Why changes to rest are vital to every doctor’s wellbeing
Jen Walsh PhD
Director, Centre for Sleep Science, UWA
Senior Research Fellow, West Australian Sleep Disorders Institute, SCGH
With strong support from the AMA (WA) membership, the AMA (WA) and WA Health have recently finalised a new Industrial Agreement which brings beneficial changes to the medical workforce.
As a (non-medical) sleep scientist, researcher and educator, it surprised me that our healthcare workforce have been working under agreements with clauses that allow significant detrimental impacts on their sleep.
In the Nov-Dec 2023 edition of Medicus, I highlighted the inadequacy of the previous agreement for allowing sufficient sleep opportunity. An eight-hour break, the minimum stipulated in the 2022 agreement, does not provide sufficient time for commuting, chores, eating and adequate sleep opportunity, let alone exercise and social connection.
It is encouraging to see that this has been increased to a minimum of 10 hours between shifts. But I hope that rostering teams (many who work 7.6-hour days, Mon-Fri) will aim to schedule at least 12 hours between shifts and be mindful of adhering to a forward rotating roster (day to afternoon to night) where appropriate.
I’m also encouraged by private health insurer HIF commissioning more important research into sleep in 2024. This shows a greater understanding by private health insurers of why sleep is so important and that it is one of the underlying, but often overlooked pillars of good health.
The research shows that almost half of Aussies are turning up to work exhausted, and 15% are taking sneaky naps at work. And I know doctors and especially doctors in training will be reflected in this data.
The new agreement highlights a reduction in maximum rostered shift length for doctors from 15 hours to 14 hours, and a minimum 48-hour break after being rostered for four or five consecutive nights. The evidence demonstrating the impact of insufficient sleep is clear – it has detrimental effects on mental and physical health and performance, including medical errors. At least four in 10 Australians achieve insufficient sleep on a regular basis, and those who do shift work (including our healthcare workforce) are at greater risk of not achieving adequate sleep and developing long-term negative health consequences.
These changes address oversights in the previous agreement and will provide greater opportunity for adequate rest and recovery between shifts and on days off, particularly for shift workers.
Sadly, every year healthcare workers fall asleep while commuting to and from work. Sadder still is that not all have survived to report the story. We must learn from these experiences, and overcome the mentality that doctors should wear their number of hours awake as a badge of honour.
A THIRD OF AUSSIES SAY THEY’VE WORKED WHILE TIRED MANY TIMES A WEEK OVER THE LAST YEAR, A MINORITY ON A DAILY BASIS
While a minority, women are more likely to say they turn up to work tired every day (8% vs 3%) and less likely to say they rarely turn up to work tired than men (26% vs 19%).
