Breaks

Standard operating procedure: breaks (medical staff)

We have put in place a policy to ensure residents take their 30 minute uninterrupted break (one per 8 hour shift, and two on a 12 hour shift).

Consultation has taken place across the consultant and resident body and the following content produced in order to put in place a more robust system to facilitate residents accessing their breaks. A pragmatic and opportunistic approach is at times needed with regards to this and we appreciate that there is not one solution to this recurrent problem.

There are 4 bleeps on the Gynaecology / Obstetric site for ST2-7 and 3 for FY/GPST/ST1 as well as others ‘on call’ without bleeps. This document focuses on the high workload areas within our department and specifically the roles which require the residents to be contactable by bleep.

When residents are struggling to take their breaks then it is their responsibility to inform the consultant on for that area. Cross covering each other in each area (gynaecology area or obstetrics area) is to be encouraged to facilitate breaks.

Gynaecology

Gynae reg on call (carrying 1625)

If the ST has been unable to take a break the Gynae Consultant will take bleep between 12:30 and 13:00 Monday to Friday unless a significant clinical emergency prevents this.

During this time period the nursing staff in PSC/ GTA/ ward 210/ Day surgery unit will be instructed to only call the pager if there is a life-threatening emergency.

If the Gynae Consultant is unavailable, then the Senior ST on bleep 1616 is the fall back position.

FY/GPST/ST1

As per previous documentation regarding more junior staff:

210 Ward (08:30 – 16:30) (on 4001)

Cover – the Gynae ward and Gynae Tier 1 doctors to cross cover each other
Bleep – Gynae Triage Tier 1 to take bleep
Escalation – Gynae on call consultant

Gynaecology Triage (10:30 – 18:30)

Timing – ideally before 14:30 but no later than 15:30
Cover and bleep holder – 210 ward tier 1
Escalation – Gynae on call consultant

Other

Those based in clinic and theatre should be able to go for breaks during the natural breaks within these sessions. The obvious issue here are the long gynaecology major cases – please speak to the consultant at these lists and swapping out of staff to facilitate breaks should be possible.

Opportunist breaks can and should be utilised between theatre cases.

Obstetrics

Within each of the on call obstetric settings, when fully staffed, breaks should be cross covered by cross covering bleeps/ roles and involving the consultant on call for each relevant area when necessary.

Labour ward registrars on call

Cross covering bleeps in a stepwise fashion and informing the midwife in charge of the plan.

E.g. ST 3-5 hold ST2 bleep (16??) for 30mins then, ST6-7 holds ST3-5 bleed (1622) to allow them to go for lunch etc.

Labour ward FY/GPST/ST1

Long day labour ward 119/211 – 1st break

Cover - LW Tier 1 and ward tier 1 to cross cover each other

Bleep – cover person holds the bleep

Escalation - LW Consultant

Obstetric Triage Reg and FY/GPST/ST1

We hope that with the return of the 1030-1830 ST2-7 shift within obstetric triage that it will be easier to facilitate more timely breaks. It is recommended that each member of the OTA team takes their breaks in turn to ensure the department has adequate staffing.

As the reg will now start at 10:30, a break should ideally be taken between 14:30 and 15:30, by this time the consultant on for this area should have completed the ward rounds and be available in triage.

Ante-natal clinics and other areas

Again those based in clinic and theatre should be able to go for breaks during the natural breaks within these sessions. If sessions are running on please again speak to the consultant on for the session so you can have a break prior to any afternoon work.

Nights

Requirement is for at least 2x breaks, though a flexible approach is preferred by the team.

Cover and holding of bleep to be arranged by LW team.

Summary

Unless there is a life-threatening emergency you should be able to take a 30 min break.

We appreciate that time management in a busy unit is difficult especially when individuals have multiple responsibilities. However, if you are unable to take a 30-minute break this has to be escalated to the Consultant for that area.

Last reviewed: 31/07/2024

Next review date: 01/02/2025

Reviewer name(s): Helen Brauer.