The Dark Side of A&E

You don’t always notice how it creeps up on you. It’s hot and you’re not sleeping well, you’re tired all the time. You go out to a restaurant, and people are keen to catch up, they never see you any more. Your dentist makes a comment that she can tell you’ve been grinding your teeth, and do you have a lot of stress at the moment?

I recently had a week off. It was fixed annual leave – I didn’t have a lot to do for the first half and for the latter I went to Wales and escaped City I Live. I finished nights on Monday morning, and by Thursday I’d noticed some things were different. I was sleeping better – in fact, I was sleeping to excess. I was eating better, feeling better, more energetic and awake and alert than I had felt for a while. I just hadn’t realised I was being worn down until it stopped.

I’ve never done a job as stressful as A&E. You go in to work and it’s hours of trying to bring order and calm to a chaotic department full of worried, unwell people. You break bad news, sometimes many times a shift – you may have cancer, your husband has had a stroke, you are miscarrying your baby – and then you have to go in to see the next patient, untouched, smile, hello, what can I do for you? The rota punishes you, eating up your evenings, your nights, and the next thing you know you’ve not seen your other half in a week despite living in the same house. You go home and the media tells you about the crisis in A&E, politicians say they will introduce more targets, or fewer targets, or other variants on doing nothing. Yes, the increasing attendances to A&E are a problem. Yes, we’ll close some more down, I’m sure it will be fine. The papers bash out stories of how rubbish you, as a specialty, are. As you try to sleep the department is always there, ticking over in the back of your mind.

The work in A&E is inspiring, interesting, fast moving. You make a difference, often for better, sometimes for worse. The problem is how stressful that work is, and how under-recognized that stress is by the government. A&E doctors are leaving the field in droves [The Times], patient numbers are increasing [The Nuffield Trust], the service as it stands faces (in the words of the president of the College of Emergency Medicine) an existential threat [Parlimentary Report]. What will the politicians do with their pretty words [The Telegraph] and endless votemongering when they realise, too late, what they were warned of all along? When, in ten years, they have nothing left but A&E departments with broken backs and an ever-growing mountain of straw?

In case you can’t be bothered to read the above links, this Guardian article written by an A&E doctor is telling. Watch the top video. Read it.

The Perfect Storm indeed.

It took me a mere week off to realise how much of it was getting to me. A week away allowed me to unwind, recover something of my ‘old’ life, and I’ve only been in A&E a couple of months. Imagine what a lifetime could do to someone. It’s not hard to see why people are leaving.




2 responses to “The Dark Side of A&E

  1. I watched all the recent episodes of 24 hours in A&E recently, partly started watching having been inspired by recent blogs and wanting to know more of the reality, but then once I saw one, I wanted to keep seeing them. It was interesting seeing what comes in, how they cope, the approaches you have to take and dealing with people. It’s amazing, I couldn’t do it, I think I’d just end up crying all the time.

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