I fight every day to care for my patients – but junior doctors are at breaking point
3 min read
One family told me their mum had only been waiting six hours on the floor for an ambulance. Only six hours. For a moment I thought this was a positive outcome. A patient in their 80s, lying on a cold hard floor for the equivalent of three quarters of my shift and I felt this was good patient care.
Sadly, this genuinely was better than earlier in the year with patients waiting over 12 hours on the floor and an additional 16 plus hours in an ambulance. I cried when I got home about how far we’ve fallen.
“Yes, it does appear that you’ve had a small heart attack,” I told the next patient, apologising for the eight hour wait and sending them back into the waiting room. The patient afterwards was a similar case. Both should have been on a heart monitor and their treatment initiated within the first four hours of symptoms showing. They suffered significant harm because of delays and there was nothing I could do.
The emergency alarm goes off. A patient in the waiting room is in cardiac arrest. They had been waiting over a day for a bed. A preventable death but there was nowhere to administer the treatment. It reminds me of another patient who arrested in an ambulance because we couldn’t get them to assisted ventilation, or the one that arrested in the corridor surrounded by patients, their family screaming at me for not doing more and the patient losing all dignity in death.
A patient in their 80s, lying on a cold hard floor for the equivalent of three quarters of my shift and I felt this was good care
We comfort the late-diagnosis cancer patients terrified of the inevitable, manage critically ill patients awaiting essential surgery that has been delayed due to a lack of theatre spaces, or watch patients with dementia fade away because they have been waiting in hospital for a care home for six, eight or even more than 12 months.
Why are we burnt out? Empathy. We treat patients as if they are members of our own family. We imagine our friends and relatives waiting in pain, suffering in corridors, or spending a week alone in a ward.
In a functional system the illnesses we see would be appropriately treated, the morbidities from any delays minimised and the deaths, whilst sad, mostly expected. Now, I have no idea what to expect when I go to work. We work 12-hour shifts without breaks. Most of us have 70 hour weeks in our rotas, supposedly averaging out over the year to 47.5 hours weekly but not including the unpaid late finishes. We break down for all the grief we have seen, the emotion we have felt and the care we have given.
Witch-hunts often ensue when staff try to raise concerns; a lack of rest spaces and food out of hours, difficulties arranging leave to attend family weddings and funerals, being made to feel guilty for not working additional shifts and therefore “not supporting our colleagues”, cases of bullying, racism and sexism, and to top it all off, writing inquest statements in our own time to “defend” our best efforts to save patients the system failed. Unsurprisingly, the wellbeing tutorials telling us to “exercise more”, “eat a balanced diet” and to “just be less stressed” are not the magic solution higher powers seem to think they are.
It would be nice to say that at least our families can be close by to support us but this is not always the case. Some colleagues are allocated jobs hours away from their families and even terminally ill relatives. The solution? They are told to take a year out and reapply the following year, generating yet another vacancy.
We need a properly funded NHS but there is no sign of any true help coming. We have to protect ourselves by reducing our hours, leaving the country or leaving the profession altogether.
Patients deserve better. We deserve better.
Anonymous junior doctor
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