Adherence to the European Working Time Directive and its influence on clinical experience

Abstract

Aims and MethodTo identify deficits in senior house officer (SHO) on-call experience since the advent of accident and emergency (A&E) liaison nurse cover, by retrospectively examining records of 267 A&E patients between October 2004 and January 2005. We collated our data in terms of presenting symptoms.ResultsThe majority (59%) of A&E referrals received no SHO attention. In particular, SHOs had no involvement in 69% of ‘social’ presentations, 72% of presentations involving drug or alcohol misuse and 63% of presentations with associated suicidality, self-harm or overdose.Clinical ImplicationsClinical experience is being lost in key areas, and is not yet being replaced via other routes. There is a pressing need to consider methods to ensure development of these skills, at the same time as adhering to the European Working Time Directive.