ADMIN/NON MEDICINE
WELLBEING + BURNOUT
PromptRostering and fatigue management principles
ResponseSafe working hours
Regular access to days off
Casual staff to be included as “part of the team”
Rotate from high stress to low stress areas
Regular breaks (q4h)
Overtime pay consistent with standards
Safe places to sleep at work
Taxi vouchers if unsafe to drive
Regular access to days off
Casual staff to be included as “part of the team”
Rotate from high stress to low stress areas
Regular breaks (q4h)
Overtime pay consistent with standards
Safe places to sleep at work
Taxi vouchers if unsafe to drive
PromptList important Infrastructure to assess staff wellbeing
ResponseNon clinical areas (eg tea room)
Change rooms with showers
Non clinical office spaces
Food storage/management (? Do they mean a fridge?)
Natural lighting
Change rooms with showers
Non clinical office spaces
Food storage/management (? Do they mean a fridge?)
Natural lighting
PromptPositive outcomes from wellbeing
ResponseStaff retention
Decreased sick leave
Decreased patient errors
Improve civility, handover accuracy, care times
Decreased sick leave
Decreased patient errors
Improve civility, handover accuracy, care times
PromptJunior doctor has mental breakdown on shift - Management
ResponseContinue managing sick patient
Seek assistance from a different doctor to treat patient
Assign senior staff member to check on junior doctor and ensure their safety
Arrange for jr to be relieved - time off floor and go home
Meet when able (off floor) in non confrontational manner (chaperone if opposite sex) to discuss/understand their behaviour
Likely delayed discussion about expectations, professionalism, responsibilities. ?DEMT/mentor best for this
Advise DEMT about events
Discuss with doctors mentor
Seek assistance from a different doctor to treat patient
Assign senior staff member to check on junior doctor and ensure their safety
Arrange for jr to be relieved - time off floor and go home
Meet when able (off floor) in non confrontational manner (chaperone if opposite sex) to discuss/understand their behaviour
Likely delayed discussion about expectations, professionalism, responsibilities. ?DEMT/mentor best for this
Advise DEMT about events
Discuss with doctors mentor
PromptSymptoms of burnout
ResponseGeneral exhaustion and fatigue
Lack of motivation in life
Cynicism and negativity
Difficulty concentrating and task completion
Deterioration in job performance
Interpersonal problems outside of work
Unhealthy lifestyle choices
Poor job satisfaction
Constant pre-occupation with work
Development of health issues, eg: depression, obesity, Htn
Lack of motivation in life
Cynicism and negativity
Difficulty concentrating and task completion
Deterioration in job performance
Interpersonal problems outside of work
Unhealthy lifestyle choices
Poor job satisfaction
Constant pre-occupation with work
Development of health issues, eg: depression, obesity, Htn
PromptApproach to minimise night shift burnout
ResponsePersonal strategies
Exercise before sleeping
Outside time with exposure to natural light before sleep
Well darkened room to sleep during daytime
Eating healthy, avoid junk food
Melatonin to help reset circadian rhythm
Organisational strategies
Adequate staffing for ED overnight
Rostered senior staff on call
Adequate bed flow without access block, no boarding in ED
Rosterin in shorter blocks (Eg3-4 nights not 7)
Days off to recover post nights
Exercise before sleeping
Outside time with exposure to natural light before sleep
Well darkened room to sleep during daytime
Eating healthy, avoid junk food
Melatonin to help reset circadian rhythm
Organisational strategies
Adequate staffing for ED overnight
Rostered senior staff on call
Adequate bed flow without access block, no boarding in ED
Rosterin in shorter blocks (Eg3-4 nights not 7)
Days off to recover post nights
PromptManagement of a Reg who is underperforming
ResponseInvestigate and ensure no need for mandatory reporting
Identify work stressors
Identify personal stressors
Identify lifestyle factors - drug or alcohol use
Identify self harm/suicidal ideation
Identify and offer ongoing support - Family/Friends/Mentor/DEMTs
Offer alcohol/drug liaison service referral
Offer time off / roster changes to accommodate for trainee burnout
Offer them leave, be flexible with leave
Ensure the Emergency Department Director is aware of the situation
Identify work stressors
Identify personal stressors
Identify lifestyle factors - drug or alcohol use
Identify self harm/suicidal ideation
Identify and offer ongoing support - Family/Friends/Mentor/DEMTs
Offer alcohol/drug liaison service referral
Offer time off / roster changes to accommodate for trainee burnout
Offer them leave, be flexible with leave
Ensure the Emergency Department Director is aware of the situation
PromptFindings concerning for problem drinking in a colleague
ResponseAbsenteeism
Drinking before work
Drinking at work
Drinking to inebriation “blacking out”
Impairment of daily activities
Prior problems with excess drinking
CAGE questions – unable to cut down, anger around drinking, guilt around drinking
Loss of memory of events
Drinking before work
Drinking at work
Drinking to inebriation “blacking out”
Impairment of daily activities
Prior problems with excess drinking
CAGE questions – unable to cut down, anger around drinking, guilt around drinking
Loss of memory of events
PromptManagement of a drunk colleague at work
ResponseMandatory reporting to AHPRA
Referral to EAS or equivalent for employee assistance
Encourage engagement with GP, psychologist
Stand-down from clinical duties until situation under control
Referral to Alcohol and Drug Services or equivalent
There will be others...
Referral to EAS or equivalent for employee assistance
Encourage engagement with GP, psychologist
Stand-down from clinical duties until situation under control
Referral to Alcohol and Drug Services or equivalent
There will be others...
PromptReg from another department won’t come and play when the intern calls them…
ResponseReview the patient yourself to exclude immediately life threatening conditions
Address the patient's concerns and provide analgesia as required
Staff safety
Call the gastroenterology registrar and instruct them to see the patient.
Address the patient's concerns and provide analgesia as required
Staff safety
Call the gastroenterology registrar and instruct them to see the patient.
PromptFactors that may determine if a JMO can perform a procedure unsupervised
ResponseExperience (no. procedures performed; credentialing)
Any previously witnessed procedures by yourself/other personal knowledge of the doctor
intern's ability to adequately describe procedure including anatomy and complications, need for sedation
Any previously witnessed procedures by yourself/other personal knowledge of the doctor
intern's ability to adequately describe procedure including anatomy and complications, need for sedation