Bitton seeks to draw public attention to the impossible situation the medical staffs face, between the talk of closure and business courses, and the news of staff additions to hospitals – while departments are overflowing and medical staff are pushed to the limit. “To be in the front line of the corona is to take shifts from one day to the next on the girl’s birthday because there was more exposure in the ward and another intern went out in isolation. It’s working on a turbo in an emergency mode. Not a week / two weeks but 5 months in a row. Long to rest, “she says.
“This story is my reality and that of my fellow doctors who have been specializing in recent months. Everything is at stake. Our health, our families. We also deserve basic conditions, we do not have to fight for more manpower, we do not have to fight for wages that are lost while leaving for isolation. “On the loss of sick days (statements about this solution are excellent and in the meantime on the pay slips …) and we should not work 26 hours in a row without a moment of rest, not in a routine and certainly not in an emergency. We collapse, collapse and pay with our health.”
Under the auspices of the Corona, shifts of interns were shortened to 12 hours
“The agreement is not in line, but is a good start”
After a long struggle by the Histadrut Brothers and Sisters, and while more than 3000 health care workers are in isolation due to exposure to a verified patient, this week the Ministers of Finance and Health formulated an outline for additional manpower – understanding that the crisis we face may be long and difficult to manage The same in a reality where the health care system has been drained over years from budgets and has become very lean. The ministers, Yuli Edelstein and Israel, agreed, among other things, to add 2,000 standards for nurses and 400 standards for doctors throughout the country.
Is this good news? According to Bitton, “the agreement is not in line, but is a good start. The lack of standards is much deeper than 400 doctors. “Immediately. At the beginning of the first wave, former Minister Litzman declared an addition of 500 standards, of which a few were accepted and did not remain as permanent standards.”
While the agreement covers the period of the struggle in the corona and not fixed standards, Bitton adds that “turning the corona standards into permanent standards that require a system like breathable air before the crisis, will allow a better division of the workload and shorten shifts of 26 hours to a more sane form of employment. “Probably in times of emergency and congestion, when the number of shifts increases in light of the departure of interns for isolation. Also, doctors should be given a ‘corona grant’ similar to that given to nurses and social workers out of an understanding of the heavy workload they are in.”
Despite the specific solutions proposed by the staffing agreement, the interns remained disappointed: their protest did not bear fruit. Internship is the period of training that turns medical graduates into specialist doctors; It lasts 5-7 years, and places interns in, among other things, emergency rooms and Corona wards, working long hours. The maximum length of the shift lasts 26 hours in a row, although quite often and under the prohibition of the law they last even longer. A survey conducted by the Prescription Organization in April 2016 found that many times these shifts are performed without sleep at all, and if sleep is possible during them it is small, and that there are multiple violations of the length of long shifts anyway in many hospitals and different types of specialties. Work continues sometimes even up to 30 consecutive working hours.
Not only the interns pay the price for the long hours – but also the public. The level of performance after 24 hours of continuous wakefulness is similar to the level of performance with a blood alcohol concentration of 0.1% (the permissible threshold for drivers in Israel is 0.05%). In studies published in countries where the duration of shifts is shortened to 16 hours or less, a significant improvement was found both in the quality of medical care and patient safety and in a sweeping improvement in the quality of life of the interns.
And while interns are forced to work long hours in conditions of stress and severe fatigue, senior physicians, with very few exceptions, are not required to work shifts. The world has begun to change direction – and change the shift hours so that they do not exceed 16 hours. “Unfortunately, the struggle to shorten the shifts was pushed aside during the corona crisis, when in fact the problem only got worse. Says Bitton. “This issue cannot be postponed.”
In addition to the announcement by the Ministers of Finance and Health about the increase in manpower in the health system, on Friday Minister of Finance Israel Katz announced that an outline was formulated in his office according to which the days of isolation or illness of medical staff who were in isolation or contracted by the Corona virus. They will receive an additional payment for the period of isolation or illness, after more than half a year in which medical teams are sent to isolation and are required to fund their absence from their sick days quota (they do not receive full pay for their absence), despite being exposed to corona patients.
At this time, it is not known when the agreement will be implemented and whether the crews who have had to bear the economic costs of the corona in recent months will be reimbursed. Bitton clarifies that this is not the first time the medical staff has heard statements, and that now is the time for action: “Already in the first wave we participated in the Knesset Health Committee where similar statements were made, since thousands of doctors went out in isolation / sick and paid on sick days if they had, and severe injury. “In wages – sometimes 30-40%! All this in addition to harming their health and well-being.”