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It’s a call I’ve made only once before in my medical career, and I’m dreading it.
She answers on the third ring. I can hear the background hustle of the ward and the unmistakeable fatigue in her voice.
‘I’m sorry, I’m not well, I can’t work today,’ I say. I hold my breath. I’m not sure what I am expecting. Perhaps a ‘pull yourself together’ or a ‘do you know how understaffed we are?’.
But she is nice, and I am relieved.
Although my illness will be only transient, I cannot shake the feeling that I have let people down. Have I been weak where others might have persevered?
But it is not the patients for whom I feel guilty - they will be well looked after whether I am there or not.
My guilt is for the burden I have placed upon my colleagues. The colleagues already working well beyond their hours, missing their children’s bedtime or partner’s birthday, one of whom will have to arrange childcare, placate their partner and cover my absence.
The medical take will continue, but only because of the sacrifices made by those around me.
Upon my return the following morning I am greeted by an email. In keeping with any good bureaucracy, there are two forms that I need to complete to justify my absence or my pay ‘may be deducted’.
In the first form I am required to disclose the nature of my illness. Of course, there’s always the option not to do so, in which case my line manager will ‘clarify the details of my illness at a later date’.
It seems the confidentiality I provide for my patients is not applicable to me.
The second form must be completed by my consultant, proving we have met and agreed a plan to avoid future time off work.
Overall, I am left feeling mistrusted and even more guilty.
It is well known that doctors take far fewer sick days that any other group of professionals. In a system where even ‘fully staffed’ is synonymous with ‘overstretched’, concerns for placing additional pressure upon colleagues and fears for negative impact upon career mean the decision to take sick leave is extremely difficult.
I have colleagues who are proud never to have taken a day off sick. And yet on the occasions I have worked whilst unwell, I know my propensity for empathy is significantly limited and capacity for error greatly increased.
Sickness may be part of our everyday working lives, but to relinquish the role of doctor and care for oneself before patients and colleagues goes against many instincts and is a decision which I suspect will never be guilt-free.
Our second Secret Doctor has bidden farewell and written a final blog. Until we appoint a successor, other junior doctors will be writing guest contributions for the blog, and this is the first we have selected
Read more of the Secret Doctor blog
don't be a martyr, nobody will protect you, you are viewed as disposable by the management
I'm sorry but isn't it ridiculous to have to fill out paperwork for having 1 day off work. The whole distrust from the system is sickening. There is so little humanity, so little caring from these organisations that we work in.
Sadly in the NHS with it's generous sick pay (more generous that mat leave pay which I find odd ) there has been lots of abuse of the system so that is why there is some saga when you return. I guess if you have been genuinely sick there is nothing to hide and you can decide what you will reveal after all we are in the trade so know what we can keep confidential.
If you are ill you should take the time off and come back when you are better i also know form experience of coming back to early. One thing I would say as a consultant please tell us early we prefer to know and plan it is easier to cancel a locum than try and magic one up at short notice. The worst thing is having sick leave sprung on us esp Friday night I have had it twice this year (both genuine sickness) but a v tricky time for us to get cover esp with less juniors around.
When I was junior doctor many years ago it was exactly the same. I trundled into work when clearly too ill to do the job because of guilt and was sent home by the senior sister who notified my middle grade who managed to get cover fortunately. I still felt bad over it but accepted that had I been called in to cover a colleague with similar symptoms I wouldn’t have minded!!
If you're too sick to work, then you're a danger to yourself and those around you. If you work on oncology or similarly immunosuppressed areas, this is doubly important. Those who come to work with snot running out of their nose like a tap are the real liabilities, and this masochistic nonsense should be stamped out.
I once said to a colleague: if the absence of one junior (or senior for that matter) is going to cause the system to collapse, then it's going to collapse anyway. Go home, be sick, watch Homes Under The Hammer or whatever nonsense is on daytime TV these days and get well.
I feel so anxious at the thought of phoning in sick that I can no longer tell if I am sick or a malingerer, even when I have had renal colic!
I have to rely on my husband reassuring me that I really am ill and that the ambulance would not have taken me to A&E if wasn't unwell!
I have been in the fortunate and I imagine very rare position of having superb support from HR and Occ health. It has made a tremendous difference. Their support has meant that in the short to medium term, they’ve had a doctor out of work, off sick. In the longer term they will have someone who is motivated to get back and to also offer similar support to my own colleagues. I think their approach will pay dividends. I wish I could say the same of some senior medics. I’m just glad this has been something “real” like cancer; there is not much compassion out there for mental illness... it’s up to all of us to make a difference. I know I want to go the extra mile when I’ve been supported. Not just tit for tat but it buoys you up..
I have found a distinct difference in how doctors are treated as opposed to other healthcare professionals in response to bereavement which will affect all of us. My father died after two years in hospital as I struggled to visit him , being the one of the only family members who could drive that distance , all at the time when I was working 80 to 120 hour shifts. I was expected back at work before the end of the week after his death( the day after his funeral) and to get on with it. Contrast that with the experience of a nurse colleague of mine when her father passed away after a month long illness. Three weeks of bereavement leave and reduced duties on return.
We have to take care of ourselves as no one else will. I'm still struggling with his loss 25 years later as a result.
This is a brilliant article and I am so glad that I am not the only one who feels this way. Given that our work involves making important decisions about peoples health and managing unwell patients, we need to be on top form in order to make the correct decisions and not harm our patients. If we are not well enough to do so then we should not be working. Part of the GMC's Good Medical Practise guidance includes 'Protecting colleagues and patients from any risk posed by your own health'. I agree it falls into this category.
I totally agree working for NHS for betterment of patient and we are required to be sympathetic towards our patients but I have found that NHS is least sympathetic towards their own staff, when it comes to one off the staff being sick , specially the doctors , although hospitals staff has a better package for sickness pay but as Gp's we may have no or very little sick pay as I found out at the worst time of my life when I lost my brother 5 yrs ago and after 1 week off compassionate leave I took 1 week off sick even though I was no way ready to return after such a big shock ,but came back due to the good old guilt that my colleagues will struggle with work , my pay for that additional week was deducted which left me in a state of shock , I was told that my contract did not have any sick pay , which I may have over looked , even though being in this practice for 8 years I had never been off sick for that length of time , never been on any maternity leaves etc , unfortunately my father passed away 6 weeks after the death of my brother as he was abroad I had to leave in emergency when I found out he was diagnosed with ca pancreas and Dr's had said he may not live long and unfortunately 2 days after my arrival he passed away, there were lot of things to sort out ,so I returned after 3 weeks to find I was not eligible for any more compassionate leave and had to pay back from my annual leave or else my pay would be deducted and being the only bread earner I had to compromise on giving up half of my annual leave in the beginning of the year . I argued with my partners and manager that as I was on BMA contract why was my sick leave not according to it and was told they could not afford that much sick leave and were free to make that decision , I called BMA and was told that it was up the individual practices and they could do nothing about it , as they are a business.
I had to fight my partners for a whole year and negotiate on getting sick leave and now finally all staff has been told they have 6 weeks sick leave with pay, which still I believe is nothing , as doctors and NHS staff are also humans and can be effected from ill health as any other person requiring prolonged period of sickness .
I feel vey bitter about this issue and I feel GMC should have strict rules on sick leave and should be same for all NHS staff be it surgery staff or Hospital and compatible with other sectors.
When I'm here at home there's nothing to worry about. But once I was abroad, in France for business needs and I got sick. I couldn't call for my colleagues because I didn't know the local area codes. Thankfully, I was told about this resource areaphonecodes.com/.../ where I could find all the French codes.
I once had to leave mid night shift at 5 in the morning after having to run across the ward to projectile vomit into the patient toilet. In my exhausted unwell state I tried to suggest to the nurses that it was probably just my dinner sitting funny and that I always get nauseous on night shifts, I suggested I took 5 for a cup of tea and then see if I was feeling better. Fortunately they promptly called my registrar who handed me my coat and firmly insisted that I went home. I spent the next 24h sitting on my bathroom floor unable to move without being sick. In that time I sent emails to 3 different people to explain and called the ward again to apologise. I was so clearly unwell and unable to be at work but I had such extreme guilt for leaving them in the lurch, even now part of me feels really bad about it.