Friday, September 11, 2009

NHS - A culture that discourages doctors from taking sick leave

If you’ve spent any time at an NHS hospital as a patient, visitor or member of staff, you may have had the misfortune to come across a doctor who is clearly not well enough to be at work. whether they’ve got a raging cold or flu or conjunctivitis, they’re still battling away to do their job. you may ask yourself ‘why?’ why are these doctors at work when they are unwell and therefore unsafe to work. They are putting themselves in danger and they are putting their patients at risk too, a risk that is two-fold. Firstly they are putting their patients at risk of catching the lurgy they are dragging around with them and secondly they are putting them at risk of unsafe medical practices because they are not fit to work.

I would like to give you a little insight into what is going on in that sick doctors mind. I have gone to work when i’ve felt under the weather because there is often times no provision made for you if your are unwell. You know that you’re the only one from your team who will be able to cover the ward that day, and if you don’t go in, then who will look after your patients? Similarly, If you’re on call and you call in sick, there is no provision for someone to take over your duties, the on-call team will just have to suck it up and cover for you – i.e they will have to  pick up your slack. So there is a massive sense of guilt that makes you drag yourself into work. Guilt that you will let your patients and the members of your team down.

You may ask yourself why there is no immediate provision that can be tapped to cover doctors who may have to call in sick. After all it is a relatively high risk field – decisions made by doctors every day can be life or death decisions. Planes don’t take off if the co-pilot is not there, so why are doctors allowed to practice if the whole team is not there? The cynical answer to this is that management don’t want to fork out for locum doctors to cover those who call in sick and that the NHS is unfortunately run on guilt. We all work late, do unpaid overtime and cover absent colleagues duties because we know that it is our patients who will suffer if we do not. Often times there are holes in the rota that have been known about for weeks, but the assumption is always made by management and admin staff that some poor mug will take on additional duties and hold the on-call bleep because that’s the way it’s always been. health and safety although drilled into us is conveniently swept under the carpet and away we go! Unfortunately this culture is perpetuated by doctors themselves – doctors who will step up to the plate because consultants and particularly consultants in management positions will expect and pressurise you to. After all, things were a lot worse in their time – no European working time directive during their training.

I’m writing this post because i recently had to call in sick on a week end on-call and it turned out I had to have emergency surgery and am now coming up to my second week off work. I felt so guilty on saturday morning that after taking two paracetamol to ease my pain, I did almost go into work. Subsequently, I have had numerous calls and e-mails asking me when i’ll return to work (despite the fact that I have informed medical staffing of the situation), but have felt completely unsupported and have even been told to arrange a swap for a week of nights which I’m am not fit enough to work. Just a ‘I hope you’re recovering well’ at the beginning of a phone conversation or e-mail would go a long way. Returning to work after 2-3 weeks off sick is a daunting prospect, but no one has had a conversation with me about easing me back into work at a comfortable pace. The attitude is very unsympathetic. As a work colleague used to say to me, ‘just man-up and get on with it’! It turns out that the NHS is the worst at looking after it’s sick staff. Oh the irony!

I don’t want anyone to think that I’m a bitter junior doctor who is raging against the NHS. Unfortunately the system is flawed in many ways. Cutting staff (as suggested by a leaked department of health report) is clearly not a viable answer! I do not switch off at 5 o’clock because that’s when I stop being paid, but go home when all my patients are sorted out because cheesily I got into the game to help people and wouldn’t want someone to leave one of my family/friends with out an adequate treatment plan because they clocked off at 5. The NHS is a marvellous service. I myself cannot fault the treatment I received during my recent hospital admission.

I just want to send one message out to all the managers and consultants running the NHS. Don’t forget that us junior doctors are human too. We get sick and sometimes need a kind word and encouragement to help us back when we have fallen off the horse. Many of us feel privileged to be doing the job we do, but don’t take us for granted. Appreciate us.

[Via http://driveoutdarkness.wordpress.com]

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