Usually I have a good relationship with the managers. I guess I really should do, being part of the management structure. But in the "us and them" world of clinicians and managers, I've felt we've collaborated and compromised and cooperated effectively over the last few years.
Not so now.
Managers who have no clinical contact and no awareness of clinical practice in the really real world are making unilateral decisions on how care is to be delivered. Over the last year, consultation has widely been felt not to be consultation at all, but simply a tokenistic process of letting clinicians know This Is How It Shalt Be.
Interestingly, the Board proposed significant changes in service design "for consultation" a year ago. Numerous meetings and letters and discussions and emails later (from very vocal Consultant Psychiatrists and senior nurses and formal representation) and, would you know it, the proposals are identical to what they were a year ago, before consultation. So all these clinicians views, all expressed strongly, given by different people over a good length of time, amount to nothing being changed what so ever? Hmmmm. I'm not sure what the definition of "consultation" is, I know it's not asking opinion and doing what they say, but I'd be underwhelmed if consultation is meant to be a process that doesn't effect any change at all.
As well as service design, managers have recently dictated what clinical activity senior nurses can and can't do. Now, in part the Trust has to have a governance framework for their staff to work within, so managers absolutely have a voice in this. But for neither the nurses nor medical managers nor senior clinicians within the management structure to even be asked about this perplexes me.
Clinical posts have been lost, over the last few years. Management posts have increased in number. And then managers uniltareally decide that senior nurses can stop seeing patients and start supporting managers.
And they reckon it's my patients who are mad . . .