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It’s not meant to be a competition and if it sounds like one, we’re in even more trouble than I thought. You’ll have to take my word for it, as I haven’t gone to the lengths of the juniors who measured their ‘output’ for a BMJ paper, but when I got home from work and realised that I hadn’t once used the bathroom during my shift, I knew there was a problem.
I was the responsible consultant on the admissions unit and there were patients literally everywhere.
Along with the relatives I needed to speak with, the calls for advice, the records to update, neither food nor fluid had slipped past my mouth since breakfast, and it was by now 3pm. It was one of those days – but I seem to have rather a lot of ‘those days’.
How had I allowed this to happen? I thought I was simply following Good Medical Practice – to make the care of the patient my ‘first concern’.
My first concern. It was drummed into me at medical school, to mould me from person to doctor. It was used as a stick to beat me with when, as a surgical house officer, two hours after my 12-hour shift should have ended, I dared to say that I was exhausted and planned to hand a job to a colleague. I was told that I didn’t care. But I really do care.
If I didn’t care about patients or colleagues, then it would be much easier to care for myself. The trouble is that ‘those days’ of sacrificing the wellbeing of ourselves for the sake of other people can become so increasingly common that they become the norm. And while my medical education taught me a lot about clinical management, I learned very little about how to look after myself.
There’s plenty of literature – I can scarcely read an issue of the BMJ without ‘burnout’ cropping up. But the articles tend to use jargon such as – I quote – ‘human factors approaches’ or ‘recalibrating inspection regimes’.
To me, the strategies offered feel impossible to implement straight away. While the problem is complex, the solutions need to be simple and ready to use. So here are some of mine.
Please share yours too.
- Banish the bravado – we’re very good at bragging about the long hours and hard graft. Take a break and boast about that instead – how you managed to fit it in, or how effective you were afterwards
- Make refuelling easy – bring lunch and a big bottle of water to work, and keep them close to hand
- Patients are your ‘first concern’ but that doesn’t mean that every task has to come before your own urgent needs. There will be times when you say ‘yes, I’ll speak to the family, but I need something to eat first’
- Don’t feel guilty about having a coffee with colleagues. Talking over a cup of coffee is better than a thousand fancy words on wellness. Call it ‘service development’ or ‘appraisal preparation’ if it makes you feel better
- Help colleagues take breaks by looking after their bleeps while they’re away, and they’ll do the same for you
- Have meetings (the useful kind) where staff can get together, share problems and discuss ideas. And remember the biscuits!
I want to look after the patient in front of me now, but I also want to be able to look after many more people in the years to come.
We look after everyone but ourselves – let’s change this.
Clare Bostock is a consultant geriatrician in Aberdeen