A&E waiting areas full, wards and beds full, corridors full; people are queuing, ambulances queuing. We can all see and feel it.
It’s unhelpful to hear remarks about the NHS being broken when we are all working so hard to ensure that it doesn’t pack up, but it leaves me and my colleagues questioning why we are in this situation. Chronic underfunding? Poor planning? Is there worse to come? Will we be able to turn up to work and feel like we are delivering the care we would want for our own loved ones?
We see stories about it being the busiest period for the NHS in history. Partly this is down to more severe flu than we’ve had previously. More people are sick, and sick people are sicker. Some patients with flu are so sick they need to be in intensive care. This is having a knock-on effect. Yesterday, there was only one ITU bed available across the whole of London. Where do we put all the sick people that need treatment? And how do we move them around the system? We talk about flow in hospitals, but things feel blocked – with no obvious plumber to come help fix it.
But that’s the technical stuff. More importantly, when it happens to be you, delivering care to a patient in a way that you didn’t train for, and know isn’t ideal, the personal impact of that compromise is huge. We may have to put men and women together on wards in our hospital; or put patients that we know would be better cared for on medical wards, into beds designated for surgical patients. A poor patient experience is also a poor staff experience.
It’s difficult to get an adequate number of people in to work, let alone manage unprecedented demand. Many of my colleagues are working longer and harder than they ever have. The discretionary effort being put into this cannot be an indefinite thing. People rally when they see a need. When it’s business as usual it melts away. How long can we go on like this?
However, I like to think that I’m a balanced person and strive to see positives where I can. With some of the teams I work with, engagement hasn’t been higher. There’s a feeling of being all in it together – the visibility, appreciation, recognition and thanks for the hard work from our executives, senior leaders and politicians. The derision and blame heaped upon managers for the failing state of the NHS has fallen somewhat silent. The bullying behaviour in different parts of the system feels less prominent. We are concentrating on delivering the clinical care instead of being distracted by other things, such as the urgent data request coming in at 4pm on Friday evening, or the organisation’s financial position, or the next CQC inspection. These things are important but can overshadow what we are here to do.
If you could take a temperature check on compassion, gratitude and forgiveness, I’d bet it would be higher than at recent times. Perhaps we can take these as our key lesson when we make it out of dark winter.
The author is a consultant at a London hospital
