Stressful incidents, stress and coping strategies in the pre-registration house officer year

Abstract

The incidents suggested the following interventions to reduce stress: better supervision in the first few weeks in post, at night, and for medical problems on surgical wards; more attention to avoiding sleep deprivation; more time for discussion with colleagues at work; more personal time with friends and family. The choice of incident described was influenced by the personal characteristics of the respondent.

The ethical junior: a typology of ethical problems faced by house officers

“…12 On occasion, junior doctors struggle to respect patients' wishes about treatment: while they may be aware of the patients' wishes, they may be unable to respect them when their superiors are unreceptive to the patient's requests. 13[59] Finally, house officers can breach patient confidentiality, often inadvertently, by disclosing information without the patient's permission or by looking at the medical notes of hospitalized friends or colleagues.…”

“…1,3,15 Some also report difficulties around accessing support from more senior doctors due to a variety of factors, including superiors' workloads, absence on leave or unwillingness to assist, as well as house officers' fear of verbal abuse or disapproval. 3,13 This could lead to negative outcomes for patients, particularly when a house officer's limited competence is coupled with inadequate supervision. The stress experienced by house officers can also be considerable; as newly qualified professionals, some feel ill-prepared for their responsibilities and struggle to cope.…”

What factors in rural and remote extended clinical placements may contribute to preparedness for practice from the perspective of students and clinicians?

“…There is concern that this shortage of 'hands on' training may adversely impact on P4P (Burch et al, 2005). A particularly worrying aspect of poor P4P is that it is associated with high levels of individual stress (Paice et al, 2002) which can result in emotional exhaustion and psychological distress in the internship year (Willcock et al, 2004).…”

Are educational or quality improvement interventions delivered at the induction or orientation of junior doctors effective?

“…Unnecessary deaths occurring in hospitals at this time of year has recently lead to a Coroner's Court questioning the training new doctors receive during their first few weeks of work [5] . As well as the potential risk to patient safety, commencing in a new hospital can be a stressful time for the doctors [6] , who feel overwhelmed and underprepared which potentially affect their quality of life [7] .…”