If Nye Bevan could see us now…

Today, on the 70th Birthday of the NHS, I called in sick to work. Due to sheer exhaustion, and a complete loss of all the fucks I have left to give. I am a danger to patients. I have complete empathy fatigue. I have worked 80 hours in the last week, and I am broken.

I am annoyed by everything. How dare people be ill? I have lost my ability to make decisions. Juniors are asking me for advice, and I am struggling to comprehend the simplest of ideas. I can’t even decide what to eat for lunch.

I woke up this morning, and the thought of going to work actually made me cry. I have never had that before. Sure, I have had days when I would rather stay in bed, but I have never experienced such a negative, visceral reaction to the thought of doing my job. A job which I chose, and I used to enjoy.

I am simply exhausted. Doctors rarely call in sick, and when we do, there is an unwritten rule that you don’t call in on a night shift or a weekend, as they are traditionally understaffed and you leave your colleagues unacceptably short. For the last few weeks, every shift has felt like a night shift. We are chronically understaffed, and it is only getting worse. The retention of staff is at an all time low, locum shifts aren’t being filled in the rota due to the London wide pay-capping, and those of us left on a permanent rota are filling in the gaps.

We have over 3 hour waits as the norm now. Patients are defensive and angry as a starting point. They immediately rant at you for how long they have been kept waiting. If, as is often the case, they do not need to be seen in ED acutely, they are furious that you have kept them waiting so long to tell them to go somewhere else. The idea that A&E is not the correct service for your problem seems to be equated with us not caring that you are ill. That is simply not the case. No one is more frustrated than doctors when they see a patient, know exactly what they need but are unable to organise it. Referring back to GP is not laziness; it is an unavoidable necessity. Blame the lack of funding, not the clinician seeing you.

In the last 2 weeks alone, I have been called names ranging from “unfuckable dyke” to “racist cunt”. I accept anger and abuse as the norm. In A&E, we see people at their worst, and so to deal with that we have to be at our best. It is hard to be at your best when you are working 80-hour weeks with minimal staffing. It is hard to be at your best when you can’t complete the simplest of tasks without being interrupted consistently by people asking how much longer the wait is. It is hard to be at your best when patients would rather believe an internet diagnosis over the one you give them. It is hard to be at your best when you are operating on 6 hours sleep and you see more of your work colleagues than you do your family.

So as I sit at home today, on the NHS’s 70th birthday, about to leave the UK to go and work in another healthcare system, I am torn. I am incredibly proud to come from a country that is synonymous with free at point of access healthcare. I am overjoyed that so many people still think the system is worth fighting for. But I am also approaching my limit of physically being able to work within it. Goodwill and pride only take you so far, and as a bare minimum, I would like to ask everyone who has been marching in favour of the NHS this week, to try and be a little more understanding to your healthcare professionals when you see them in A&E. We are doing our best, and some of us are broken from trying to keep this system afloat.

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