From our new management consultancy correspondent:
This certainly seems to be true, and is clearly taking a toll. So the questions should be asked who was the idiot that organised it like this, what can be done to reduce the load, and how can that be improved quickly.
12 hour shifts.
A 2 shift 12 hour day is only achievable if you can take a lot of down time during the 12 hours. PPE makes that very hard. In any occupation 12 hours straight work (OK 11 with breaks) is tough. In PPE its going to be a killer. So why arent they doing a 3 shift 8 hour day? 3 x 8 hour shifts is the norm for manufacturing.
The standard Junior Doctor contract is for a 40 hour week including breaks. 8 hour paid overtime takes it to the working time directive 48 hour limit. So are all the doctors and nurses smashing through the working time directive, putting in 20 or 30 hours overtime, or are they doing 4 days on to get to 48 hours, then a couple of days off. Who organised this shift system?
They spend a lot of time talking to relatives.
Yes, in an ideal world maybe the doctor shoud do that, but it is mostly not medically skilled, and it is stressful as hell. Putting soemone in to do the patient updates could save a few hours per doctor per day, which is equivalent to adding 25% to the number of available doctors. Every ward should have a relative liason worker, who does all (or almost all) of that stuff.
Turning patients takes a huge team.
6 to 8 doctors and nurses to turn a patient over, many of them need turning each day, this is physically exhausing work and unusual to Covid. But the skill set is not much medical. THere are a bunch of tubes and masks and stuff that need careful handling, and once over several checks need to be done. But the actual lift up over down bit, is all muscle not medical. So each ward should have a team of half a dozen lumps from the local gym to do that bit.
OK 7 extra people per ward per shift, maybe an extra half billion quid needs spending to get through this. Frankly in the scheme of whats been going on, that is small beer who cares. And we get back less exhausted, less stressed, frankly better doctors and nurses. And if the doctors and nurses actually all are banging in the overtime to meet the load, it wouldnt even cost that, might even save money.
What we have here is a classic case of highly skilled people doing low skilled work. Managements job is to reduce that, because it fries the high skilled and is an incredibly inefficent use of resources. I suspect that its all down to management, becasue every doctor or nurse you meet seems to want to do their best, but the middle managers are all busy buggering up their lives writing and taking left handed diversity and inclusion courses.