Sums it up...
“When there aren’t enough nurses, we close down beds. When there aren’t enough doctors, we don’t do the same. Nobody cares. We just have to stay late.”
A colleague, summing up a recent difficult job of theirs. And I’d never really thought about this until they said it today, but it’s absolutely true. And it’s true. It’s absolutely important that if nursing numbers aren’t adequate that we protect patients by ‘shutting down’ beds to ensure a good nurse to patient ratio. And even with that, things can sometimes still end up very difficult for our nurse colleagues. But the thing is, when you’ve got a shortage of doctors; your rota is one or more people down, or someone’s sick etc, there’s no doctor equivalent of adjusting bed numbers relative to the number of docs covering patients. Which means that, depending on the patient number and acuity, docs can end up staying late every day to make sure everything is done for their patients, and that their patients are safely covered. We’ve probably all been in jobs where there never seem to be enough hours of the day, and you always feel like you are behind. And it’s not because you’re working slowly, so much as there always seems to be a lot to do. And the minute you sort one thing, or send one patient home, that merely opens up the chance for a new admission and lots more work. As a junior doctor you learn to work fast, double-check everything (make that triple-check, because if there’s a slight chance for something to go wrong, it will), chase up on other people’s jobs, and try to be as efficient as you can. You walk fast, type faster, write faster still, and try to power through as much as you can. You think up the most efficient ways to organise your ward round and to do your jobs, in order to make sure things come back as soon as possible. You get to know the hospital inside out. Too often, juniors feel inadequate for struggling with workloads that aren’t actually reasonable. And too often, it feels like seniors are blaming you for not being more efficient, still. You can often be blamed for the faults of the system; you’re expected to pre-empt every possible problem by triple-checking everything and doing everything yourself. And it’s no wonder that many of us struggle under that pressure.
