If you’re still working from home, how many steps do you take in the average day?
Chances are, you struggle to get close to four figures, when recommended physical activity guidelines say 10,000 should be the target.
Emergency department doctors at a large Johannesburg hospital, however, average about 6,500 steps per shift. And if they’re called on to perform cardiopulmonary resuscitation that rises to 8,300.
Thirty-two doctors at Helen Joseph Hospital wore pedometers for a month as they triaged and treated thousands of patients in the 2,500m² emergency department.
They were part of a study initiated by Dr Craig Beringer, of Wits University, to help him towards a master of medicine degree in emergency medicine.
Reporting his findings in the November edition of the SA Medical Journal, Beringer said even 6,500 steps – classified as “low activity” – was too few for the doctors’ wellbeing.
“Working in the emergency department predisposes [them] to the development of burnout, and physical activity is one suggested activity to ameliorate the detrimental effects thereof,” he said.
“As doctors seldom achieved the daily requirements during working hours, they would [need] to compensate for that deficit after work.”
Beringer said he was surprised by his finding because of the fast-paced and “overburdened” nature of the Helen Joseph emergency department, which treats about 65,000 patients annually, as well as understaffing.
But he reflected that a 2015 study at Estcourt Hospital in KwaZulu-Natal found that 69% of healthcare workers had moderate to low physical activity levels – a finding replicated internationally.
Chest compressions during CPR registered as “pseudo-steps” on the pedometer, during testing before the study, leading to a higher count for the medical officers and registrars who performed CPR.
“Performance of CPR is a well-recognised form of physical activity, and furthermore has been linked to fitness level,” said Beringer.
“On average, a total of 690 joules are burnt during 15 minutes of CPR training, which equates to a 30-minute hike or light garden work.”
Patients who were given a “yellow” triage category also raised doctors’ step count. “[They] often need special investigations and further medical management,” said Beringer.
“Such requirements may necessitate the doctor walking to various locations in the emergency department to execute them.
“Patients triaged ‘green’ are typically quicker to assess, with few further investigations required. Critically ill and injured patients fall into the ‘orange’ and ‘red’ triage categories. These patients often require immediate management that is performed at or near the bedside.”
The 10,000-step target was exceeded in only 37 (11.7%) of the 317 shifts tracked during his study, and CPR was performed during 8.5% of shifts.
A survey of more than 4,000 UK emergency department doctors found they need more support to recover from work pressures between shifts.
The study of 4,247 doctors, published on Monday in the journal BMJ Open, found their “need for recovery” was higher than anything recorded in previous studies across all professions.
Lead author Dr Laura Cottey said: “Better access to leave and any reduction in antisocial shifts [such as night shifts] might ... help protect against the development of burnout.”
