A report on the welfare, morale and experiences of anaesthetists in training: the need to listen | The Royal College of Anaesthetists
Between December 2016 and January 2017, The Royal College of Anaesthetists (RCoA) conducted a survey of anaesthetists in training, to better understand their experiences of life on the frontline of UK hospital care. Well over half of all anaesthetists in training responded: 2,312 responses represent 58% of all anaesthetists in training across the UK.
With over 1,000 free text comments, the survey provides a detailed picture of the issues faced by doctors training as anaesthe tists in today’s NHS.
Alongside these surveys and to better understand the results, throughout 2017 the RCoA held a series of Listening Events with anaesthetists in training across the UK. These events explored the emerging themes from the RCoA Survey. The feedback from over 200 anaesthetists in training who attended these events also informs the recommendations in this report.
Service pressures and the role of anaesthetists in training – joint RCoA & AAGBI statement
The Royal College of Anaesthetists (RCoA) and the Association of Anaesthetists of Great Britain & Ireland (AAGBI) have issued the following statement in light of some anaesthetists in training being asked to work outside of their usual scope of practice due to recent unprecedented demands on clinical services:
Patient safety should be the first priority of all NHS staff at all times. To support the needs of patients, and their safety, we believe the following principles are important when redeployment of trainees in our specialty is being considered although some of the points made would be equally applicable to non-trainee colleagues:
Trainee anaesthetists should be redeployed from their normal duties only in exceptional circumstances, and for the shortest possible length of time. The decision to do so should be made only by the Medical Director or deputy taking account of all service pressures and the clinical environment pertaining at that time.
Trainee anaesthetists should never practice beyond their competence. Trainees working in unfamiliar environments must have clear lines of supervision and responsibility established, and they must always receive adequate induction and be familiar with local governance arrangements.
It is important that those trainees asked to help support a part of the service under pressure are selected equitably from all of the medical staff competent to contribute to that aspect of the hospital’s clinical activity and that the number of sessions each redeployed trainee spends in another clinical service is closely monitored.
If as a result of a change in duties an anaesthetic trainee misses an important training opportunity, it should be clearly outlined how this training will be accessed in a timely manner once the crisis has passed. We would encourage trainees to reflect on their experiences of working under these circumstances with their educational supervisors so that trainers can fully understand the problems trainees face and the potential for learning in these unfamiliar environments.
The decision to alter a trainee anaesthetist’s duties should be communicated by the Medical Director to the local Guardian of safe working, the trainee’s educational supervisor, RCoA Tutor (who should inform the relevant RCoA Regional Advisor) and Postgraduate Dean at the earliest opportunity. This should outline the circumstances that led to the redeployment being necessary; how long it will last for and the actions that will be put in place to avoid a recurrence in the future”.
van der Wal, R. et al. European Journal of Anaesthesiology. Published online: September 14 2016
Background: Working in anaesthesia is stressful, but also satisfying. Work-related stress can have a negative impact on mental health, whereas work-related satisfaction protects against these harmful effects.
Objectives: How work stress and satisfaction are experienced may be related to personality. Our aim was to study the relationship between personality and perception of work in a sample of Dutch anaesthesiologists.
Design: Questionnaire survey.
Setting: Data were collected in the Netherlands from July 2012 until December 2012.
Participants: We sent electronic questionnaires to all 1955 practising resident and consultant members of the Dutch Anaesthesia Society. Of those, 655 (33.5%) were returned and could be used for analysis.
Main Outcome Measures: The questionnaires assessed general work-related stress and satisfaction and anaesthesia-specific stress. A factor analysis was performed on the stress and satisfaction questionnaires. Personality traits were assessed using the Big Five Inventory. To identify personality profiles, a cluster analysis was performed on the Big Five Inventory. Scores of the extracted factors contributing to job stress and satisfaction were compared between the profiles we identified.
Results: Our analysis extracted six factors concerning general job stress. Of those, the emotionally difficult caseload contributed the most to job stress. The analysis also extracted four factors concerning general job satisfaction. Good relationships with patients and their families and being appreciated by colleagues contributed the most to satisfaction. The cluster analysis resulted in two distinct personality profiles: a distressed profile (n = 215) and a resilient profile (n = 440). General and anaesthesia-specific job stress was significantly higher and job satisfaction was significantly lower in the distressed profile, compared with the resilient profile. Experience of the emotionally difficult caseload did not differ between the two profiles
Conclusion: Personality profiles were found to be related to anaesthesiologists’ experience of work-related stress and satisfaction. One-third of the anaesthesiologists in our sample were categorised as distressed and are at risk of developing work-related mental health problems.
The Guardian – Doctors: The secret life| Published online: 12 September 2016
You have to get used to being invisible as an anaesthetist. A large percentage of the public has no idea that we’re medically qualified. I’ve been asked how many GCSEs you need to be an anaesthetist. In fact our training is as long as that of a surgeon. It takes seven years of specialist studies after you’ve already completed two years of basic general training; and that’s after five or six years at medical school.
Patients always remember the name of their surgeon, never that of their anaesthetist. But it’s still a hugely rewarding job. We’re everywhere in the hospital. In theatre obviously, but also in intensive care, on the wards, in the emergency department, and in the pain clinic, with those who are really suffering. We assess people’s fitness for surgery, how likely they are to suffer complications, and support them through the operation itself and into the postoperative period.