Last week was a bit of a throwback. You know…the one we doctors love referring to. The Good Ole Days. Away from the hustle bustle of NHS England, the politics or even the clinics I do for diabetes and endocrinology, this was a week on the wards.
I had been asked as part of the changing landscapes to help on short stay unit- once upon a time, I thought it worked well when we had one team throughout the journey of the patient- but all the leaders and great minds have decided that more silos are better…so fair enough. Help I will provide- though how that helps…ah well… thats maybe for another day.
Anyway, so a week on the wards it was. And I really enjoyed myself- a lot. We had about 4- 5 "junior" doctors- of different grades- and it was simply a pleasure. Forgive me for saying blasphemous things- but I didn't feel burnt out, we had time for breaks - we also had time for teaching. You don't have to believe me- you can ask the juniors who were there- I am sure they would be happy to go through how the week went.
What was observable was a few things which probably suggested where some of the future lies. I am sorry, but holding roundtables or even hands will make ruddy no difference- especially with an organisation which has been pushing for imposition of the contract in the first place. Thats a bit like Trump imposing the Muslim ban- then deciding to have a discussion with Muslims to discuss how it could be enforced properly. I am not mincing my words on this- its a waste of time. It may help tick some boxes for some folks- but just like the last attempt by HSJ, this will gather dust in some corner soon. You want to do something of relevance- do it properly with open and transparent engagement- or else, don't bother. Bar a twitter storm, it makes no dent in anything per se.
It was interesting to hear from the juniors their views of the senior workforce. A toxic cocktail of work pressure, lack of support or indeed belief that this ship has sailed has now percolated into many seniors. The enthusiasm isn't there- not my words- and that percolates into the juniors. When a "whoever" asks you to do something, the first thing a senior has to ask "how does this help the patient?" We are scientists- our job is to ask why. We are leaders of the wards- our job is to look after our juniors, our job is to make sure they are protected from banality….do we do enough?
The culture of acceptance seems to have seeped though- do we need to revisit our noble aim of vocation and the professionalism of a job? Forget everyone else. Do WE find time to thank our juniors, do WE find time to smile enough? I don't think we do. I repeat- there is NO junior contract amendment which will help morale- till we play our parts too. We have much to do…how much do all the Execs actually believe in the pastoral role- how many Trust CEOS would support the time needed for Consultants to do that- how many MDs would….or would they rather have yet another roundtable to consider all this?
I do diabetes. I do endocrinology. I do general medicine too. If there is a part of me which would do things out of "vocation"- that would be to find time for the juniors. Why? Because when I was one, I will never forget the role folks like David Jenkins or Tony Zalin played in my life. That is what made me who I am- learning to smile, see the positive side of things. I am not a complete idiot- I can see the pressures the NHS is under- and the optimism takes a beating every day. I also know that without looking after our future workforce, this game is over. It doesn't matter even if Bill Gates did a multi billion donation to the NHS tomorrow- there is no amount of money which can account for a junior feeling looked after. In my opinion- and I know many will disagree- we, as seniors, have to stand up and challenge things being asked of our juniors- which doesnt help patients. Medicine was, is and never will be a tickbox- however much anyone tries.
So..the Good Ole Days? A lot - still- sits in our hands. Why wait till its impossible to turn this around?