Training of LREG. 7.1 Partnership Resource Centre (PRC) training resources should be considered as part of the development of the LREG members constructive interest based problem solving skills development. Whilst noting the MCNZ limit on provisional registrants performing night duties in the first 6 weeks of employment, the parties agree to adopt a quality and safety approach to first year participation on night shift rosters. Night duties are a risk for the following reasons:
1. They usually represent isolated practice for the doctors on duty with little time to provide or receive supervision or collegial dialogue over individual patient care.
2. The most experienced doctors (senior registrars and SMOs) may not be immediately available, and the need to wake them for assistance is a natural barrier.
3. Fatigue is always a human factor when night shifts are being worked.
4. Patients being attended to have presented as or are inherently “very sick” and in need of immediate attention (that cannot / should not wait until the morning).
5. Minimum staffing levels of both doctors and other health practitioners are on duty; many staff are only available on call and not on site and not all functions of the hospital are active (e.g. limited radiology available). This environment should be actively considered prior to seeking to place the least experienced of our doctors, our first year house officers on night duty. In doing so the following parameters must be assessed, and able to be audited against. Written documentation surrounding each parameter and the DHBs facilities and support should be readily available to review, and undergo reassessment in November when first years start work, and June ahead of the particularly busy and often pressured winter months, of each year. What contributes to quality and safety at night? • Experience • Not working in isolation • The right skills • Physical alertness • Support and supervision • Only doing what needs to be done and not being loaded up with catch up work from the day • Effective, documented and approachable escalation processes • From the doctor on duty’s perspective; • Not activated by the doctor; • Clear protocols.
Training of LREG. Partnership Resource Centre (PRC) training resources should be considered as part of the development of the LREG members constructive interest based problem solving skills development. Whilst noting the MCNZ limit on provisional registrants performing night duties in the first 6 weeks of employment, the parties agree to adopt a quality and safety approach to first year participation on night shift rosters. Night duties are a risk for the following reasons:
