… we need to stop making ‘excuses’ for things that go wrong and stop putting it so much on a pedestal. Firstly, I’ll write some ‘disclaimers’ (for want of a better word). I do like the NHS, it keeps me alive and has stopped me dying many times. It also gives me free prescriptions, which I wouldn’t get elsewhere in the world, and it’s free for me to use, and I use it a lot. I’ve got several friends who work in the NHS in varying positions and all do great jobs, but they also point out problems with the system. The culture surrounding the NHS is changing, and while we can blame a lot on the government and the way it funds and manages it, some of the problems are being caused by our attitudes towards it. I’ve had some great care while being a user of the NHS, but *because* I use it so frequently and spend a lot of time sitting in different healthcare centres, I also have a slightly different insight into it than most people, so can see some of the flaws. By making excuses and saying the phrases below, we’re just adding to the problem.
I’ll probably refer to teaching a lot too in this post, but mostly because I used to be a teacher and we also had restrictions placed on us by the government, Not because I think teaching and the NHS are the same.
Staff are overworked and underpaid.
Staff are overworked, yes. They’re also probably not paid enough, also true. But why do we excuse slower or poorer services in the NHS when we don’t in other sectors? Would it be acceptable for a teacher to ignore a child all day and then say to them ‘sorry I was too busy to mark your book or talk to you today, I had other people to deal with’? No. So if you’re a patient on a ward and don’t get spoken to all day, why do we go ‘it’s ok, you’ve been busy’ when actually it’s not ok? Nothing will change if we don’t raise the problem. The government will just say that the NHS is fine because no one complains about it. You can still show empathy for the staff while expecting the service we’re entitled to.
It’s free, you should be grateful.
School is free. But people used to ring me up all the time if things weren’t right in their child’s education. And they were right to do so. You can be grateful for something but still expect good service.
Staff attitudes are changing.
This is something I’ver noticed a lot in the past year or so, coinciding with a rise in ‘save our NHS’ and similar news stories. Newer or younger members of NHS staff do not have the same working ethos as more experienced members of staff. A lot of things are not their ‘problem/fault’. I’m a very calm and polite patient, I show empathy. But here are some things I’ve been told as a patient:
- ‘I’ve just picked up your chart. You’ve only just become my problem’. If your name is on my chart as the Doctor responsible for me, and you haven’t had time to come and see me, I’m still your ‘problem’. It’s down to you to make sure I don’t die on your watch. If I do, you are responsible, even if you were busy elsewhere. Someone has to be ‘responsible’ for my care. And also, how dare you call me a problem?
- ‘I’m not doing that. My shift finished half an hour ago and I want to go home’. *said while thrusting a ‘talk to the hand’ hand in my face*. Ok, fair enough. But how do I know when your shift ends if you don’t tell me first? You answered my call button. Are you going to ask someone else to help me or did you just come to my bed to be rude to me and bitch about the fact you’re still here past your shift end?
- ‘Can you not see we’re busy here? You need to stop asking me for your medication because I won’t do it any quicker’. I *can* see you’re busy, but unfortunately my life threatening, critical and time sensitive illness doesn’t care and making me wait an hour is not acceptable. If you don’t give me my medication soon, I’ll probably die, which is a bunch of extra paperwork and time and energy for you. So how about you stop moaning about the fact you’re busy and spend the 2 minute rant you just had tracking down my IV hydrocortisone.
- ‘I hate it when we have patients like you turfed to our ward. They just expect us to be able to provide your meds and we never have them.’ Thank you for making me feel like a burden. Thank you for making me anxious about the next time I need help because you seem really grumpy. Thank you for not providing me with any reassurance because I’m back in hospital again and I’m pretty upset. And now you’re making me stress out about the fact that you don’t have my meds on the ward and you don’t like patients like me. It might be true and a problem with the system, but do you think you could maybe conceal your frustration from me? I’m having a crap day too.
- ‘I can see you’re not going to listen to me so I don’t want to deal with you anymore’. This one was my favourite- she shouted this from outside my patient room and then punched the door in frustration. What had I done wrong? She’d got my medication list wrong so I corrected her. That’s it. Yeah it probably wasn’t anything to do with me, she was probably having a bad day. But that’s not fair to take it out on me.
- Me: ‘If you don’t issue me with a repeat prescription, I will die within 48 hours,’ followed by a response of ‘you do what you have to do then, I’m not giving you it’. Effectively, this individual was telling me they’d rather see me die than go and check with a doctor that what I was saying was true. This stressed me out so much I ended up in hospital for 2 days.
I can’t tell you how many times I’ve been told ‘it’s not my fault you…’ by junior members of staff. Sorry, but if you’re speaking to me, you represent the NHS and you *are* responsible at that specific time. The least you can do is a token ‘I’m sorry you’ve been made to feel that way, what can I do now to sort it out?’, which is basically saying ‘it’s not my fault’ in nicer terms but at least shows me you care about me as a patient and want to help.
There are times when you do end up covering for stuff which is not your fault. Which you had nothing to do with. Or things which have gone horribly wrong. However, it is not professional to communicate that to patients. It would be the same as me slagging off another teacher to students- you think it in your head, but what comes out of your mouth has to be professional.
Yes, but the overworked staff are ‘saving lives’.
I get a bit tired of hearing this because you can save lives and still be professional and courteous about it. And, actually, if we’re being pedantic, most of the staff in the NHS aren’t directly saving lives, they’re doing preventative healthcare or maintenance healthcare. I ‘saved lives’ in the same respect as a teacher- I stopped several children from attempting suicide indirectly, I helped wean a couple of kids off energy drinks when they started damaging their health and I provided breakfast for vulnerable children out of my own back pocket.
They work really long hours.
Yes they do. But a nurse’s working week is the same hours technically as a teacher. And yes they work beyond their end time, but so do teachers (and many other sectors). And teachers do get 13 weeks holiday a year, but we work through a lot of those and spend a lot of time in school- NHS staff aren’t expected to turn up to work when they’re on holiday (unless they’re senior) but teachers are.
They don’t get paid enough.
No one in the public sector gets paid enough. Lots of people have been earning less the past few years because they’ve had no payrise/cost of living rise.
NHS staff get abuse thrown at them when things go wrong though, they don’t get paid enough to deal with that.
I was sworn at most days in teaching. Shop owners, call centre workers, traffic wardens all get abuse shouted at them. Sometimes people in those professions are also physically abused by service users. It’s not acceptable, but it happens. And have you seen the abuse local councils get on social media when someone’s dustbin doesn’t get collected one week? I used to say this to student teachers a lot- there is a difference between being sworn at in frustration and being verbally abused. Is the person swearing at you directly e.g. ‘you re a f****** b***’ or are they just swearing because they’re annoyed and scared e.g. ‘you need to f****** help me’. There’s a difference. And, to be honest, when I’ve been told that I’m a problem and made to feel like an inconvenience, I sometimes feel like swearing at people. But I don’t. So maybe everyone should think about the way they deal with each other? (granted, some people are just idiots and abuse even the nicest of NHS staff. That’s obviously not acceptable).
NHS staff go above and beyond.
Some definitely do, and I always make a point of thanking them and emailing their supervisor. E.g when someone makes a point of tracking down my very busy consultant even though he’s in a different hospital and they’ve got a perfectly good endo on site- that’s really good patient oriented care. But lots of industries have staff which go above and beyond, but because they’re not ‘saving lives’ people don’t acknowledge them the same way. The recent snow dramas made me think- lots of people were crediting the NHS staff for making it out in all weathers to help people, and they definitely went above and beyond. But what about farmers who went out in all weather to tend to livestock and crops to make sure our food supply wasn’t interrupted. Or AA and RAC people who rescued people from dangerous breakdowns when they got stranded- they were putting their lives in danger potentially doing that. Or people who maintain water and electricity supplies? But twitter was full of recognition for NHS staff and less so (if any) for other people and industries.
We should reward the staff who do a good job
Yes we should, but I keep hearing a lot of people giving NHS staff gifts for having treated them ‘amazingly’. But when you ask them what was amazing in the way they had their broken wrist treated, it tends to be because the staff were friendly and did their job e.g. you got an x-ray, a plaster cast and pain relief. Does that really deserve a thank you box of chocolates when that’s their job? No. If someone had worked on their father in the middle of a cardiac arrest and the father survived because of excellent team work and care from staff, yes that does deserve some kind of special credit. But rewarding someone for doing the bread and butter of their job means that it becomes expected, and if you’re already being paid to do a job, expecting additional rewards from patients for doing the basics is a bit much really.
Looking at it a different way now, there are amazing members of staff who are being let down by the system.
Younger members of staff don’t want to ask senior members of staff for help.
The problem with putting the NHS on a pedestal is it creates an awful lot of pressure for Junior members of staff to be brilliant at the medicine side of it all the time. And that means a lot are reluctant to ask for help or admit when they’re wrong. Which causes me a massive problem because I spend most of my time having to explain my rare illness, but some junior staff can’t and won’t admit when they’re out of their depth because they’ve been conditioned to act that way. And that definitely doesn’t help with the ‘it’s not my fault’ mentality. It could also be down to senior staff not wanting to/not having time to make time for their med students. You learn from your mistakes but it feels a lot like med students aren’t allowed to make mistakes.
It’s assumed that the patient always lies.
It was always the case to take some of what the patient was saying with a pinch of salt, because people do hide things and withhold things and do lie. But not everyone does, and there very definitely is an attitude that the patient lies and shouldn’t be trusted amongst less experienced members of staff. Again, this might come from more senior members of staff trying to speed the consultation process up, but new doctors don’t have the benefit of years of experience yet to determine what’s a lie and what’s not, so can’t and shouldn’t assume they know the patient is lying. It fosters distrust between patient and doctor and vice versa, so actually slows down the whole process overall.
It all comes down to money.
Even the most amazing of staff can’t fix this one. Tests and scans cost a lot and the semi-/privatisation of the NHS only makes this worse- doctors are having to justify every test and patients are being told they can’t access treatment even though their doctor says they need it. So sometimes Doctors aren’t able to do their job properly because they’re blocked by red tape. But if we never complain and kick up a fuss because the NHS is overburdened and we can empathise, nothing will ever change.
I’m not saying we shouldn’t give credit where it is due for good work by NHS staff. I’m saying that by putting it on a pedestal, giving it free passes and making excuses when it doesn’t live up to expectations by saying one of the phrases above, and never complaining about it, we’re actually making more of a rod for our own backs. Nothing will change for staff or patients if people idolise the system and ignore all of its flaws. The system doesn’t work at the moment, because it was never supposed to cope with this level of demand but hasn’t been updated since its conception. It needs a complete overhaul, which won’t happen while the government can keep justifying sticking metaphorical gaffa tape over all of the holes in it at the moment. It might seem harsh to point out shortcomings when you can see the staff have worked hard on something, but you can easily write that in a complaint- acknowledge the staff who do well but question or criticise the service which went wrong. If we don’t, nothing will change.