What matters to me?

 In Blog

By Dr. Phil Riddell

July has arrived.  That means that I have almost completed my first year as a Junior Doctor.  My paperwork is complete and this allows me to sit back and reflect on what I have learnt from this year. This reflection is especially important currently, as in four month’s time I will have the opportunity to apply for a Specialty Training post.

There are many different aspects to picking a career that I feel is the correct one for me.  Whilst the technical and theoretical aspects are extremely important, they would not be complete without an added dimension- joy.

Joy in work is something that has been well explored by Samantha Buttemer, a GP from Canada. She defines joy in work as a sense of meaning or satisfaction from a job and argues that a lack of joy is a major contributor to burnout. But how does this concept apply to my daily work?

Looking back over the past year, it has become increasingly evident when I have found joy in my work. The difference between joy and ‘un-joy’ has been subtle at times, but by teasing these differences out I can make informed choices about which specialty is the one for me.

Teamwork

The entire NHS works in teams – whether that be multi- and uni-disciplinary.  As I have rotated through three different departments, I have noticed that some teams work more effectively than others. On reflection, I think two things have stood out; respect for the opinions of others and socialising as a team. I feel these go hand-in-hand.

I have worked across three separate departments, each with their own unique ways of working to achieve their common goals of safe, effective care.  To do this, they must be able to work as a team and integrate the (often differing) opinions of multiple staff members.

In my opinion, the teams that have been better at respecting each other tend to be the teams who socialise together.   For example, my rotation on General Medicine came at a time over the busy winter period.  The high-pressure environment and need to discharge patients quickly once they were well enough could have contributed to a negative work environment.

The thing that made these busy days better were the 08:30am morning multi-displinary team meetings, with representation from all ward staff groups and the discharge planning team.  These were highly focused when they started, but as people arrived there would be a noticeable buzz as we discussed our evening or weekend plans, the news or family news.  Discussing the latest developments on our favourite TV shows, or our plans for the weekend reminded us that we are all human and created an atmosphere where our individuality was respected.  Personally, it gives me joy to connect with my colleagues on matters other than the care of our patients, even if it is just for five minutes of the day.

Gratitude

Everyone in the NHS does an exceptional job in the difficult circumstances we face on a regular basis.  However, I feel that the achievements of staff members can be overlooked, leading to an experience where people feel their hard work is not recognised.

A particular example of where gratitude can make a positive impact on joy comes from our Learning from Deaths panel.  This is a group that has been set up to review at all deaths that occur in our hospital and is part of a National drive. If our reviewers have identified areas of good practice, or family members have specifically praised our care, we will receive a ‘thank you’ card from the reviewing Consultant explaining what aspects of our care were deemed to be noteworthy.  This could be technical skills, or ‘soft-skills’ such as communication with patients, their family or other staff members.

Identifying good care and praising it, even if this is only achieved through conversations, seems to have a big impact on self-esteem.  Knowing that what I have done has made a difference gives me a sense of pride in my work and ultimately promotes a sense that my efforts are valuable.  It gives me joy in my work.

Our gratitude does not have to be reserved for the extra-ordinary though – it can be expressed for any job, no matter how routine it feels to the person doing it.  We do not have to be extra-ordinary to be thanked for our efforts.

Ability to enact change

Whilst the NHS is a remarkable institution to work for, it has its flaws.  As a member of staff on the frontline, these limitations can be frustrating to deal with when trying to provide the best care for my patients.  Often, I cannot see a simple solution to these complex problems.  However, on occasion I can. What would make these limitations even more frustrating is not being able to enact my suggested change (or changes).

Having the ability to implement a change requires many different things, but a key ingredient is a team that is willing to listen and respond to what I am saying.  This team can be ward based, a department or even the senior management team.   Personally, I find that I become disengaged from those who fail to listen.  This ultimately stops me from providing suggestions to them in future, as I feel my efforts will be wasted – It drains my joy.

Fortunately, my experiences have been overwhelmingly positive.  That is because I have been lucky enough to find those who listen and respond to what I am saying.  Being heard is a key component to joy in the workplace for me, as we all want to make a positive impact on the care of our patients.

For me, all of these aspects feed into a culture of safety.  With good teamwork, a team that listens to my suggestions and outward expressions of gratitude, I feel more confident to speak up when things could be better.  I am confident enough to make suggestions for improvement and have the belief that my opinions are valued. I also feel reassured that people take note of the care I am giving and that as a team, we value a positive approach to the care of our patients.

I have joy in my work.  Do you?

Questions to ask yourself/your team

  1. Do you feel supported by your team?
  2. Who listens to you when you have suggestions for improving the care you provide
  3. When was the last time you thanked someone for their contribution?

For more thoughts on joy in the workplace, this is a great starting point:

Beyond Burnout


Phil Riddell is a Foundation Year doctor working within East Anglia after graduating from Medical School in 2017.  After positive experiences at Medical School, he is planning on pursuing a career within the field of Patient Safety.

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