The title “Junior doctor” can relate to someone just out of medical school or someone who is as much as 5 years out of medical school.
In many hospitals across the UK you will find very junior doctors covering hospitals, particularly at night, with very little support however the responsibility for clinical decisions will still always lie with senior medical staff.
Having such junior staff in very busy departments such as the Emergency Department (ED, formerly A&E) can present a problem for the hospital but also the patient. This short article will deal with just a few of the issues arising from junior doctors.
- Junior doctors can be overly cautious. Just by the nature of the career they have chosen to follow, we know they are high achievers in life and have so far done very well. They are terrified of making mistakes and this is likely to happen when they start treating real patients. Much of the work in ED is making numerous decisions and not making the right one can be a terrifying prospect.
- Junior doctors can be inclined to inherit another doctor’s thinking rather than apply their own judgement. This can be a particular problem when they are involved in handovers and at the end of shifts. This can also be a factor in cases involving recurrent attending patients if the junior doctor does not look beyond what his colleague wrote in the notes a week before and he/she fails to listen to the patient or carer. This can lead to the correct diagnosis being missed.
- Junior doctors are overworked particularly during night shifts when they are tired and more likely to make a mistake and there is less supervision.
- Junior doctors by their nature are very inexperienced and this will be apparent in their judgement. They will struggle with young children as patients. Quite often this is because the junior doctors have never been around young babies or infants and in most cases will not have started families themselves. They also struggle with neurological injuries and issues particularly involving the spinal cord or patients with multiple injuries. All of this increases the risk of them forgetting/missing something.
- Junior doctors can be pressured to make unsafe clinical decisions. In many cases the junior doctor will ask for a speciality review (e.g. surgical review for a patient with suspected appendicitis) or ask for some complex imaging such as an MRI. However in many cases the junior doctor is unable to assert themselves to get someone to see their patient or to get agreement for a scan to go ahead and they accept what in some cases turns out to be unsafe advice to discharge the patient.
The NHS is attempting to minimise mistakes and provide all staff with more support systems and standard operating systems. For example, many hospitals/Trusts now have specialist teams set up to deal with patients suffering from life threatening and changing conditions such as strokes, sepsis or cardiac arrests. They are trying to ensure that there is more senior review available and they continue to introduce safety netting policies to cover a range of situations however calamitous mistakes continue to be made and in some cases the mistake was avoidable.
If you are concerned about any treatment or care you have had which you believe has caused you to suffer an injury, please do not hesitate to contact us and speak to one of our specialist solicitors.
Ashleigh Holt – May 2018