Tag Archives: health

we are not numbers

I had a relatively quiet week at work, off the wards, so tackled my to-do list. It’s a long list. I chose my least favourite task, writing the ward rota for the Respiratory Consultants. Why is a Consultant doing this tedious task, you may ask? This is a symptom of more than a decade of underinvestment in the NHS and the false economy of cuts, and more cuts, to a dwindling admin support team, resulting in more and more tasks being piled onto the clinical workforce. It would have been unthinkable to expect a Consultant to write a rota ten years ago. From a public and organisational perspective, it makes no sense to have employees who are paid well for their expertise and experience, performing admin tasks. Whilst I wrestle with excel spreadsheets, and attempt to solve hierarchical constraints problems, I am not delivering or improving patient care. Not only this, an undervaluing of admin in the NHS has led to low staff retention and poor patient experience. False economy is a feature of the modern NHS. Next time a politician talks about ‘cutting backroom staff’, remember that the work of the backroom does not go away, it just lands on the desk of the front line staff.

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Tired of being tired

I’m sure I didn’t used to get so tired. My 40 something year old body just does not keep its’ charge as well as it used to. But it could perhaps be forgiven as it had to cope with 12 consecutive days at work with a 12 hour Sunday shift thrown in for good measure. There are well documented adverse health effects of working extended hours including: depression and anxiety; sleep quality; physical injury; coronary heart disease; and some cancers. There are also concerns about decision fatigue setting in by the end of a 12 hour shift. This has not been adequately studied, but it certainly feels true.

“Tired” by Sima Jo Benson.

It’s not merely long hours that have contributed to my fatigue. The constant chaos of the NHS is draining, driving many colleagues to retire earlier than planned. I attended a Kafkaesque meeting in which the first half was spent discussing the dictat that we find ways to save money. We are provided with no data, no suggestions, no project management support. There is also zero focus on improving patient care. Just save money. The second half of the meeting was spent looking at recent staff survey outcomes which are the worst they have ever been, showing staff feel unable to provide high quality care, do not feel in control of their services, and do not feel supported in their improvement plans. We were asked to explain why we are so unhappy and what we propose to do about it!

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Silence

It has been 5 weeks since my last post. My routine of reflecting each week was disrupted by climbing a mountain and it has taken until this weekend to feel that I am back to normal life.

5 weeks is a long time in the death throes of internationalist liberal democracy.

Newscloud (Chaos) 21 August 2018 Marc Quinn 2019
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Hostile spaces

I had a stressful Wednesday. I was called to give evidence in person at an inquest, which was a surprise as my involvement in the patient’s care was peripheral. The court was tiny. We started very late, and had to wait for an hour in an unheated corridor between the door and the toilet.

All I could think about was every more useful thing I could be doing with this time. In my mind, my to do list is a pile of crisp bits of paper, each one with a task typed on it on an old fashioned typewriter, like the in-tray from a movie from the 1950s. This gets higher and higher, and then becomes an unruly mess, threatening to topple over and crush me. I had moved things around to be available all day, but could not move a webinar I was co-presenting in a 1 hour window at lunchtime. I asked to be released for this. After some discussion I was allowed to give my evidence first.

The Coroner’s court is supposed to be a fact-finding mission, rather than an adversarial or litiginous process, but this depends on whether there are lawyers present, and if so, what approach they choose. The questions were fair but challenging. It was a good experience, to have given evidence when I only played a minor part in the case. All healthcare professionals can expect to be involved in legal processes these days. We all find them very stressful.

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This is why we can’t have nice things

We’re a week into the New Year and already things are quite terrible. Here are a few lowlights:

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New year, new hope

It’s a New Year! January the 1st is not only the start of the New Year in the Gregorian calendar, but also the Roman and Julian, so if you’re still following the Julian calendar like the Amazigh people, then we’re in synch. There are of course New Years all through the year in different countries and cultures, and some New Years which move. This feels destabilising. I like the predictability of seasons and festivals. This week I learned that January the 1st is a feast day in the calendar of Eastern Orthodox calenders because it is the Feast of the Circumcision of Christ. I’m not sure this knowlege has enhanced my life. And now you can reflect on whether it has enhanced yours.

I did not stay up until midnight. I was pretty exhausted from work so had the most luxurious evening eating a lovely dinner and retiring to bed. My favourite thing about getting older is that I feel less and less need to do what’s expected and instead I do whatever I like! P__ stayed up but he’s a definite night owl, wheras I’ve had to accept that I’m more of a morning lark.

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Fast and slow

I seem to have lost a week in a blur of christmas parties, overflowing inboxes, overbooked clinics, carols and mince pies. And I am harbouring yet another Respiratory virus. They are persistent this year, with coughs lasting weeks. I was asked if colds last longer as you age. I can’t find any evidence this is the case. Illnesses last longer in those in poor health and at the very extremes of age but there’s no reason for differences in illness duration of 40 somethings vs 20 somethings.

Nutrition is of course a major determinant of health and immune funcion. A plant based diet is associated with a lower risk of hospitalisation in COVID-19. Plant-based diets provide micronutrients, including vitamins A, B6, B12, C, D, E, and folate; trace elements, including zinc, iron, selenium, magnesium, and copper; and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid, which play vital, often synergistic roles at every stage of the immune response. Plant-based diets are also anti-inflammatory, and support a healthy microbiome. There is little data on diet pattern and viral illnesses other then COVID-19, an area that needs further study. Despite having grumbling illnesses for weeks I’ve not had a single day off work. I’m convinced it’s the plants!

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Granny’s Garden

I spent most of the week at the British Thoracic Society Winter Meeting. It was a great mix of catching up with colleagues, discussing projects, and learning from the latest research. It’s an exciting time in the world of COPD with real hope for new treatments and a transformation of care over the next few years.

Medical conferences are not always comfortable spaces. I wrote about my ups and downs in a thread. Thankfully 2024 was a definite up.

I wrote this 🧵on the other place in the run up to #BTSWinter2024. The conference starts today, so I’m copying it over here. On belonging, joy, fear, imposter syndrome & how to enjoy medical conferences. 💙 1/n

[image or embed]— DrLJ (@drlaurajane.bsky.social) November 27, 2024 at 6:58 AM

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A Tranquil Space

P__ and I went to Turn Up for Gaza at The Colour Factory. The venue is very cool. The line up was great, hosted by Jen Brister, and including JJ Bola, the repeat beat poet, Rozi Plain, Robyn Rocket and more. A highlight was Donna Thompson who made magic with her voice and a looper. And of course, my all time favourite Hollie McNish, who made me cry, as always. The event was in support of All Our Relations, supporting families displaced by conflict and violence, providing them with the financial, organizational, and emotional aid they need to rebuild their lives with dignity. I hope the event raised a lot of money. You can donate here or use the QR code.

There has been heavy rainfall in Khan Younis and other areas of Gaza. Osama tells me that conditions have deteriorated. There is no infrastructure. There is no shelter. Everything, everywhere is cold and wet. They worry that tents will be flooded and destroyed. I got paid, so I sent his family more money. Please help with whatever you can. I am matching all donations between now and Friday* so whatever you give will be worth double!

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Impatience

I was recently asked what my primary emotion is, and I answered, without hesitation: impatience. This is both a blessing and a curse. It drives me to work hard try to change the problems I see everywhere, every day, and makes me very productive. But it also makes me a bit of a nightmare to work and live with. I struggle to slow down and to accept the slow pace of change that is a common reality. I tell others to remember their sphere of influence and not to expend energy on things way outside it, as this way burnout lies. I often fail to take this advice myself. This week I have felt very impatient.

COP 29 is happening. At least 1,773 fossil fuel lobbyists have been granted access to the summit in Baku. In an open letter, a group of international experts have stated that the UN Climate talks are no longer fit for purpose, and called for reform. Global emissions continue to increase, carbon sinks are being degraded and we are headed for more than 2.9°C of warming by 2100. I respect those who continue to participate in COP but I would not have the patience or diplomacy required.

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