Recently I lost a patient. A lady in her 60s whose hand I held for months and whose passing will stand as a turning point in my career.
Autumn gives way to winter and the medical press headlines are full of bad news; early retirements up, applications for GP training down and the latest, QOF achievements have fallen too. Most clinicians are struggling in various ways. We should remember however that we do not have a monopoly on stress. The private sector knows a thing or two about this area and a few of their methods may just be useful for you ...
Having discussed the importance of perspective and communication in my previous articles, it seems only fitting that I now comment on the role of these factors in improving healthcare. Namely, where an understanding of the patient's perspective gleaned through open communication can lead to new innovations in improving NHS systems.
Presenteeism is when people go to work even though they should be at home. The term was coined by psychologist Cary Cooper. Sometimes they may be ill, potentially contagious and not functioning at 100 percent, but they still feel like they should be at work.
As this year's crop of newly qualified medical graduates settle into their first jobs, feelings of inadequacy are not uncommon. Although not mentioned on ICD 10, there is a condition known to psychologists that may explain what they are feeling. Impostor syndrome is the fear and self-doubt that causes people to question their abilities - even in the face of success - and to constantly search for external validation.
This month's release from a newly updated National Institute for Health and Care Excellence (NICE) website included the much debated Lipid modification clinical guideline. The draft of this guidance prompted a letter whose signatories included Richard Thompson, president of the Royal College of Physicians, and Clare Gerada.
Hans was apparently the name of the plucky young man who plugged the hole in the dyke wall with his thumb, thereby saving his town from flooding. Sometimes NHS clinicians may feel like Hans, trying to prevent 'imminent doom' with 'heroic' deeds.
Memory is complex and what we know has largely been gleaned from studying memory-deficit problems such as dementia and amnesia with newer technology such as functional MRI. We do know that in addition to ageing, emotion and stress can also influence our encoding and retrieval of memories. As the song says, "Can it be that it was all so simple then, or has time re-written every line?"