Here’s the thing: I hate working weekends. Not because of the loss of time with other, non-healthcare people. I’m quite capable of feeling up every “free” weekend with conferences or meetings anyway, so that doesn’t make much difference. And I don’t mind working night shifts over the weekend either. But I dread working Saturday and Sunday day shifts.
I hate it because despite the fact that junior doctors have a #7dayNHS the truth is that patients don’t. We don’t have the same staffing levels or the same access to services at 10am on a Saturday as we do on a Tuesday, and so the care that we provide on a weekend is different to the care that I can (usually? hopefully? aspire to???) provide during the week.
Especially at this time of year, there’s a lot of pressure to be a certain type of doctor. The tasks of medicine seem to take precedence over the art. A ward round is encouraged to be a “business round” to get things done; get through the tasks; move on and on and on…
It’s not my kind of doctoring. It makes me uncomfortable; it makes me worried; and (I think) it makes me a worse doctor. I suspect it even makes me less efficient in the long-run as I reach emotional exhaustion much sooner. A grumpy penguin is not one that you want in your team. I really, really doubt that you want one as your doctor.
So, last weekend, I did something different. I thought what would happen if I came home every night after my shift and could go through my day with someone that I trusted, and who would understand things from the patient’s side. How would I feel telling them about my day? Would I feel happy about what I’d done? Or would I feel ashamed about the way that I’d acted and the care that I’d given.
I don’t really buy into the whole concept of “What would X do?”. It’s far too easily manipulated to what we ourselves want to happen, particularly if the person in question is a historical figure, 2000 years old with patchy fragments of oral history to form an idea of. But I know a little more about what I’m like, and how I feel. I know what I’d be happy to share, and what I would want to hide from the people that I respect and trust.
Eight months ago, I lost one of those people. And now I can’t go back and tell him about my day and which bits I cocked up. But I can think if that was a shift that I would have wanted to tell him about; if he would have understood the decisions I made, or if he would have gently (but quite firmly) told me off…
It was a much better weekend. Maybe I did take a bit longer with each patient; maybe it wasn’t (on the surface) the most time-efficient ward round I’ve ever done. But it’s the first weekend in years that I’ve come home and not felt disappointed in myself. It’s the first weekend in a long time that I haven’t felt cross or frustrated; I had fun with my patients – there was paint and Lego and proper paediatrics involved. And I think it’s a weekend that I would love to have shared.