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Following an overwhelming response to Tim Yates’ post about doctors being bullied by patients, we turn to another workplace taboo prompted by a new report from Mental Health International entitled Target Depression in the Workplace which examines the cost of mental health to business in Europe.
The Labour Force survey released last November by the ONS listed health professionals as having the highest rates of workplace anxiety, stress and depression (ASD) of most industries.
Is ASD something you’ve encountered in your professional life? Do you think it’s something employers take seriously enough - and if not how would you like to see them do more?
In reply to Anonymous:
Stress levels have many causes
1. Unmanageable workloads- there is no means of getting employers to ensure workloads are manageable. Workload cannot be addressed through job planning at the moment
2. Most consultants esp men consider it a sign of weakness to complain about workloads or hours. So stress exacerbated by colleagues.
3. Poor staffing levels of doctors. There is no proper ways of addressing this.
4. Long hours without rest or sleep. No EWTR compliance required by NHS.
5. Job plans appeals process can choose to ignore the view of the only medic in the panel. It can be dangerous
6. We are going to burn out very soon.
7. If you happen to speak beware of the consequences-disciplinary process
I have just had the NICE public health guidance for the workplace pointed out to me, which may be of some interest to people.
The Health and Work Development Unit (HWDU) - a partnership between the Royal College of
Physicians (RCP) and the Faculty of Occupational Medicine (FOM) - published the second round of a national audit of NHS trusts in England (round 2 - 2014). The executive summary can be found here:
The audit asked organisations about their mental wellbeing policies (a little more than a half have a policy - only a modest improvement on the first round).
Also asked about monitoring mental wellbeing - results of annual staff survey, reviewing sickness absence data, uptake of counselling or EAP services, attendance at wellbeing events, bullying and harassment monitoring, use of HSE management standards to assess risk and if training is provided to managers to promote mental wellbeing through supportive leadership styles and good management practices.
Working long long hours and going the extra mile, sacrificing family life is extremely stressful. Delivering a very good and safe service for your patients is very rewarding and keeps one going. It's an achievement to be proud of. Service re-organization forced by execs and managers is now going to destroy this.
Feeling depressed already, job satisfaction gone and retirement far off. Never had to take sick leave so far. It's likely to happen soon...
First time in my long medical career, i went off sick due to unbearable work load. Team support drastically reduced in the face of increasing work pressure with attached deadlines. On my return, i had to deal with the backlog as the deadlines were moved. Nothing has changed to improve the matters.
I think there has to be an acceptance that medicine is stressful - it is impossible to do the work we do, treat the patients we treat, make the decisions we have to make and not be stressed - it would be abnormal to be otherwise.
Where the problems have arisen is from a system which has normalised that stress and asked us to ignore the physical and emotional effects it has on us. Our systems and behaviours have stigmatised a 'normal' stress reponse so that most will "put up and shut up" until the day the pressure cooker explodes. The crisis that follows is often viewed as 'failure' as many of the posts above attest.
We need to move to a view where we accept that stress is a thoroughly normal and acceptable response to our busy and demanding working lives. We should ask the BMA to do all it can to improve our working conditions but in the meantime we should be looking to find more positive ways to deal with these stresses; avoiding alcohol and drugs as stress reflief, mindfulness, constructive dialogues and collegiate departments will all be helpful in this.
Cognitive behavioural therapy (CBT) is a proven tool in reducing workplace related stress but we have to learn to accept that having therapy / counselling is not a 'failure' but actually a positive step towards self-knowledge and resilience in the face of a challenging career. Preventive strategies rather than reactive crisis management.
I am lucky enough to come from a department (Teaching hospital Oncology) where we have pro-actively engaged in group CBT as a tool to work with stress. We funded therapy sessions for all the senior doctors and subsequently have offered the same to the nurses and radiographers in our department. We are still stressed every day but we recognise it, acknowledge it and deal with it (most of the time) in a constructive and helpful way. We have 'outed' stress and destigmatised talking about it - we want that work to spread.
To the last poster - is there any chance you might let me know what your trust is, so I can enquire further about the funded therapy sessions and group CBT? ([email protected]) I'd be very interested in finding some positive examples of employers taking this issue seriously to go with a further article, if you were willing to share.
Here is the piece that went up this week on the subject, if you haven't seen it: bma.org.uk/.../call-for-stronger-safeguards-against-stress
In reply to Stephanie Jones-Berry:
The BMA has just launched new guidance and resources for doctors who are concerned about the physical or mental health of their colleagues - including how to identify those who may be in need of support.
I am a district nursing sister and have worked in the community for 20 years. Never in my career have I fely so under valued and under so much pressure to meet targets etc. 5 years ago under a new management regime experienced staff started to leave due to lack of support and increasing demands. Staff were not replaced under the CIP to save money. The impact was increased sickness and staff leaving. 30% of staff increased workload left. The bottom line is a demoralised workforce and many looking for an exit strategy from district nursing. There are not many happy nurses certain;y not i my geographical area. Is all this an intentional strategy to encourage staff to leave, to make the NHS appear incompetent and therefore set it up to be privatised??
Hello everyone - just to let you know if you are interested, we are picking this subject up again for BMA News. Please see here for a new thread about stress in the workplace and take part in the poll.