Background There are many physical, mental and social complications of fatigue associated with working shifts. Emergency Medicine is experiencing a crisis within the UK with a low recruitment rate and a high attrition rate. 24-hour Emergency Department (ED) provision requires doctors to work long, often unsociable shift patterns, at risk of becoming unsustainable. Junior doctors are vulnerable to this, and thus to suffering the aforementioned complications of fatigue. This further contributes to attrition, perpetuating the workforce problem.

Objectives

• Increased awareness amongst junior doctors and other important stakeholders of the effects of shift-work related fatigue.

• Junior doctors to be enabled to better manage fatigue associated with shift-work through sleep hygiene.

Methods Work was conducted within the ED at Derriford Hospital, University Hospitals Plymouth NHS Trust. Local wellbeing research was reviewed, establishing that ED staff had a high ‘need-for-recovery’ score compared to respondents in the validation study working jobs classed as ‘stressful’. National Emergency Medicine Trainee Association surveys of 2015 and 2017 highlight key concerns for trainees as fatigue, workload and rota scheduling. These findings were contextualised through consultation with the Junior Doctors Representative Committee and ED Wellbeing Committee.

A printed advice leaflet was created, containing basic sleep science, highlighting potential complications of shift-work, and giving advice on how to manage shift-work associated fatigue. The leaflet was peer-reviewed, then disseminated to ED junior doctors.

Impact From feedback received, this leaflet has raised awareness of shift-work related fatigue. Recipients are better equipped to manage fatigue whilst working shifts and have tools to practice sleep hygiene.

Further measurement of improvement will involve an anonymised questionnaire and analysis of the Junior Doctor component of the imminent ED staff survey.