Ooh I’ll get by…but can I have a little help?
I have been encouraged to write this post because I am finding work quite a struggle at the moment. Not physically, but mentally.
We all know that over the winter months there is a dire crisis in Emergency Departments and hospital wards due to lack of capacity, huge over-spilling of patients and limited resources. I shan’t go in to the politics of it all because I am hugely ignorant about the ins and outs and also do not want my website to have political views on it, but find any newspaper or Google page and you can read until your heart is content!
The last few weeks have been very busy where I work and it is only going to get busier. I’m not sure what it’s like when you go off to work in the morning; do you sit in the car thinking of the pile of jobs you need to get through? The emails that need to be sent or products that need to be packaged? Clients that may need to be spoken to? I would love to experience different lines of work once in a while to see how it differs from my own job because on arrival to work every shift without fail, I have been greeted by a waiting room that is standing room only, no free cubicles, frazzled-looking doctors and nurses full of cold yet still the wonderful buzz of the department ticking along that gets my adrenaline running, no matter what.
I truly believe that I have one of the best jobs in the world and being a doctor is a true privilege. I cannot think of anything else I would want to do. Only a few days ago my mum said to me on the phone that she feels her day has been productive and successful when she has made her library tidy and organised (she’s a librarian!), but to help save a life is on a different level. As big-headed as that may sound, sometimes I am inclined to agree.
This week my senior colleague, four nurses and I tried very hard and successfully, to maintain the life of someone who needed but did not want our help. This really plays on my mind because we are doing our jobs but it is not what the patient says they want and they tell us that. They do not ask to use up the time and efforts of six members of staff (half of all the doctors and one third of the nurses in the department in the middle of the night) or a valuable resus bed, but they need it. As I helped this patient I was wondering how things got this bad for them, why it had possibly reached this point and what could I do in the future for other patients earlier in this downward spiral to avoid more situations like that.
More and more patients are attending Emergency Departments asking for help with their mental health. The positives of this is that as doctors we are getting better at managing it, but our mental health resources are scarce and patients often wait many hours to be seen by a specialist nurse. I also feel relieved when some people who are clearly really struggling come and ask for help. Too often patients are brought in under section against their will, or for a different reason completely and their suicidal thoughts or low mood are then unpicked (if the right questions are asked), but those that are able to realise they have a serious problem and want to get better feel that they can attend the hospital and be helped, which is really good.
I struggle to sleep after a shift when all night we have been swimming upstream through a treacle river, fighting against a huge waiting time, helping very unwell people in the resus room and also managing patients in the waiting room who have been there for 6 hours and want to know what on earth is taking so long, or sometimes just shout at our assumed incompetence without having a clue what is going on behind the double doors.
I find that the people who need our help the most, ask for the least. Those that are in the most pain, request the least amount of painkillers and those that are the most upset, stay the quietist. I am mindful of this because flip the coin and I think we find that the patients with the loudest voices and who can walk up to a staff member and say what they really want or think they need, get the most. Therefore it is up to me as a doctor to ask my patients the correct questions, advocate for them and ensure their true needs are met without them having to scream and shout for it amongst the other 150 patients in the department.
Not everyone has a friend or relative with them when they are in hospital, so I need to be that person they can rely on. This is one of the many reasons I love my job, but when I am driving home reflecting back on all the patients I have seen that night I wonder to myself if I have done enough. Maybe I could have checked in on that person an extra few times, spent a little more time asking them about their life rather than rushing through the generic questions and moving on to the next person. I always hope that my patients are satisfied with the care that I and my colleagues give them, but being responsible for so many patients at one time means that we make compromises and I wish it wasn’t so.
These feelings of advocating for people are not just related to work, but my work plays a huge part in my life and the experiences I have then impact on how I think and live. Life is so precious and although it doesn’t always seem that way, if we have someone that we can rely on then there is always hope.
I would like us all to think about not only those who we rely on, but those who can rely on us to help pick them up or maintain their happiness.
Winter has long, dark nights and many occasions of apparent celebration, but it can be a very lonely time for many people. Let us have a few extra thoughts for not only the community we know but everyone else around us and understand that what we see on the outside is certainly not how things are on the inside, so a smile and some conversation, with an offer to help where needed, can go a very long way.