A Line in the Sand

By Veronica O’Doherty, psychologist and IMPACT member (written in a personal capacity)

September 2011

Morality, like art, means drawing a line someplace. Oscar Wilde (1854 – 1900)

When cynicism becomes the norm and satorial remarks commonplace you know there is a problem unfolding before your eyes. Everywhere I meet health care workers from all sectors in hospitals, primary care and voluntary bodies across the whole of Ireland and across all the professions I see signs of serious stress and sometimes outright burn out. Humour is often used to mask the desperation of those who seek to provide the best care possible for people needing the professional care and experience of those trained to provide that care.

Many years ago I presented a paper at a student nurse conference as a 1st year nursing student called “Who Cares for the Carer?” which touched on some ridiculous outdated practices that prevented nurses from doing the best job that they could do at that time. Sadly the issue of caring for health care staff is more relevant today. Stress is a growing silent epidemic in our health care system that is being ignored.

When good people loose the love and motivation for the job they trained for many years to do it should be a major concern for all of us in society. Working in health care is challenging, rewarding and also difficult at times.

It is never an easy job to face head on the despair of a family whose child is terminally ill and provide that support for the whole family and nurse their child to an easier death. It is never an easy job to give evidence in court case after case for each child that is hurt by physical, sexual and emotional abuse. It is never an easy job to perform surgery on a person when it’s the only option which may give relief from a painful condition yet the outcome may not be guaranteed. It is never an easy job to see anyone on a trolley in A&E nor indeed to turn someone away at the door because there is no room at the inn. (But then we don’t ever do that do we?)

Health care professionals want to do what they do best. That job is to facilitate healing and support people to die if healing is not possible. Healing has physical, psychological and social aspects and human beings bring their individual complex histories to the clinics, the GP practices, theatres and primary care settings. There are a myriad of specialties that are interwoven to work together to support people on their journey to wellbeing. When that breaks down we have things half done, partially done or not at all.

This results in frustration and sometimes despair as professionals know this is not good enough. They know too well when the tapestry comes together and when people feel they truly got every support necessary. Then they sleep well that night with the knowledge they did the best they could do.

Since the inception of the HSE and in fact many years beforehand there have been so many change documents, some with lovely pictures on them such as butterflies transforming themselves and so on… one would think we should have managed this ‘transformation’ so well by now. I am not knocking those who no doubt worked tirelessly on producing these nor am knocking those charged with effecting the alleged ‘transformations.’

What I am saying is that over a decade or more of transformation has not included a planned change management strategy that realises that health care workers are human beings also. They cannot continually lurch from one change to the next with confusion and uncertainty their daily medicine. Something has to give way and I think it has. The levels of stress which manifests itself initially in cynical remarks and the reality that most people when asked will admit they want to get out or want to retire if they can is a very sad reality for the Irish health system. When it gets to the point that health care professionals need to take care of themselves as they begin to suffer the effects of long term stress we have a major problem that needs to be addressed.

Movation and vocation for this type of work is an essential component for good health care and unless we wake up to that fact and start treating health professionals with the caring they truly deserve for the hard job they do every day we will regret the loss of the legacy of caring which has been a cornerstone in Irish Health. Just don’t say you haven’t been warned.

I write this as an individual with a background in health and thus represent my own views on this.


This article also appeared on the politico.ie website.