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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?
Yes, I have experienced work related stress and have had to take a lengthy period off work. This was from bullying by colleagues which I reported. I asked for an informal investigation rather than formal. Nothing came out of it and I was put in a worse job than the one I left. Now I am having to toe the line as if it was my fault
I find the stress comes from the fact that the general patient population is still under the impression GPs do 2 short clinics and then spend the rest of the time doing nothing. I wish the media would be honest about the fact we generally work on average 11-13 hour shifts with no breaks, where you are lucky to eat lunch by 3pm with your left hand while filing pathology reports with the right. I am happy to work hard but it is demoralising when we are constantly having funding cut, more work pinned on us and the media portraying us as lazy part-timers. I entered this job to look after patients and use my brain diagnosing illness, not spending most of the day ringing people to say "your blood tests are normal just like the receptionist told you" or "yes I will issue you another sick note", or worse patients that ring the duty doctor saying they are unwell but just want a repeat prescription. Actually the most stressful part is being told all the extra money i have been paying into my pension to retire at 60 is just going to evaporate while I am forced to work until 67. We need more respect for the work we do.
how do i reply anonymously?
In reply to Anonymous:
It is easy to get burnout/stress depression as a busy Health care professional.
Whilst trusts do have a counsellor for a limited number of sessions, I never felt able to trust them because trust paid. also sessions limited.
Also if found to be "stressed" no sympathy and seen as weak member of team.
Are we comfortable telling the public/patients that important professionals are being treated for depression? Whilst the patients are not entitled to know, is it the same as drs having heart attacks? chronic asthma? Do hospital consultants accept depression and stress? Rather than thinking oh we are all stressed and get down, so grow up? This stops a good policy of work adjustment that can be implemented to keep disruption for work and person to a minimum. Difficult if locum needed, but good for dr to work part time. Financial resources already stressed.
How do you think the trust will react when theatre staff have to see HR when they are ill and they are bullied into coming into work when ill. I had a list where the scrub nurse had to disappear to vomit halfway through the procedure. She hadn't kept anything down for 24 hours. the nurse felt unable to go home without attracting criticism and appeared to scrub for the afternoon list. despite being ill.
I agree with below comment. Bullying also makes a contribution. unless the system can improve all over, and bullying recognised then if you say anything it is at best ignored and at worse further difficulties are placed in your way, - this is subtle, such as being kept out of the circle of influence.
hey i could go on all night.
PS research shows that "pseudo teams" such as when bullying happens gives worse outcomes for patients than if no team at all. - so all this is doubly bad for patients who will benefit is we learn to work together properly and respect individuality
It is a fact of life that the world is run people who can cope with the stress of their own jobs and look for more in a leadership role. There needs to be more recognition that not everyone is like that, and we need more control over how much work and stress each of us takes on. A standard job plan for everyone doesn't work.
Remember also that many of us have chronic mental health problems. The stress isn't always the cause of the illness, but it may exacerbate it or simply make it more difficult to cope with the underlying illness in the workplace.
In taking ill-health retirement last year, the assumption from the medical advisers to the pension scheme was that taking away the stress of work would make everything alright. It doesn't always work that way.
Mental and physical illnesses interact. For me, something as simple as catching a viral infection from a colleague who decides to continue working despite being ill could push me from just about coping to a two- or three-week episode of being severely disabled by depression or hypomania.
And meanwhile one is made to feel guilty for letting the team down by not being at work.
I'm currently being driven into insanity by a colleague who's mental health issues should preclude her from practising in our 'high pressure' specialty but she completely lacks insight or is in denial. Her passive aggression, suspiciousness and paranoia are causing me sleepless nights, constant butterflies in my stomach and general discontent with my workplace - ie my own mental health is suffering. Local NHS counsellor was very good. Didn't make the colleague go away but helped me figure out what's making me unhappy. Burden halved at least.
I am an associate specialist and 10 years ago I was asked to act up "temporarily" to cover a retiring consultant in charge. They never replaced her and I was left isolated, overworked and overlooked. Demands increased, as they always do and the beginning of the end was having to organise and implement a recall of patients after another doctor (since given conditions by GMC) missed a lot of deaf children. He left, they didn't replace him either and the dept. never really caught up.
Then, as the only doctor in the dept I didn't have time to take a break or talk with colleagues ever. My CPD fell behind, as did my appraisal. I was briefly admitted with cardiac arrythmia brought on by stress in Nov. 2012. I kept my Trust fully informed and asked for help. Empty words of gratitude were all I got back. There was idle talk of employing a consultant but I was told no funds - the money I'd saved them over the years got ploughed straight into CIP.
In Feb 2013 I was off for 1 week with stress. I went on fluoxetine, purely so I could carry on and kept my manager informed. In April I wasted time I couldn't spare writing JD for consultant post at Trust's request. In May this ray of hope was extinguished and no-one had the courtesy to explain to me why we suddenly weren't going to advertise the post (cost again, I later discovered).
In July I requested interview with Medical Director to ask for help. I got more empty words of praise and sympathy, but no actual help.
September 2013, after holiday break realised I was now too ill to return, because in danger of "losing it" with patients. I've been off sick with stress since. What a revelation! I'd been run down for so long I'd forgotten what my actual personality was like. November 2013 the Trust finally put plans in motion to get that illusive consultant - I believe he starts today (May Day!). Good luck to him.
I had planned to return, but found even the thought of going back in the future made me feel sick and lose sleep. I finally took the decision to retire early and take my pension. I plan to forget I ever was a doctor in sole charge of a department. I'm finally free at the end of May.
The final kicker. The Trust decided 1 full-time consultant wasn't enough to do the job safely that I did as a part-time AS. They appointed another, with talk of getting a registrar too. It would have been a dream for me to work as part of a team like that, but if they had advertised for 1 consultant a year earlier I wouldn't have been driven to go off and they wouldn't have had to pay out for a second consultant, so false economy on their part. (Though "false" is a pretty apt, one word summary of my old, much hated Trust). My message to health workers who feel as I did is "Get out, if it's at all possible. It's not worth it to be dead inside over a job."
If my experiences are anything to go by the NHS is a time-bomb, because in the political rush to "put patients first" it's being forgotten that healthy, supported staff are essential to do that, in the long term.
The BMA should take this far more seriously ... I do not know a happy doctor ... need I say more?!
I worked a 1 in 2 for 5 years as a acute consultant surgeon and my recorded awake hours in the hospital exceeded 120 per week. Then my secretary left to take up a management role and I took 2 weeks" stress leave" before coming back to the same work pattern. later in my career I was told that I had not been considered for a role because I had a history of "Stress". Nice to feel valued.
I note that everyone feels that they should be anonymous on this subject- need one say more.
I've been bullied in my dept for 10 years. I think the bullying stems from being chronically understaffed and 2 other colleagues singled out the weakest in the herd as it were to vent their own stress. I have suffered stress for this period of time and no don't really know who I am any more. I cope less and less well as each year passes. I saw the stress counsellor at work who suggested I freeze stews at home to make meal times easier and considered having another baby so I could have a year off! My Gp told me ' some people can just cope with a life in hospital medicine and some just can't' . Marvellous!! My employer uses my history of stress to prevent any career advancement or role change. If my mortgage and kids didn't depend on it I'd quit. There is a little voice inside me that reminds me that I am a good doctor but that voice is getting quieter daily.
Hi - this is Steph, one of the writers at BMA News. I just wanted to say thank you to everybody who has shared and commented on this thread. I am really interested in your experiences and I think this shows that this is a very real and present issue. If anyone does want to speak out about anxiety, stress or depression and the workplace, and would not mind going on the record, then please contact me at [email protected]. I will also consider some of the points you have made in an article I am currently putting together on the subject. Many thanks.
"It is a fact of life that the world is run people who can cope with the stress of their own jobs and look for more in a leadership role. There needs to be more recognition that not everyone is like that, and we need more control over how much work and stress each of us takes on. A standard job plan for everyone doesn't work."
I couldn't agree more with the person who said this above. I want to be able to do my clinical and teaching roles well (which I think I do) WITHOUT being assumed to be auditioning for a management role that I don't want and without feeling under pressure to agree to these additional tasks. There needs to be an acknowledgment that being a hardworking and competent clinician is as valuable to the NHS as leading strategy and service redesign, instead of constant attempts to lure such staff away from the clinical coalface.
The same thing happens in nursing, with nursing colleagues forced to apply for team manager roles in order to further their careers and income, which takes them away from their nursing roles and frequently leaves us with less competent nurses.
There will always be those who want to do management roles and that's fine - I am grateful to them. But not to want to do one should not be seen as laziness or a shirking of responsibility. There needs to be parity of esteem between clinical and management work and I feel that this is not the case. The world needs strategists and completer-finishers. We cannot and should not all be expected to be all things to all people.
My stress at work comes largely from the expectation of Trust management for me to be someone other than who I am.
Having had a long history of depression myself, I am thankful to have an understanding boss. However, the strain of revalidation has been so bad I was hard put to continue working. I fing even the appraisal process very threatening. There should be more support for those of us with mental health issues to deal with this. Only at the last minute was I advised of a mentor who is the only one in the area as far as I know.
Also I am trying to support a patient who is a very good physio and stuggling to cope with pressure to take on extra work. She tells me she is awaiting for a disciplinary hearing for refusing to take on a more demanding role. This is ludicrous.