Saturday 29 August 2009


We're not absent, a lot.

I've not had a day off sick, this year. Or last year, come to that. On working through an annual appraisal with one of my Consultant colleagues, we pulled his sickness record for the last 16 years. He'd had just one day off sick.

I know some colleagues who don't use all their annual leave entitlement. Instead of going on holiday or having time off at home or whatever, they stay at work instead.

Gets you thinking.

No, it's not that all my Consultant colleagues are workaholics and passionately addicted to saving lives and making the world a better place. No, it's not that there's any financial advantage to working more (indeed, none of the extra hours or overtime or worked leave is paid). No, it's not that they've dysfunctional lives or grim home settings so would rather be at work.

The issue that one of my Consultants shared at appraisal was this. A holiday was less relaxing and more stressful than being at work. When we're away from work, nobody does our job. Our teams have discussed this. CPNs cover for each other. Ward staff cover shifts. Our OTs and social workers cross cover. Even our secretaries cover each other. This cover is substantial, involving sorting out work, doing depots, reviewing patients, typing letters, getting the work done.

With Consultant Psychiatrist cover, it's just cover for emergencies and specific problems. Nobody does my clinics whilst I'm away. Nobody does my home visits. Nobody does my reports. Nobody does my CPA reviews. Nobody sorts all the GP and solicitors' queries.

We've less Consultant Psychiatrist time than the Royal College say we should have, for our population. We've markedly less Staff Grade and junior doctor time than any other mental health unit I know. We've no Associate Specialist of Hospital Practitioner sessions. We don't have capacity to do the work of anyone else whilst they're on leave.

Through this, when we come back after leave, we've that week's work to do, plus the work of the last week when we were away. All the letters, emails, 'phone call messages, supervision, care home reviews, meetings, teaching, out-patient clinics, home visits you didn't do last week you somehow have to fit in to the week or two when you return, on top of everything else.

The stress some colleagues feel from this is such that they simply feel they can't be off for more than a week, or would give up their holiday entitlement and not go on leave at all.

Can't be healthy.

Must think on how to manage this differently . . .


The Girl said...

Wow, that is rough!
I hope you manage to sort something out.

Milo said...

for some reason, i don't like holidays either! all the best with stress management and all the rest.
kind regards,

Kathryn said...

It strikes me that there are huge similarities in our situations...I'm a parish priest, so when I take annual leave, Sundays and funerals will be covered (the equivalent of your special programmes, and emergencies I guess) but none of the day to day care and visiting...
Knowing what will be lying in wait on my return is definitely a disincentive to take the needful time away. Sympathies. I hope there's a solution somewhere...

The Hippocratic Oaf said...

Do you think this is true across most specialties? From what I understand, mental health does not receive anywhere near the funding it deserves.

Catherine said...


I am a teacher rather than a doctor, but I do not like to be out for the same reason. I was recently ill, throwing up ill, and I had to be out of work for two days. I ended up coming in for several hours on the weekend just so I could catch up.

Please, if you figure out what to do about this, please let me know.