It is heartening to see how much development and reflection is happening in the central area of patient care in NHS D&G. Dr Donaldson and others are to be congratulated for bringing this area to where it belongs- at the core of what we do in our daily work.
Would it be feasible to extend this open mindedness laterally also?
We all work in teams in the Health Service. The NHS is the largest employer in Europe…that’s an ‘awfy lot of people’. How well do we relate to those other people who are our co-workers in this amazing endeavour that is the NHS? Could I suggest that the best measure of this is not based on a computer checklist but inside ourselves…how do we feel?
As a GP I regularly communicate by telephone with DGRI and many others in allied fields. I worked in Outpatients for a time also giving immediate contact with any of the hundreds of people working in the Hospital on a given day. More recently I have been employed as a GP locum across the region. At the risk of crudeness I can (like all of us) sense the ethos of a workplace in my gut.
Is it warm and helpful or off -putting and officious?
It is in the tone of voice before a phrase is uttered.
It is in the body language- a smile that says “I have time for you’ / ‘I see you as another person trying to do what is best for your patient- not a problem’.
It is also there in how the staff in a location interact with each other. Is it respectful and supportive or brusque and dismissive?
Across NHS D&G a huge deal of the former and much less of the latter happens. It is there from the telephonists in DGRI through medical secretaries, laboratory staff , Nurses and Health Care Assistants and so many others. In Primary Care it is in medical receptionists with their understanding of elderly patients on the phone or at a desk, the welcome of Practice Nurses and the commitment of GPs. Paramedical teams like Physiotherapy or Podiatry go the extra distance that makes all the difference.
(The picture above is of the Welcome Desk ladies at DGRI. A member of the public recently posted a lovely comment on Patient Opinion about them which can be read here)
Each small effort contributes to the building of ethos. It needs to be valued for the vital component it is. Can we learn to say thanks more often- especially those in positions of power and management? Just a moment to say ‘I appreciate your help’ or say in an e mail – ‘you are doing a good job there’ creates positive waves that flow far beyond that simple contact.
For a brief time I had the pleasure of working with medical students and junior doctors in DGRI reflecting on their experience of the hospital…not the hospital as building but the hospital as people.
I was blown away by their positive feedback. Everyone commented on how welcome they felt, how supportive everyone was and how much better an experience they had as a result. Sadly, they had felt this had not been the case in big teaching hospitals in the cities.
So we have a good ethos in D&G – but it needs to be treasured and nurtured. If we value and respect each other then doing the same for patients and their families follows naturally.
It is something that needs to be nurtured and valued and can be lost when not prioritised.
The consequence of losing sight of the value of the individual has been brought home to me as I am currently working 12,000 miles away in New Zealand. Christchurch Hospital has a huge core of Uk doctors working at all levels. It appreciates its doctors from the UK who are well trained, speak excellent English and fit into the Kiwi way of life like a hand in a glove.
On first questioning they usually say they are here for the adventure. Question a little deeper and there are other drivers that have brought them here.
These invariably include words like valued, respected and not feeling that happened in Britain. It goes along the lines of ‘working my socks off to get into medical school, continuing to work hard and knowing that would continue in my hospital jobs but there would be the pay back of doing a good job. Instead I worked shifts that left me unable to get settled in the same ward or the same team.Seniors got frustrated and so did I. Then I wanted to progress and hit up against MTAS*. I felt like a widget made in the factory of medical school who was just to be parcelled up and sent anywhere.I had little say and there was nobody to listen- just a computer.
So I came out here and I feel like a person who is respected for my skills and potential.’
This story of expensively educated young British doctors is repeated across New Zealand and Australia.
Some will return home- where they are badly needed. More will not and we have lost a valuable asset. The root of that loss is not valuing what we have and allowing an industrial process be applied to people.
There are people in D&G in senior management and consultant level who can influence what is happening with the training of our young doctors at national level. They need to use that influence and force the decision makers to listen.
Most of us do not have that influence. However, in continuing to make D&G a good place for all of us to work we may entice back some of our former medical students and junior doctors. That can only benefit us all who work for NHS D&G and the community we serve.
*MTAS – Medical Training Application Service -the UK wide computerised system which allocates all medical training posts.
Dr Laura Jones is a GP who works between Dumfries and Galloway and New Zealand, from where she follows our blog.