The pluses and minuses of Weekend Working

There’s not much that stirs up the pot of medical opinion these days quite like telling a doctor—or nurse, for that matter—that they must trade their Sunday morning church choir for the beeping of a heart monitor. Where once we were considered a pious backwater of Catholicism, and banks and businesses shut up their premises on Friday evenings as if preparing for the End Days, Ireland is now open 24/7. Except, perhaps, its hospitals.

The latest policy decree is this: hospital staff are to brave the weekend shift as regularly as the postman his rounds. Now, whether this is a stroke of policy genius or a recipe for professional burnout served piping hot, well… let us ponder.

Terence Cosgrave

First off, let us not be too dismissive of weekend doctors like our good friends at the IMO who seem to think the move is akin to holding the All-Ireland Hurling final on a Wednesday night, or moving The Late Late Show to Saturday mornings.

From the patient’s vantage point, it’s like discovering diamonds in the mud. Imagine you’re Mrs O’Sullivan – you’ve been clutching your chest since Saturday noon, and Sunday morning finds you in a foul mood because you can’t hail a physician outside of working hours. But now, hurrah! there’s Dr Murphy in the Emergency Department, cheerful as a lark and armed with more knowledge than a revised edition of Gray’s Anatomy. Weekends no longer mean ‘see you Monday’—they mean ‘we see you now’.

Patients gain a treasure trove of benefits:

• Quicker Care: No more waiting until Monday to be hauled in for that kidney stone. The pain might be medieval torture, but at least you won’t wait 48 hours for relief.
• Continuity of Treatment: Aunt Bridget’s chemotherapy sessions can finish on schedule, not postponed until ‘after the weekend’. That steadiness improves outcomes faster than you can say ‘Oncology On time’.
• Reduced Hospital Stays: Early intervention on a Saturday afternoon can nip complications in the bud, shaving days off your hospital calendar. You’ll be home in time to watch the Omnibus edition of Fair City on Sunday morning.

But hold your horses—every rose has its thorn, and every Saturday shift has its groggy-eyed physician stumbling for strong tea at dawn. For hospital staff, weekends used to be a hallowed realm of family picnics, church services, and wildly competitive rounds of backyard Gaelic football. From now on it will be bleeps and beeps – and the faint smell of antiseptic – where children once played on green fields.

Consider young Dr Finnegan, who now must trade his weekly visit to his proud mother (who scrimped and saved to fund his medical degree) for a night shift. The costs, dear reader, are manifold:

1. Family Sacrifices: Sunday dinner with the Finnegans—a tradition that spans more generations than the Book of Kells—is now rationed to quick telephone calls between IV insertions.
2. Mental Wear and Tear: There’s a peculiar sort of exhaustion that is born of constant nights and irregular days and it’s more deflating than a flat pint on St Patrick’s Day.
3. Reduced Workforce Morale: Even the jolliest among us turn sour when weekend pay comes in at half the delight of a weekday’s toil. It’s the difference between a full belly and the longing for a second helping.

And let us not pretend these costs vanish like mist in the morning sun. They accumulate, until one day Dr Finnegan finds himself asking, “Is it worth it?”—and perhaps skulks off to sunnier pastures. There, however, he may find, foreigners also get sick at weekends about 2/7 of the time. This is a worldwide problem for golf-playing doctors.

Yet, if we step back to gaze upon the grand tapestry, we see threads of sound reasoning. Hospitals, much like Irish weather, can turn stormy at any moment—heart attacks don’t check calendars before they strike. A weekend policy ensures that one needn’t postpone life-saving surgery because ‘we break for tea at 3pm’. Of policy merits, then:

• Public Health Equity: Rural towns like Clonmel and Boyle get the same standard of weekend cover as Dublin’s grand hospitals. No more ‘you’ll have to wait until Monday’ just because you’re off the beaten track.
• Emergency Preparedness: A workforce that’s accustomed to seven-day schedules is more agile in crises—be it flu pandemics or unexpected visits from political dignitaries.
• International Benchmarking: Other advanced nations—save for some backward hamlets—already employ weekend staffing norms. We don’t wish to fall behind Sweden or Australia in such modern norms. Or even South Sudan.

True, the policy is as bold as sticking your head out the window in a gale, but boldness sometimes breeds progress. Jennifer Carroll McNeil seems oblivious to gales, landmines, the IMO and a myriad of other excuses for delaying or cancelling the measure.

But before you saddle your unicorn and set off to join the picket line, remember: the Irish spirit is nothing if not adaptable. From desperate famines to Rugby World Cups, we’ve weathered harsh  trials aplenty. If weekend hospital work were to become as routine as rain in June, we’d learn to enjoy the odd cup of strong tea at midnight, and cheerfully swap stories about the fellow in Bed 12 who claimed he was Elvis in his previous life.

And the patients? They’ll be snug in their beds, knowing that whether it’s a weekday or a Sunday, capable hands are never more than a corridor away.

So, is forcing hospital staff to work weekends a blazing stroke of policy brilliance, or a misguided tempest brewing professional dissatisfaction? I’d say it’s a bit of both. Patients bask in the sunshine of immediate care, while doctors bear the occasional hailstorm of exhaustion. The cost in morale is real, but so too are the benefits to public health.

In short, this tale is like a well-poured pint: it’s a mix of froth and stout. You may lament the missing foam (doctors’ weekend leisure), but you’ll celebrate the smooth pour (patient well-being). Like any good policy, it may require a wee bit of tinkering—perhaps better shift rotations, extra incentives, and that all-important weekend bonus that rings sweeter than the peal of Christmas bells.

At the end of the (week) day, whether you lean on the side of medical altruism or on the side of a well-earned rest, we can all agree that Ireland’s hospitals will hum a bit more cheerfully—just, perhaps, a little bleaker for the staff. And if the policy shifts again, well, that too shall pass, like the seasonal rains. Until then, may your Sundays be safe, your doctors be well-caffeinated, and your policy debates ever light-hearted.