Junior doctors' strike: 'We're absolutely broken'
Kiwi junior doctors began a second lot of strike action on Tuesday, downing their stethoscopes for 73 hours, and causing the cancellation of thousands of appointments and surgeries.
So why are they striking?
Kathryn Foster is a junior doctor or RMO (Registered Medical Officer) and union executive who works in the emergency department at Auckland Hospital.
She told Newshub strike action is something her union, the NZRDA (New Zealand Resident Doctors' Association), has only pursued as a last resort.
"We felt we've all got to the point where we won't make any more progress in our negotiations if we don't strike, but it never feels good to walk out of an employment situation, we want to be there for our patients, we want to be working, but, we feel we have no choice."
The strike by RMOs is essentially over their work hours. Most junior doctors work at least 60 hours a week or more and for sometimes 12 days in a row without a rest day.
Dr Foster says the long hours are draining, and dangerous.
"Three nights is fine, four nights is acceptable, but once you start getting up to seven nights you start to make really interesting decisions and that's all well and good but the interesting decisions can have really big ramifications for patients and we want to able to look after them as well as we can.
"You really start to feel the pressure as you're heading into your fifth, sixth, seventh night. The sleep deprivation, it just gets to you."
Dr Foster says she used to work up to 13 days in a row when she was a house officer, sometimes for up to 16 hours a day.
She says the long hours were punishing, and that so-called rest days were spent recuperating.
"The only thing we could do was get out of bed to eat and roll back into bed. You know that you have to look after yourself but it's really hard to do when you're absolutely broken."
Why have negotiations broken down?
As an NZRDA executive, Dr Foster has been privy to bargaining and negotiations with the DHBs (District Health Boards) over a new working hours contract for RMOs.
She says her union works hard with the DHBs to find a solution and maintain an amicable relationship, but every time a solution appears close, higher management steps in to disrupt negotiations.
"We keep getting to the situation where we're almost at the point where we could settle and then something happens and the CEOs change their mind, and we're now heading into that third time around, so the frustrations are mounting.
"We don't want to keep negotiating, we don't want to keep striking, we want to be able to work and give our all to our jobs. But we're in a situation where there are few hold outs on some very big issues for the RMOs that really need to be settled for all of us to move forward."
DHBs claim it's largely business as usual
National contingency planner Anne Aitcheson told Newshub the strike shouldn't cause longer waits for patients.
"The number of people with less urgent care needs are likely to have those needs met by their GP, so waiting time is always an issue, we don't expect it to be any worse."
Canterbury DHB chief executive David Meates says while up to 600 non-urgent surgeries have been postoned in the region, he expects emergency care will function as normal.
Will there be a third lot of strike action?
Dr Foster believes RMOs are wary of further strike action, and that there's still plenty of support for negotiations and settlement.
"It's nothing we undertake lightly and there has been significant pressure from the DHBs not to strike.
"In saying that my experience is that our numbers are stronger than ever, our members are more vocal than ever they're more engaged in this process, they really want this to work.
But Dr Foster believes a settlement with the DHBs is close.
"From here the process to a resolution is simple, it's saying our priority is safer hours, the DHBs have agreed to that, it's looking at taking that priority and making it work."
What do junior doctors do when they're on strike?
Dr Foster told Newshub she will be taking the chance to do some medical study over the next three days while the strike is on, and that many of her colleagues will be doing the same.
She is also aware of RMOs planning to give blood or meet up for a rare social gathering.
"I think lots of us are feeling pretty burnt out with this process at the moment and the idea of a bit of recuperation is high on a lot of people's lists.
"All we do is study, sleep, and work."
Will the strike action work?
Dr Foster claims that RMOs would not be engaging in strike action if it was a hollow or futile undertaking.
"We see this as an opportunity to really stand up and say 'yes, our hours are important and we're grateful for the progress we've made but there's still a distance to go'.
"We're still standing strong and we're not going to give in because ultimately this isn't a fight for us, it's a fight for everyone in New Zealand.
"We're fighting for the ability to care for people properly, and that's a fight worth fighting."