Work-related stress among paediatric non-consultant hospital doctors

There have been many reports of Non-Consultant Hospital Doctors (NCHDs) deciding to leave hospital medicine in pursuit of a career with better hours and lifestyle such as general practice. It is not known, however, how widespread feelings of dissatisfaction are in paediatrics and whether work-related stress is a contributing factor. A postal survey of NCHDs in paediatric posts throughout the country was conducted in November 2000. Data collected included demographic and personal details. NCHDs were also asked their level of stress in relation to their daily work, patient-care, hospital environment and dealing with other staff members using an incremental scale from 1 to 5 (5 most stressed). 69% (71/103) of the questionnaires were returned. Equal numbers of males and females responded (48% vs 52%). 51% (36/71) of the NCHDs were registrars; 51% (36/71) were working within Dublin. More than three-quarters had graduated from a European Union (EU) medical school (77%, 55/71). While the majority (79%, 56/71) were either satisfied or very satisfied with paediatrics as their chosen specialty, 79% (56/71) admitted to work-related stress causing job dissatisfaction with 71% (50/71) having experienced 3 or more stressful situations in the previous week. 56% (41/71) graded their occupational stress level at 4 or 5. Routine non-medical work and poor job prospects were the main factors causing job dissatisfaction. With regard to daily duties, the situations causing stress were acute emergency situations (51%, 36/71), being solely responsible for patients when on-call (52%, 19/36) and making decisions after a night on-call (76%, 50/67). The general attitudes of nursing staff were stressful to 40% (28/71) with 39% (27/71) stating having a difference of opinion with a nurse at least once every week. Relating to consultants was moderately stressful to 26% (19/71) and very stressful to 4% (3/71). Uncomfortable sleeping quarters and having insufficient time for meals were noted to be at least moderately stressful (stress levels 3 to 5) for 70% (50/71) and 92% (65/71) respectively. 59% (42/71) felt that their social life was greatly affected by their work. 68% (48/71) have considered leaving paediatrics with almost half (48%, 23/48) considering this seriously or very seriously. More than half stated that their alternative career choice would be general practice (61%, 29/48). The results of our survey show that work-related stress is common among paediatric NCHDs and is associated mainly with long working hours, sub-optimal on-call conditions, and dealing with very ill patients.