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Some well-meaning manager has put up a poster in the staffroom. It’s all about how to improve your work-life balance and reduce stress: make sure you take your lunchbreak; leave early; try working from home. All sound, non-controversial advice.
Except that this staffroom happens to belong to the neonatal intensive care unit. So I added some helpful notes to it.
Leave early – no-one will really mind if you skip handover.
Take your lunchbreak – that resuscitation can wait.
Try working from home – take a 24-weeker with you!
(Actually, I quite liked the image of myself dragging a transport incubator, complete with syringe drivers and monitoring, onto the bus to take home with me. But the clinical governance team, not to mention the infant’s parents, might possibly have other ideas.)
This kind of advice is just not practical for people working in pressured clinical roles. In some jobs you can choose, at least hour-by-hour, what you’re going to do and how you’re going to do it. Most doctors do not have that luxury: we have to respond minute-by-minute to whoever deteriorates on the ward, or walks through the surgery door, or (in the case of NICU) unexpectedly arrives into the world blue and apnoeic.
Non-medics often talk about ‘the office’ as if it were a universally familiar setting: the desk, the watercooler, the deadlines that can, at a pinch, stretch to one more day. For doctors, life isn’t like that. (It’s also totally unlike that if you work in a shop or a warehouse, of course, but that’s a whole other column.) Efforts to improve our experience of work must bear that in mind.
Lunchtime yoga classes for staff with no predictable lunchtime are of limited use. Cautions against ‘presenteeism’ are meaningless when you know that, if you don’t drag yourself into work feeling rough, someone else will be stuck holding two bleeps and dealing with a double ration of emergencies. As for flexible working, for most of us it’s an obvious non-starter. Generic advice which ignores the special circumstances under which we do our job can feel like rubbing salt in a wound.
So thank you, managers, for trying to improve our working lives. But please do it by running humane rotas, dealing with leave requests in a way that doesn’t force people to reschedule their own wedding, providing decent places to rest, and – above all – recruiting adequate numbers of staff. Of course, it might turn out to be a little more expensive than putting up an ill-thought-out poster in the ICU staff-room.
By the Secret Doctor. Read the blog and follow @TheSecretDr on Twitter and on Facebook
Good point. I’d like to work from home, but not sure if I could take that RESUS patient or that displaced fracture home with me.
Maybe we should take a lunch break and leave them with the bleep
When I was an FY2 I was once cornered by management during monitoring fortnight and asked why I haven’t taken my dinner break the following evening. After I explained that my dinner break would mean a patient would breach in A&E I was told I should manage my time better! Go figure.
But please do it by running humane rotas, dealing with leave requests in a way that doesn’t force people to reschedule their own wedding, providing decent places to rest, and – above all – recruiting adequate numbers of staff. Of course, it might turn out to be a little more expensive than putting up an ill-thought-out poster in the ICU staff-room.
May I add, or in such a way as to make life so hard that compassionate leave is only if your immediate family die, and not before hand while tending one's mother's chemotherapy appointments.
Amazing! You should get a job as Health Secretary.
Secret Doctor - you are going to burn out prematurely if you feel that everything adverse that happens to you at work is "done to" you by managers! You are intelligent and streetwise and no one knows your duties better than you do. If you don't like your rota why not get together with colleagues to make it better? The only reason a manager would design it is in the absence of any input from a clinician. Also leave requests are approved by clinicians who may be line managers - and if this isn't the case it should be. There are lots of things that can be attributed to failures by "managers" - but leave requests and rotas aren't in my book on that list!
So much this! Especially with leave and rotas. I only qualified in July but the frustrations of continual leave requests being declined and 'helpful date suggestions' aka when it's convenient for them I can have the day off. Rota gaps don't just mean less staff but fewer opportunities to take leave otherwise we drop below core numbers. And heaven forbid a well thought out rota...
Typical Management rubbish suggestions!
spot on !
As a junior doctor we were once told by management that us CHOOSING taking leave in August, when staff changes over, is causing huge financial losses. They failed to see that our leave was fixed and predetermined by 'management'.
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Noticeboard in mess:
"BMA fatigue and facilities charter: Take your breaks"
"Please ensure all discharge summaries are completed by the end of your shift"
"Remember to complete monitoring/exception report"