Monday, November 28, 2011

Must. Not. Bang. Head. Against. Wall.

Those of you residing in Ireland with me may understand where this is coming from. Those of you working in health care most likely understand exactly where this is coming from. And anyone who has ever been annoyed by an illogical loop of policy and stupidity will definitely know where this is coming from.

I just took a day off of work. (yeah... I know... Liz took a day off of work... Do both of her legs work?!). I worked 7 days straight, including 2 weekend shifts in the A&E spent dodging vomits and getting coughed on. Summed up, it sounds like this: bark bark bark bark cough whinge whaaaaaaah! sniff sniff wheeze bark bark wheeze PUKE! (yeah, that's a croup joke). I rolled home just after 11pm, ate a light snack, set my alarm so I'd get to work at 8.15am, tried to fall asleep... And the vomiting started around 12.30. I'm not going to be exceptionally graphic here, but I was miserably awake until 4am. Clearly when my alarm went off, I had to ring my co-worker and tell her that I wouldn't be able to come into work... And I felt guilty. With next to zero sleep, having been up sick all night long, probably dehydrated, definitely hypoglycaemic, and barely able to move, I felt guilty for not going into work.

I should take a moment to clarify that at present, I'm actually working for a neonatal service. I work with small babies. Small babies that are unvaccinated, because they are too young to have them yet... Prem babies, little babies, very sick babies... And I felt guilty not going into work. Why? According to my contract, if I have to miss more than 2 days due to illness, I need a doctor's note (yeah, I know, soak up the irony)... And I felt guilty taking one day.

Before further exploring this emotion, I need to discuss the last week and an email I've received. This past week, I have been at odds with one of my superiors. At odds is a nice way of putting that I completely disagree with the way they function at work. I have been pushed further and further out of my comfort zone as a doctor. It's been progressively worsening for the past month, and I feel as though I'm not learning, I'm just trying to keep my head above water as more and more work is poured onto my shoulders. Work that I'm neither competent to complete nor qualified to complete (nor am I paid to do)... I had to force my superior to do something they'd asked of me for "Medical-Legal" reasons. I have reached a breaking point when I have to throw down law to keep from doing work. (I won't get into the shifts I work... EU law be damned).

I also received an email from my medical union requesting I fill out a survey. The survey was focused on the working conditions and how to improve to keep the Irish trained doctors from leaving the country. (Spoiler alert: We leave because working conditions are shite and we are over worked, underpaid, and asked to do things that we've never been taught how to do. We aren't taught because all the seniors are overworked and filling the gaps of people that have left or been fired or are on maternity leave and the HSE can't be arsed to pay for cover.) Most of us work the jobs of two or three people, and yet we're expected to somehow take our annual leave, take our study leave, pass our exams, research and publish, and improve the system. You know what, feck off. SHOs burn out for a great many reasons... I've mentioned a few of them. And no, the other systems out there aren't perfect either, but I do know that if I were at home, I'd not have to move cities every 6 months for my jobs.

Now... with all of that, how could I ever, possibly, even minimally feel guilty taking a day off when I'm projectile vomiting for a night? Because I know that without me there, my co-worker will have to do her work AND my work. That anything I didn't do on Friday night will not only be waiting for me, but probably doubled in volume because there are things that can't be handed over to other people. Because there are patients that I've been seeing every day for a week and no one else knows them as well as I do. And because I am me... I've always felt guilty when my body isn't strong enough to do what I want it to do. For that last reason, I worry that I won't be able to remain in Irish medical system.

I will go back to work tomorrow. Just over 24hrs from the last time I vomited, I will go back to work. I have a 24hr rule, some places have a 48hr rule. There's nothing in writing right now that says whether or not I need to go back tomorrow or if I should take another day... Welcome to survival by the goodwill of your workers. But with the best and brightest leaving the country or burning out over the ridiculousness of demands, this system is on a road towards crash and burn. Maybe when I'm sick, I'm more cynical... Maybe I need more sleep... Maybe I'm just being bitchy. Who knows. But I needed a rant, and there it is.

1 comment:

Amit said...

The system is going to crash and burn over the next couple years, till the folks that are away slowly start coming back and accepting the crapy system and turning into the consultants we have hated so much, because the system has turned them bitter and angry. I probably will be one of those folks!!!