that the “emergency patient times are usually fixed work”.
in Addition, according to Bütikofer, that patients should, wherever possible, be by the same Physicians cared for. The quality of care depended decisively. “Continuity and frequent change of shift are often in contradiction to each other”, gives the H+to the concerns of the Director.
“the emergency patient is not on fixed working hours.”
Anne-Geneviève Bütikofer, Director of H+
it also refers to the “desire of many assistance and to afford the top doctors, stage a above average, also with regard to the working hours”. Who strive, professionally, quickly ahead, intention to learn in the training time as much as possible and is therefore willing to make a special Effort.
Jana Siroka, compared to the clinical reality: “The late shift starts at 13 PM and ends at 23 PM. Then in the evening is often not, rather, I have to write reports, which may take until well after midnight.” The grinding and liquor a from.
the administrative prevalence
Wars used to not even worse? Older chief doctors like to remind that you have worked at the time as an assistant and senior physicians 70 and more hours per week. “20 years ago, everything was slow and quiet,” says Siroka. For example, the patient remained with a lung infection two weeks in hospital care today, you will be discharged after five days. The make the work more hectic and intense, so the VSAO-representative.
Yet something has changed: The Doctors must cope with a much larger administrative burden – to the detriment of patient care. Responsible for the Calls for increased transparency and burden of proof on the part of the authorities and health insurance companies. Siroka can understand this Desire. A duty she sees the hospitals. This should be Administrative and documentation tasks as possible to non-medical personnel transfer.
when asked about this, says Bütikofer from the hospital Association H+: “the fact That the bureaucracy takes in everyday clinical practice, the prevalence is mainly due to the legal requirements. We have to announce the fight.”
Sharper eye of the labour inspectors
The top and the Interns and doctors is helped only once so little. The more Jana Siroka insists on strict adherence to the legal working time requirements. “It seems to me that some of the hospital lines to understand the working of the law rather than a recommendation – but it’s a Must.”
see Here to the Right, is the task of the cantonal labour inspectorates. Sikora, certify this that you can throw in the meantime, a sharper eye on the hospitals. “Very good work, in particular, the Zurich, even if you can, of course, only samples,” says the Doctor.
Between 2017 and 2019 were made in the Canton of Zurich, eleven controls in hospitals, it is called in the office for economy and labour. In seven cases of violations relating to Overtime have been identified; in the remaining four no violations came to light, or not related to the working time.
“where, in individual cases, was necessary, are we in the hospital lines make representations.”
Michael Mauerhofer, office for economy and labour of Basel-Stadt
The Canton of Berne claims to be the first Canton of the implementation of the labour code in hospitals extensively tested. The checks have shown, the office for the economy, “that the observance of working and resting time regulations difficulties”. It is an awareness of violations of the labour law had been in many places created.
The hospitals in Basel had been from 2014 to 2016, the focus of the work inspectors, says Michael Mauerhofer, responsible for the working conditions in the office for economy and labour of Basel-Stadt, “it would have been without Corona, also in 2020”. From the samples, no evidence would have been points for systematic violations of the labour law, so Mauerhofer. “Where, in individual cases, was necessary, are we in the hospital lines make representations.”
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