Our crumbling health service
Our crumbling health service
There is no doubt about the fact that the National Health Service is on its knees and that we are determinedly blind to this evident fact. This is a huge topic that we could explore from many angles – our deteriorating health, corruption in politics and our obsession with sustaining life at whatever cost (aka fear of death), as some examples.
This article has come from an interest in and first-hand observation of how we work and whether this supports or further destabilises our healthcare service.
On the shop floor in the maternity services in a large teaching hospital in the UK we have a staffing crisis. The most talked about aspect of this is that there are too few staff available on pretty much every shift. A more severe and systemic, but overlooked problem, is how effective and committed we are when at work …
Pretty much everyone complains about the fact that they have to work and in giving this emphasis we undermine completely the possibility to enjoy, let alone love work. In fact, you are perceived to be a bit of a weirdo if you do display any enthusiasm let alone commitment to, appreciation and/or adoration of your work; that the accepted status quo is to do the minimum required rather than boots and all go the extra mile supporting your workplace, colleagues and those in your care.
It is apparently ‘cooler’ and easier to fit in if you say you hate what you do, become artful at cutting corners and collude with others in the championing of this approach.
So I am going to lay myself bare as a full on weirdo … I absolutely adore the work I get to do … it is a raw, exquisite, beautiful privilege to work as a midwife and it is the perfect job for me, working with women and their families, walking alongside people at a very particular and intimate time in their lives and simply being in the richness of our interactions and the opportunity to serve.
What I observe in the staff rooms and corridors at work are endless hopeless, degrading and negative conversations, at best about work and the state of the health service, at worst belittling each other and those we care for, with a bit of ‘poor me’ and burning, long-suffering martyrdom thrown in for good measure. Yet, most of the people who chose a career in healthcare did so because they had a genuine interest in supporting people at very vulnerable times in their life. What happened to the integrity, commitment and keenness to work that most of us experienced when we first set out on a career in healthcare?
Healthcare staff, like most people in the world, have become obsessed with being away from work, by whatever means possible … our breaks, holidays, retirement, health issues discussed and focussed on to the max … the net result is a lot of time being taken up avoiding actual work. This is a far cry from the enthusiasm with which most of us entered the profession … what is going on here?
In our obsession about breaks and clock watching at work we completely obliterate the opportunity to maximise the joy of work and as we constantly look at ways to avoid work, we deny ourselves the chance to be present in each moment, to have fun with whatever task is there before us and to simply commit to the service we are there to provide. And this is a self-perpetuating set-up. The joylessness feeds the clock watching which simply guarantees more clock watching. Lack of presence is also potentially dangerous and always inefficient, resulting in delays and poor quality care. Which again leads to further staff dissatisfaction and low morale as the pressure mounts on the staff who are present and working.
As this situation gets cemented in, a presumption builds that we ‘deserve’ breaks, holidays, retirement, days off and a horrible equation is set up in the workplace with employers losing trust in their staff, relating to their teams from the belief that everyone is trying to ‘bunk off’ whenever possible.
And hey presto, we have a cocktail of ‘them and us’, distrustful, combative relationships within companies everywhere. This of course has a huge impact on whatever service we are providing, which we all feel, whether we are receiving care from a disengaged, stressed and/or resentful healthcare professional; unpleasant service in a hospitality setting or lack of care in our everyday interactions.
I have watched colleagues attend to women in their care with such disregard it makes my toes curl. From abrupt words to rough handling that are tantamount to abuse and lack of simple awareness of, and sensitivity to how people are feeling. I have come to realise that it is lack of respect, care and regard for ourselves that means we can treat others in the same way and so the cycle of degradation perpetuates.
Back to this super weirdo who is now known for not taking breaks on shift, for coming in on days off, for staying on after a shift has ended to complete and say goodbye to people in my care.
It has not always been like this; I spent many years in a pattern of resenting work, calculating how to get out of things and allowing insecurity and lack of self-worth to dictate how engaged I was at work. But there came a point of realisation that this was a travesty … that work was actually a huge support and my reactions to it were dysfunction on steroids. It was like facing the negative narrative and habits and declaring they were nonsense and starting to live in a way that honoured and appreciated the impact of work, the joy of having the opportunity to serve and realising the wages were a bonus on top of so many gifts. I got fit by refining my diet, staying hydrated, walking and exercising regularly so that physically I could take the work in my stride and be ready for whatever was called for. This is an ongoing and enjoyable process. It feels like a very simple equation, one that I reckon we all do know, that what we put in comes back in spades … cutting corners leaves us feeling poor and diving in with both feet showers us with riches.
It is fun to serve, it is a great feeling at the end of a shift to know you have given it your all, which by the way does not equal running yourself ragged … a strong foundation of self-care is needed to be able to ‘give it your all’ when in service to others. In this approach we can arrest the ongoing social malaise and crumbling work ethic to offer a critical shift in our health services.
And whilst staffing is often inadequate, more staff is not the fix all solution if staff are only bringing a fraction of themselves to the workplace.
So what if we are missing a big one … that the collective movement to avoid work is a downward spiral of lethargy and resentment that has us way off track from the joy, support and fulfilment that work offers us? What if we can turn around our workplaces, our productivity, our engagement and enjoyment; that by committing in full to taking responsibility for our health, well-being and appreciation of what work offers, we are in turn ready to fully support others?
There is so much magic to be part of in our workplaces, and the knock-on effects of either ongoing disenchantment or whole-hearted engagement are beyond extraordinary.