I'm exhausted. Four years of intense study, placement, and recently taking on the government have taken their toll on a body that doesn't like to play nicely at the best of times.
Exhaustion I can handle. But I spent yesterday afternoon on the verge of tears. After three years of nurse training, a year of working for the NHS and four years of medical school, not to mention over £100k of debt, I find myself genuinely unsure as to whether I can really build a career in the NHS, or even in medicine.
I didn't do medicine for the money. Frankly, with two previous degrees, I could earn more, in far more sociable jobs. That's true for most of us. To be frank, one has to be pretty bright and determined to become a doctor, and once we're qualified, many companies are jumping at the chance to employ us and our many transferable skills. Got to cut a really tough deal with some hard-headed business types? If you have ever tried to perform a difficult and painful but necessary procedure on a scared four year old, while their terrified parents and siblings watch you and grill you on your reasoning, all at three in the morning, then I promise you, the business types hold little fear in comparison. There have been some doctors who have already taken advantage of this employability - this is an excellent example, and sadly, one of many.
I chose medicine because I have seen the work junior doctors do, I have directly benefitted from it, I have watched them fight to the last for two of my brothers in Intensive Care Units, and I wanted to be able to do that for someone. I wanted to be the person that patients could trust, who would do all she could to protect and care for them. I still want to be that person. But not if I can't do my best. Not if I don't think I'll be safe.
I was asked to explain the whole issue today on social media. Four years of negotiations and spin aren't easy to distill, but here's the basics: the new contract has removed safeguards that currently stop doctors working too many hours, and replaced this with 'Guardians' - a scheme which has left many unconvinced. This is a problem because the Government are determined to have a 'Seven Day NHS' except no one is entirely sure what they mean by 'Seven Day' - they refuse to clarify what it is that they want to happen at weekends that doesn't already. So we're having to assume it means clinics, and elective surgeries.
The problem with this 'Seven Day Plan' is that we already have a shortage of doctors, and morale is at an all time low. Mr Hunt has declared that the new contract changes will be cost neutral, so won't put any extra funding in for more doctors (incidentally, we'd also need all the other staff, such as nurses and radiographers - no plans for them either). So he wants more services, with no extra doctors. This means the already over-stretched doctors we have will have to cover more shifts and services.
Consider then that he has made our lives immeasurably harder by lying about statistics and trying to turn the public against us (learn more about 'The Hunt Effect' here), and that his efforts have already led to an increase in staff leaving the UK and a decrease in students applying for medicine, and you begin to understand the scope of the issue.
On top of this, to fund his 'cost neutral' seven day plan, and cover weekends, he is going to have to cut weekend and extra hours pay - cuts which far outweigh the so-called 'pay increase' of 13.5%.
This is difficult for medical couples (of which there are many), as they will need more weekend childcare (which isn't cheap), and specialties which are already hugely understaffed such as A&E will see staff taking even bigger pay cuts as their out of normal hours pay will be reduced. So they'll recruit even fewer staff.
Is the money an issue? I'll be honest, yes. If I'm working more hours, and going to be even more-stretched than the doctors I see currently who never leave work on time, then I want some financial recompense, as I could expect in any other sector. Especially considering how much debt I have to pay off. But mainly, I want to have a life outside of medicine.
I want to have children. I want to see them. I want their dad to see them too. I don't want to spend the time I do have with them exhausted, or worrying about my patients and the care I've been giving them. I don't want to be stretched so thinly that I'm not safe.
Medicine is where my heart is. It is what I have worked so hard for. Now I'm heading into my finals exams, and it's only going to get harder. But the government has been attacking me and my profession for months now, and I'm exhausted.
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