I’ve had a LOT of emails and messages this week linked to various Wellness Programmes and links and my emotional response to them has surprised me. I’m not normally a cynic, I’m usually someone who is keen to engage and see the benefit of things. I have, instead of wanting to engage with these items, been really irritated by them and so I wanted to explore why I feel this way and understand if I’m the only one.
Let me start by talking about what my currently day to day looks like, as I think my thoughts linked to this are very context specific. I’m just getting home at 19:30 after leaving the house at 6:30 this morning and working a 10hr day without lunch or tea break. I have an hour and half to spend with my husband and eat before going to bed and starting the whole thing again tomorrow. The sad thing is that this has actually been quite a reasonable day, 12+ hour days are frequent.
Last week I ran 2 conferences and so wasn’t tied to my desk, followed by a couple of days off sick post booster vaccine That meant going into last weekend I had over 2200 emails on my inbox and over 1100 unread. I needed to cover IPC over the weekend and so in order to try to get back on top of it I worked to get the email mountain down from 2200+ to 156 to action. As I’m also on clinical this week that action pile in one day is back up to 190.
What’s the point of me telling you this? I think my aim is show that I fight just to stand still. If I take my eye off the ball even for a day I sink into quick sand. No one covers my whole role if I’m off sick, there isn’t another Consultant Clinical Scientist in the department. My point is that I don’t get how wellness works when this is my life?
My Trust and the NHS has invested a lot in wellness programmes and resilience training. This post may sound like its having a go at the really lovely people who provide those programmes and put so much energy into getting them up and running, but it isn’t. This is a post that is expressing my tiredness and exhaustion at working in Infection Prevention and Control in a pandemic within a system that does not deliver the resource for lunchbreaks, let alone provision for me to be training up my successor so there would be cover.
So what is that doesn’t work for me about wellness and resilience programmes?
The programmes we’ve instituted are things like ‘Wellness Wednesdays’ which includes a lunch time seminar on a wellness topic. We’ve been given access to the headspace app to support meditation and promote sleeping and healthy eating. There are also things like yoga sessions run in the Trust and GOSH supported 5k Park runs to encourage an active life style. There’s also access to counselling.
All of this looks amazing when written down and don’t get me wrong I think its great. However it only works if you’ve addressed the system issues that are driving some of the problems.
For example, I have never managed to attend a wellness seminar, despite having them in my diary, because I don’t have time to have lunch and usually spend my life in back to back ‘urgent’ work zooms. The biggest system change for me would be to enable me to have a lunch break and then I could choose whether to spend it on a wellness seminar OR I could step outside my windowless office and see sunlight!
The activity stuff is great. I used to run pre-pandemic. Now I work mostly 12 hours days with a 3 hour round trip commute. On a good day I get 2 hours at home in the evening during which time I might, for instance, have time to wash my hair and eat. On weekends I am either working or too broken to make food and catch up with all of the household tasks, such as food shopping, that are needed to get me through the next week. In terms of wellness, the better fix for me would be to enable me to actually have a homelife so I could choose what to do with it, if I don’t have time to eat I’m not going to be able to join in yoga.
One of the final things that I find really tricky about all the wellness stuff is that it seems to go on and on about being present in the moment. I have a meeting in a Tuesday where the first 5 minutes is a wellness meditation. I will give an honest confession here, if I have time I use that 5 minutes to actually make a cup of tea so I can have a drink. This doesn’t normally happen as I’m always running late from previous zooms, but that is the intervention that works for me. I find being in the present hard. I’m exhausted and physically pretty broken, spending 5 minutes noticing that is not helpful to me. I’m surviving this by planning and focusing on the future, which is how I always manage my stress and survive.
So where is the system letting me down?
Some of the problem with this is the way that Healthcare Science functions. We’re not like some other specialists, who effectively do the same job with different specialisms and therefore cover each other for sickness and holiday. We’re not like some other colleagues who work in a team of multiple similar roles and, although may not always truly cross cover, have someone to pick up their responsive role. We are usually lone individuals, as there’s never considered to be enough work to have more than one of us. That causes issues in terms of career progression and training up someone to eventually take over (as it can take 10+ years) but it also means that no one actually covers your work load. They may pick up the screaming urgent stuff that has to be managed but the rest just builds and builds.
All of this means taking holiday becomes a trial that becomes inherently stressful. You spend so much time trying to pin everything down before you go that you pull double hours and when I return I frequently have up to 3000 – 4000 emails and my diary is back to back as I’ve been unavailable for a week or 2.
It also means that when that workload becomes too much it very hard to get someone to help carry the load. Don’t get me wrong, I have great teams and we work really well together but I don’t have someone I’m training up to be the new me that I can hand bits off to, in the way my medical colleagues do with their registrars. It also means we’re not planning for the future
It’s not just Healthcare Scientists that are struggling however, so it’s not unique to us as a group. It is physically not possible to be on 8 hours of zoom calls, deal with 300 – 600 emails and a day and then actually do productive work that requires thinking on top of this. So how do we change the system to improve the way that we communicate? To determine whether the meetings we have are productive? To change expectations in terms of being available for 8am meetings and 6pm meetings when we only supposedly work 9 – 5? This is something we can start to tackle as individuals but requires changes in culture, which is in my opinion is something that organisations should be investing in as much as free yoga.
Instead the response is usually that we should find things that we can drop to create time and space. The sad thing about this response is that it means all drivers for work become focussed on core work and reduces both time and acceptance for tasks that require creativity and innovation, the kind of tasks that will actually permit changes to the system in which we are existing. For me it is these tasks that energise rather than drain me, these tasks that give me hope that I will make it out the other end and permit planning for a future where we do things better for both ourselves and our patients. I feel especially infuriated when I’m told I should discard the only things that are enabling me to continue, to do even more of all the things that are leaving me hollow and tired, even when these things are done on top of everything else. I know to many it seems like an easy fix but to me it would be the straw that broke my back.
So here’s my plea. Instead of placing the burden to fix burn out on individuals, lets also work with the systems that led us here. The pandemic is a once in a lifetime challenge, but what it’s done is expose problems that were already present in the system, not ones that only exist because of the pandemic. Personal responsibility is important, but making people feel responsible for their burnout as if its another of their failures is not the way forward. Support them, offer individual help, but also acknowledge the system wide issues that led them there.
Apologies for the rant, but I for one feel waaaaaaaaaaaay better for getting that off my chest. Now I’m off to watch a YouTube video on the importance of laughter yoga.
All opinions on this blog are my own.