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14 Nisan 2017 Cuma

Desperate hospitals beg doctors to take on extra shifts – at £95 an hour

Desperate hospitals are so short of doctors they are pleading with them to take on extra shifts, with some offering up to £95 an hour to cover gaps in medical rotas to maintain patient safety.


Hospitals are so chronically understaffed they have been hiking pay rates in recent weeks and bombarding doctors with urgent emails and text messages in a bid to ensure standards of care do not suffer.


On Tuesday, Peterborough City hospital raised the pay available for working overnight that night in its “extremely busy” A&E to £95 an hour for a 10-hour shift to try to attract recruits.


“Exceptionally, we approved a maximum hourly incentivised rate for our senior trust doctors. This will ensure safe medical staffing levels and enable the department to continue to give high quality care to all our patients,” said Neil Doverty, the North West Anglia NHS foundation trust’s chief operating officer.


Hospitals often scramble to make 11th hour arrangements to fill rotas. Last Monday the Dudley Group NHS foundation trust in the West Midlands was forced to increase the fees for senior house officers in its A&E from £60 an hour to £70 an hour for shifts lasting 10 and 12.5 hours.


The Guardian has seen messages sent by dozens of hospitals across England and Wales to doctors which paint a picture of near panic as many of them struggle, often at the last minute, to have enough medics on duty.


Many hospitals have been struggling to find enough doctors to work over the Easter weekend, with some trying more unorthodox approaches to get staff in. West Middlesex hospital in London, which is facing problems staffing its rotas despite having a well regarded bank of staff and paying high locum rates, this week offered any doctor working over the holiday weekend an Easter egg as an incentive.


Faced with an acute shortage of A&E doctors last month, the John Radcliffe hospital in Oxford sent scores of doctors an email entitled “help!” which said: “I am sorry to be sending so many messages but I am in real need here. I am practically begging at this point. I really need some help.


“Can ANYONE help out for any length of the shifts needed this weekend? It really is a matter of keeping the department safe.” The email was sent on 16 March by Brigid Greaney, the medical staffing administrator for the hospital’s emergency department.


This week Lewisham hospital in London, in its search for doctors to staff its general medicine department, sent an email that said: “We are struggling with the cover for on-call shifts this week. Please let me know if you can help.” It offered to cover doctors’ day shifts if they agreed to work nightshifts.


Doctors’ leaders say the problem is getting worse, blaming NHS workforce planning and the pressure of coping with the growing number of patients needing care.


“Hospitals should not be reduced to begging, but what other option do they have when the NHS is so chronically under-resourced? This should set alarm bells ringing right through the NHS,” said Dr Liam Brennan, the president of the Royal College of Anaesthetists.


Dr Mark Holland, the president of the Society for Acute Medicine, said: “Rota gaps are common – very common. I would be surprised if any hospital anywhere has a full complement of staff. There are some trusts under huge stress and where putting a workforce in place is very challenging, I would be surprised if there wasn’t a sense of desperation to get doctors on the shopfloor.”


Hospitals are sometimes being forced to pay well over the normal rates for hard-to-fill shifts because “there is a pan-NHS workforce crisis. This isn’t about greedy doctors,” Holland said.


The emails and text messages show that almost every branch of medicine is experiencing acute shortages of doctors in at least some hospitals. They range from surgery to cardiac care, anaesthetics to A&E and general medicine to intensive care. For example, Manchester Children’s hospital last Tuesday solicited volunteers for 19 “long days” and 26 nightshifts this month in its paediatric intensive care unit “to be paid at the enhanced rate of £60 per hour”.


Some hospitals facing acute shortages are advertising scores of shifts at a time. Milton Keynes hospital this week notified doctors of 52 shifts over 20 days this month in its A&E. Worcestershire Royal hospital in Worcester has so far only filled five of the 69 shifts it is seeking to fill between now and early August.


A doctor at Chesterfield Royal hospital, who asked to remain anonymous, said: “The rota gaps problem here is insurmountable and, frankly, rather dangerous. The quality of my life has been greatly impaired by the busiest winter we had on record followed by no real drive by the trust to recruit more doctors to anticipate this deluge of patients. The biggest culprit is A&E which is almost entirely staffed by locums, most of them being long-term [locums], followed by the emergency medical unit, which is very short on nights and weekends.”


Despite hospitals’ best efforts some shifts are still going unfilled, which puts extra pressure on other staff. A trainee surgeon at a major London teaching hospital said: “I’ve had occasions where instead of having two on-call senior house officers to hand over to, I’ve had to cover both shifts, after already working 12 hours.


“Working locum shifts in short-staffed departments often feels like juggling with your medical licence as your clinical decisions are affected by time pressures and bed shortages more than your assessment of the patient in front of you.”


Hospital bosses warned that endemic understaffing is threatening patient safety.


“Along with high levels of bed occupancy, gaps in rotas can mean patient safety is put at risk. Fewer medical staff on shifts create intolerable workload pressures for all staff. This is bad for morale which has a further impact on the quality of care,” said Saffron Cordery, the director of policy and strategy at NHS Providers, which represents hospitals.


“Workforce pressures are fast becoming the number one concern for many NHS trusts, including hospitals, mental health, community and ambulance services. These are particularly difficult over holiday periods. All types of trust are affected but we know that this can be very challenging in rural areas and in specific specialties. Patient safety is always the top priority and every trust wants to guarantee safe care. The steps described here are an indication of just how seriously they take this,” Cordery added.


A Department of Health spokesperson said: “Staffing is a priority – that’s why we have invested in the frontline and there are over 31,400 more professionally qualified clinical staff including over 11,200 more doctors, and over 12,100 more nurses on our wards since May 2010.


“With over 52,000 nurses in training we will continue to make sure we have the staff available to give patients high-quality care as part of a safer NHS seven days a week.”



Desperate hospitals beg doctors to take on extra shifts – at £95 an hour

2 Nisan 2017 Pazar

How space travel leads to cognitive shifts in awareness

The two people who have paid for a private moon mission next year will undergo a psychological as well as a physical journey. There’s a fundamental shift in human perspective offered by space flight. This radical shift in viewpoint – sometimes called ‘the overview effect’ – the cognitive shift in awareness that astronauts talk about when they look at Earth from orbit. The idea of how we view ourselves in the world was established in the 1980s with Professor Richard Morris’s water maze experiment. The maze consists of a tank with submerged platforms that rats seek out to rest on. By manipulating the landmarks we can study how the rat navigates and creates internal spatial maps.


What’s much less frequently studied in rats or people is the moment when you escape from the world in which you’ve been contained, and see a familiar landmark from a radically different perspective.


Astronauts report a deep change in their sense of themselves and the world. This is something neuroscientists need to engage in – we’d better start saving now.


Dr Daniel Glaser is director of Science Gallery at King’s College London



How space travel leads to cognitive shifts in awareness

19 Ocak 2017 Perşembe

Nurse shifts left unfilled at nearly every hospital in England, figures show

Almost every hospital in England has fewer nurses on duty than each believes are needed to guarantee safe patient care, research shows.


Analysis of official data by the Health Service Journal (HSJ) found that 96% of NHS hospital trusts in England had fewer nurses covering day shifts in October than they had planned and 85% did not have the desired number working at night.


The disclosure of such widespread failure to ensure hospitals are properly staffed has prompted fresh concern that a chronic lack of nurses and the NHS’s dire finances are putting patient safety at risk.


Nurse shortages have led to patients having to wait for medication, going unwashed or not having observations done on time, the HSJ said.


Janet Davies, the chief executive of the Royal College of Nursing, said: “This is yet more evidence that there are too few nurses caring for patients, putting people at serious risk. Safe staffing levels aren’t an optional extra. Having the right number of nurses is essential to ensure that patients can recover properly.”


The college estimates there are as many as 24,000 vacancies for nurses across the UK.


Nurses told the HSJ that understaffing meant hospitals were already providing substandard care, leading to patient safety “near misses”.


The figures are the worst hospitals have recorded since they were obliged to start publishing details of staffing levels in 2013, in the wake of a report on the Mid Staffordshire care scandal.


The number of trusts that do not have planned numbers of staff at work has gone up despite the recruitment of record numbers of nurses by acute hospitals. Limits introduced in 2015 on the amount hospitals can pay to hire agency nurses may help explain why staffing levels are dropping in many places.


One nurse said: “Sometimes observations get missed and I can recall many times where the patient is found to be deteriorating when they are eventually done. This gives you immense stress as you are left with the realisation you did not pick up on your patient’s condition early enough to prevent an acute episode.”


Another said: “I have seen patients not have proper care, dressings not changed, [and] not given the choice of shower or a wash as it takes more time that we do not have.”


HSJ reached its conclusions by examining data on nurse staffing levels that trusts release through the NHS Choices website. These include the numbers present in general medical wards, maternity units, surgical wards and intensive care units at 214 acute hospitals.


In hospitals in England, a nurse is meant to look after no more than eight medical patients, and the ratio can be as low as one to one in neonatal and intensive care units.


The figures show that Dewsbury and district hospital in West Yorkshire had 75% of the number of nurses it had planned to have on duty last October, down from the 87% it managed in the first three months of 2015.


Princess Alexandra hospital in Harlow, Essex, which went into special measures that month, covered 77% of shifts, as did Pontefract general infirmary in West Yorkshire.


The HSJ found that some trusts were employing unusually high numbers of healthcare assistants. That may suggest they are replacing nurses with cheaper personnel who have little clinical training.


Prof Peter Griffiths, of Southampton University, a member of NHS Improvement’s safe staffing committee for acute wards, said: “This is clearly not a good place for the NHS to be and it isn’t getting any better.” He said healthcare assistants could help plug gaps but relying on them to deputise for nurses in the long term risked compromising patient safety and involved “the risk of a false reassurance”.


The shadow health secretary, Jonathan Ashworth, said: “Tired, overworked nurses cannot be expected to continue providing the quality of care which patients need. The government needs to do much more to make sure nursing remains an attractive profession and to ensure hospitals can get in place the number of nurses they need to keep patients safe.”


A Department of Health spokesman said: “We expect all parts of the NHS to make sure they have the right staff in the right place at the right time to provide safe care. That’s why there are already almost 26,000 extra clinical staff, including almost 11,400 additional doctors and over 11,200 additional nurses on our wards since May 2010.”



Nurse shifts left unfilled at nearly every hospital in England, figures show

12 Eylül 2016 Pazartesi

I used to fear working NHS night shifts would kill me

A patient came to see me at my GP practice the other day. “I know you from the hospital,” he said. “It was you I saw on the night I went to A&E.” He paused, and then added: “You seemed tired”.


I couldn’t recall the event – it occurred during the A&E rotation of my GP training in 2014. At the time I felt that night work was killing me slowly. Driving home in the mornings I used to fear it might kill me quite suddenly. In that particular job I was obliged to alternate so frequently and jarringly between day and night work that after three months my life had blurred into a homogeneous grey fog in which I took pills to go to sleep and pills to wake up again. Driving was hazardous but working wasn’t straightforward either. On one occasion I fell asleep while phoning a patient’s relative in the middle of the afternoon. After three months I was struggling, my heart was skipping beats and I was so depressed that I started to think that maybe crashing my car wouldn’t be such a bad idea.


A&E was dreadful, but the doctors working there have one important benefit; they are generally guaranteed a break, of some sort. By contrast, the doctors working unsupported on the wards manage their own time and only take breaks if they reach the end of their jobs list. All too often that doesn’t happen, the bleep doesn’t stop bleeping.


The system is presently unsafe for doctors, I’d argue that it is unsafe for patients as well. A doctor who isn’t safe to drive isn’t safe to work. It’s hazardous, it has been for years but it’s a necessary evil and the prevailing attitude appears to be that we have to accept the risk.


There are plenty of factors maintaining the status quo, the availability of resources, both financial and human, and the expectations of other staff members, and patients to name a few. I would suggest there is another important but unspoken element to this that shouldn’t be overlooked. It involves the doctors themselves.


Doctors are a mixed bunch but there are common threads discernable in their psychological makeup. They are generally competitive high-achievers who are sensitive to social pressure. They often strive tirelessly to achieve the best outcomes for their patients, or to invert that subtly, to be the best doctor they can be.


This ideal best doctor character is a tower of strength, indefatigable and endlessly resourceful, no challenge too great, no demands too exhausting. It’s the ideal that society looks up to and praises, it is one that the average doctor is happy to embody. Unfortunately best doctor is indispensible, doesn’t need sleep and doesn’t leave work unfinished for colleagues to sweep up. Best doctor stands nobly in a proud tradition of colleagues who have undergone the same trials, nay, worse ones, as our forebears are ever eager to remind us.


Best doctor doesn’t moan about hardships, they are battle scars, a source of pride, evidence to show that this doctor stands shoulder to shoulder with the best of them.


The flawed diurnal human pulling the levers behind the facade is just going to have to cope. If they are too tired to drive their car and have to drink alcohol to make it all go away, well, that’s just the price that has to be paid.


Making night shifts safer would require substantial system changes to moderate demand, but alongside them an obligatory level of self-care for doctors. Anything less stringent will simply be ignored.


Unfortunately our chances of witnessing such changes are laughably remote. The current political will, with Health Secretary Jeremy Hunt as its hapless mouthpiece, is more geared towards exploiting these convenient character traits than compensating for them. As the system is placed under increasing strain I expect that the situation will only get worse.


If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.


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I used to fear working NHS night shifts would kill me

31 Mart 2014 Pazartesi

Reinventing Investment: The Funding Landscape Of Lifestyle Science Shifts For Excellent

The legal landscape and demands for a existence sciences business to fundraise in the US are a nightmare, to place it gently. Suggestions changed recently with the Jumpstart Our Company Startups (JOBS) Act, and the sheer number of investment strategies for a daily life science startup executive to realize and pursue are staggering.  Or, as Life Science Nation (LSN) Founder Dennis Ford puts it, “When I started my company, I invested 18 months traveling all around the planet going to tons of investor conferences, but actual traders had been nowhere to be found. The VCs in this room just couldn’t get any returns and no longer have the cash we want.”


Making use of that premise, he set out on a mission to reinvent the way traders and entrepreneurs share data, negotiate, and now, how the markets themselves function. The premise is primarily based on fit. Altering the preexisting shotgun technique for raising capital to a much more productive model. 


According to those in the field, the future of lifestyle science investment is not the phase two and three ventures of the previous. Translational and early-stage funding are the locations where actual value is located, and where the US investment globe is headed no matter whether traders are prepared or not.


bioe.2013.15-F1

LSN Shifts To Early-Stage Investment Models



Connecting Merchandise, Solutions And Capital


At LSN’s most latest Redefining Early Stage Investments Conference (RESI), as a lot of as 10 diverse categories of daily life science investors have been showcased and their respective early stage investment strategies were presented and debated. Mr. Ford asserts, “Each of the classes of early stage daily life science investor has its own character. Loved ones offices, virtual Pharma’s, and patient groups all have their very own cause for investing, and the fundraising scientist/CEO ought to understand the nuances of each and every investor kind. 


The goal of the conference setting was not only to give lifestyle science firms a space to connect and produce dialogue with likely investors, but also educate everybody in the ecosystem by introducing new gamers and approaches. The workshops and panels at RESI ranged from How to Value Your Startup to Commercialization of Academic Technologies to investor debates centered on rare ailments and how orphan indications can influence investment choices.


There is a true want for a RESI like conference, that to date has gone greatly unmet in accordance to Susanna Ling, Director of Company and Program Improvement at EBD Group. “While the monetary markets have improved in the biopharmaceutical sector in the previous 12 months, there is still a powerful want for funding of early-stage organizations and analysis. It is very good to see high quality investment options matched by a diversity of investors with the flexibility to participate in new sorts of economic models” she says.


A new function of the RESI conference was the RESI Challenge where 32 picked organizations were provided area on the exhibit hall floor to pitch their businesses to investors who voted with “RESI money”. Mr. Ford was delighted to announce that three female CEO’s took first, 2nd and third spot.


New Roles In Investing


Ms. Ling even more contends that, “The increasing function of venture philanthropists, family offices, and public/private partnerships is helping to bridge the funding gap of progressive analysis that can go onto entice far more conventional capital at a later stage of growth.”


Even though a number of investment approaches presented at RESI had been standard strategies wrapped in new verbiage, most have been disruptive to standard science investment. For example, Greg Simon, CEO of Poliwogg who attended his 2nd RESI Conference, says that, “each yr a better percentage of attendees get that this is the finish of the previous investment methods and the starting of the new. There is a lot a lot more cash offered for the 97% that VCs really don’t appear at alternatively of the 3% that VCs normally seem at.”


The premise of their function at Poliwogg, is to generate platforms and metrics to let men and women invest in emerging firms in a number of approaches by producing the cost of entry go down.


RESI Conference 2014, Boston, MA. Photo Credit: Lavinia G. Lowerre

RESI Conference 2014, Boston, MA. Photograph Credit score: Lavinia G. Lowerre



A Fresh Take On The Old


Previously pulling collectively financing from the ever-expanding sorts of capital obtainable was generating an previously complicated and time-consuming fundraising approach far more so. Mr. Ford’s organization LSN also curates an early stage daily life science investor database. His company covers these new investor classes by way of one-on-1 interviews with his analysis staff, then publishing investor profiles that are effortlessly searched by fundraising clientele. The traders are keen to participate since by declaring their interest to the LSN researcher he can get entrepreneurs that meet investment criteria.



Reinventing Investment: The Funding Landscape Of Lifestyle Science Shifts For Excellent

21 Ocak 2014 Salı

Is functioning evening shifts negative for you?


Graham Wettone, 52
Retired police officer


I started doing nights in 1980. There was nothing open back then. Monday to Thursday, all of society went to bed at midnight. Even the television shut down. In those days you worked shifts on a four-week cycle. In the space of five days, your whole system and body clock was completely the wrong way round. I’ve had doctors say you shouldn’t eat at night, but I always took some sandwiches in or stopped by the kebab shop or the local fried chicken place.


It is physically demanding to try to stay awake all night. You are tired during the day and tired during the night. As I got older, I found it even more difficult to stay awake. By the time you get to the Monday, you’re a zombie. You forget appointments, you have to write everything down. The quieter nights were harder.


Graham Wettone Graham Wettone: ‘The biggest problem was digestive – I had loads of stomach upsets.’


Unfortunately, you don’t get a chance to sleep during the day. The rest of society doesn’t expect you to sleep. In summer, everyone’s out in the garden, cutting grass; you’ve got the curtains pulled and the earplugs in.


On the flip side, I loved night duty. The station was ours; no hustle and bustle in the workplace. You could get things done. But I packed it in because it was having an impact on my health. The biggest problem was digestive – I had loads of stomach upsets. It wasn’t so much the heart problems or breathlessness the report mentions: I got checked for that, along with other colleagues. After 15 years of working nights, it was a bit of a relief when I stopped. I could almost feel my system saying: “Thank God that’s over, it’s back to normal now.” PC



Kathryn McLaughlin, 30
Burlesque dancer and fire performer


I have been working nights for about 10 years. The week gets later as it goes on. Thursdays, Fridays and Saturdays, I get to bed about 5am. I have never found it hard to stay awake. When I was little, my mum used to take me to the doctors because I would be up all night reading. I have always been a night owl. Even if I’m not working I wouldn’t go to sleep until about 3 or 4am. I find it easier to do things that require more thought later at night.


I suspect some of the health effects tie in with the fact that, when you get in late, you are not inclined to sit down and make a proper dinner. I think it’s more about making choices to eat something sensible instead of just grabbing something on the go. I have my evening meal between 10.30 and 11pm. I go to the gym five times a week.


For me, this is actually a better way of living: I’m not somebody who functions well at 8 or 9am. When I had a job with more normal hours, I was always drinking Red Bull or eating cheese toasties on my way to work to reward myself for having got up. PC


Dr Zakia Akhteruzzaman Dr Zakia Akhteruzzaman: ‘The most ­difficult thing is no fixed times … it’s difficult to have a social life.’



Dr Zakia Akhteruzzaman, 32
General practitioner


“I worked night shifts on and off for three years when I was a junior doctor, but the worst time was four long months in A&E. It was disorientating. A&E totally messes up your body clock. You have long shifts – 12 or 13 hours – and you have no time to process anything. There’s no window in the main emergency room, so you don’t know what’s happening outside. I felt totally out of touch with the universe. The most difficult thing is that there’s no fixed times. One day you do 8am to 5pm and then 8pm to 8am for a few days, and then sometimes till 2am. So every day is different. It’s difficult to have a social life, and your body can’t adjust.


You feel very unwell and jetlagged. I could barely talk sometimes. I would be seeing a patient and taking down their history, and then would have to go to the toilet and cough up phlegm. Twice when I was on night shift I had to take time off as I was sick in bed. I remember feeling really guilty.


When we qualified, there were some doctors who wanted to do A&E, mainly because they enjoyed acute medicine and the associated adrenaline rush, but it wasn’t for me. I don’t see how you could have any work/life balance and work those shifts.


But as difficult as it was, I also remember it with some nostalgia. It sounds strange, but hospitals can be peaceful at that time. During the day, the patients are in the corridor and there are doctors huddling. But at night, it’s often just you walking along the corridors. We would have really deep conversations at that time – even discussing spirituality and deeper issues. I have never found that during the day. I think people feel a bit more vulnerable and open up more. Also, another positive thing is that at this time you really get a chance to bond. Sometimes the junior handles the shop floor while the senior is asleep or does some paperwork, and so the motherly nurses – especially on paediatrics – would look out for juniors and would make a bed and say: “It’s quiet now, get some sleep.” AG



Lucy Horsfall, 34
Senior cabin crew


I have been doing this for 11 years. It’s my job, and you just fight through it. The challenge is going through time zones. Coming back from Los Angeles, it’s dark and then you see the dawn rising through the clouds – and in the cockpit they say we haven’t even got to New York. I tell myself it’s still night, keep the window blinds down. I think that’s the only way I can deal with it.


My airline is very good. It gives us the correct rest. You get allotted a break time on the long flights and you have a bunk you can sleep in. The minimum rest is three hours. That really helps – you can actually fall asleep. The hardest part is at about 2.30 or 3am, when you start getting really cold. That’s when I get most tired. It’s a really heady feeling when we land in the morning. But an hour or two later you get a real crash and start to feel sick. Diet-wise, it can be tricky. You’re craving sugar through the evening, eating chocolate or whatever’s around. You’re eating dinner at 3am just to get a sugar hit.


I suppose you could get depressed if you worked on your own through the night. You could start thinking about things. But I have got a team around me. We’ll have a chat, a cup of coffee, and if one person’s tired we’ll go and do something like cleaning: it’s just a little thing, but it takes your mind off it.


I’ve never had anything wrong with me, other than tiredness and jetlag. When I come back from maternity leave I’ll still be doing night shifts, but I’ll be part-time – two or three long-haul flights a month. PC



Alex Lester, 57
BBC Radio 2 DJ


I’ve been doing night shifts for 26 years and I’m still alive, so hopefully it’s all right. It just turns your day on its head, that’s all.


The downsides are mainly social. I play a lot of music, and I’m always looking out for new stuff, so I get invited to a lot of concerts, and I have to say: “I’m sorry, but unless it’s a Beatles reunion with all the original members I won’t be able to make it.” They say: “The band are on stage at 9.30.” And I go: “Er, I’ll have been in bed for two hours.”


There are upsides, though. I don’t get stuck in the rush hour. I don’t get stuck in crowds, so during the day I can do things while everyone’s at work. My Christmas shopping is usually done before everybody else’s.


During the first few months I had a bit of trouble sleeping. There’s this figure eight hours that’s been plucked from somewhere, and when I started working nights I would go to bed thinking, “I must get my eight hours!”, and then lie awake all night worrying about getting the amount of sleep I needed. People worry far too much about that, but your body will tell you how much you need.


Once you are doing night shifts on a permanent basis, your body clock sort of adjusts. So I’m now a nocturnal creature. I tend to go to bed at 7.30 in the evening and then get up at one in the morning and go to work. Then I’m back in bed again by about six in the morning and tend to be asleep until 10 or 10.30am. That’s the way my body clock works. I’m hoping that it won’t have any long-term health effects. I’d have thought I would have noticed it by now if it did. TM


Simon Matthews Simon Matthews: ‘There’s a different atmosphere at night; it’s nicer.’


Simon Matthews, 48
Freelance lorry driver


Night working is a damn sight easier than day work. At night, there’s far less traffic on the road, especially in the summer. There is something peaceful about it: you’re totally on your own, with nice open road most of the time. Serenity is a good word. There’s a different atmosphere at night; it’s nicer. People aren’t so stressed. Probably because the rest of the world is sleeping.


I don’t do many nights any more because I’m semi-retired, but I never really had a problem staying awake. Your body clock seems to be set so that it wants to shut down around 2.30 or 3 in the morning. Your body temperature goes down, but I don’t really ever seem to want to go to sleep.


The longest stint of night shifts I have done, without day shifts between, was eight weeks. I was carrying chilled food products. It was a similar journey every night, from Taunton up to Oxford, down to Southampton and then back to Taunton. I felt as if I was permanently in a different time zone. It affects your head. You feel totally out of sorts coming off nights and then having to live a day life for two days, and then going back on to nights again. I imagine it would have very detrimental effects on you, especially mentally PC


Torgeir Fotland, 33
Former psychiatric nursing assistant


I did this temping job in Oslo in 2010 and 2011. There were three of us working from 10pm to 8am, making sure that patients were asleep and taking care of them if they needed to get up. We were just waiting there in case something happened. That made it harder to stay awake. The others brought in their computers or were in front of the TV or reading. They had some sort of activity which occupied them privately. I was a bit miffed, thinking: just sitting here looking at a wall, I might fall asleep in five minutes. I was working with guys who had done it for decades. They had their routine. I spent a lot of time on YouTube – I don’t know how people survived this job before the internet.


You’re fine until midnight, even sociable. Two comes, three. And then you become cold. You’d be sitting there at 4am, saying: “This is not good for the health is it?” “No, definitely not.” “How long are you intending to do it?” “A while. Better pay.”


For me, it was a temporary thing. But looking at my colleagues, the regular staff, they had a routine. They had done it for 20 or 30 years. I don’t think that can be good. You miss out on life; you don’t really see people; you are on the outside of society. I’m on the same bus as everyone else, but they’re going to work and I’m going home. They look fresh and I look like I just killed someone. I couldn’t do it for long without thinking: what’s going on out there in the world? PC


Dan Doherty Dan Doherty: ‘The atmosphere in a 24-hour restaurant can be … interesting.’


Zdenek Honsa, 35
Engineer


I have just changed jobs so as not to work nights. For 18 months I worked as an engineer on the London Eye – mostly maintenance, fixing things that had broken during the day. I worked a 12-hour shift, 8pm to 8am. I didn’t find it hard to stay awake, but it used to take a week to get back to normal. It doesn’t surprise me that there may be long-term health effects. I hope I didn’t do it for long enough to matter. I felt very tired. If I got five hours’ sleep that would be really good. Sometimes it would be four or less, and often not in one go. I also noticed that my digestion went quite funny.


It was nice to get to see the city at night though. It was quite special on the London Eye. Even the commuting was quite nice in the dark. Going over Waterloo Bridge was lovely. And I could see my son during the day more. If I had a choice, I wouldn’t do nights again. But sometimes you can’t pick jobs. PC


Dan Doherty, 29
Executive chef at Duck and Waffle 24-hour restaurant


It’s surreal, that’s the only way I can describe it. Working an eight-hour shift from 10pm to 6am is so much more different from eight hours in the day. I do both throughout the week – post-midnight dining is an integral part of our business – and so my body is in a permanent state of jetlag. At 2am, you get more celebrities; footballers on one table, Made in Chelsea on another. There’s also travellers on different time zones and couples on dates. It’s always strange because all the signals that normally dictate you leaving a restaurant – catching the last tube, the waiters clearing up – don’t apply and the atmosphere can be … interesting.


I do like it, but if you don’t plan it properly, not seeing sunlight can have an adverse affect on your personality – it’s not normal, is it? It goes against everything our bodies do. I’m more spaced out. You eat too much, the same way you do when you travel, and it can make you feel gross. You’re constantly dull-eyed and because I mix it up and it’s not routine, my sleeping patterns are entirely random. My wife works normal hours and I try to cook when I get in so we can at least have breakfast together but even that’s hard – I want sausages and mash after a night shift ends at 6am, not eggs or pastries.


The upside? Sunrise is the most beautiful time to drive through London. NI


Peter Collins, 33
Spacecraft engineer


I work as part of what we call the flight control team at the European Space Operations Centre (ESOC) in Darmstadt in Germany. I’m currently working on a mission called Gaia, which is a star mapper. It was launched in December and is travelling to a point which is 1.5m km from the Earth in the opposite direction to the sun. From there, it will map our galaxy, the Milky Way.


My particular area is the power and thermal systems on Gaia. I have to make sure the spacecraft’s got enough power; that the solar array is working as it should; the distribution of the power through the spacecraft’s working; and, on the thermal side, that everything is in the right thermal ranges.


In the first few months after the mission has launched it’s quite intense. The first few days are critical. Once we’ve launched, for the week following the launch, we’re in 12-hour shifts. So you’re often working through the night. For those four or five days you basically just eat, sleep and work. You get into just working and not really knowing what time of day it is.


It’s totally worth it for me, but then I don’t have to do it for years and years and years. We have what are called spacecraft controllers, who come in when the mission is up and running. They have to be there the whole time to make sure the spacecraft is working. They’re on their own in the control room overnight, day in, day out, night in, night out, which must be tough. I wouldn’t say they’re odd, but it’s not something I could do, because of the loneliness. Personally, I think it’s being on your own for the whole time that would have an effect on your health; it’s losing touch a bit of what’s going on around you because you’re so focused on work.


In my case, I don’t think working nights has had a lasting effect on my health, but during the period that I’m doing it I would say my home life was affected, in that all I was doing was going home to eat, sleep, get up and go back to work again. My wife does a similar job, elsewhere at ESOC. It will be the same for her in a couple of years when her mission launches, but we both understand that it’s only a short-term thing. TM



Is functioning evening shifts negative for you?

4 Ocak 2014 Cumartesi

GPs "paid £1,500 a night for A&E shifts"

It comes after a poll found that a third of GPs consider the public should be charged to attend A&ampE to deter those who do not need to have to do so.


A examine in 2011 estimated that unnecessary A&ampE visits are costing the NHS more than £100 million a 12 months.


Roger Goss, of the campaign group Patient Concern, advised the paper: “GPs can not be ready to turn out for their own patients but they are content to work elsewhere for a great deal more money.


“So significantly for the interests of the sufferers, it’s the interests of the physicians which are paramount.


“The explanation patients are going to A&ampE is due to the fact they can’t get into their very own surgical procedure.”


Meanwhile figures from the European Commission recommended that Britain has fewer operating physicians per head of population than virtually all other EU country.


The Uk had two.71 practising medical doctors for every single one,000 folks – fewer than countries including Bulgaria, Estonia and Latvia.



GPs "paid £1,500 a night for A&E shifts"