Saturday, July 25, 2009

Under Pressure

Shit, as you all know, rolls downhill.

Th more I see of what passes for management in the NHS, the less I like it; everyone seems to have an agenda, and increasingly, it doesn't seem to be about the patient.

The four hour target is a cracking example of this. There are many, or at least some, aspects of this target that are a good thing. Waiting for 16 hours on a trolley is a bad thing. But please don't pretend that a rapid transit through an Emergency Department speeds up your treatment. We're just pushing the wait back one level, so you at least wait on a bed; but you still wait.

Anyway, the pressure is on where Shroom works. The targets are not being met, and we must fix it. What frustrates me is that the management seem to see this as a problem that is just down to us, to the ED. The management seem reluctant to take shared ownership of the situation, although i am reasonably sure they are happy to accept praise when the targets are met.

And so the pressure is applied; I might normally claim to thrive under pressure, and maybe that's true... but right now, there's a bit much for me, and it's beginning to tell.

I had a bad week last week. It happens, but last week was particularly so, and several of my patients were sicker than they looked, sicker than I gave them credit for. And so, I have had to answer for this; once again, the responsibility comes solo, and no-one wants to hear that i felt under pressure to 'move the meat', as it were.

I'm struggling to find the way to deliver the same care in half the time.

Maybe I just need a break.

No comments: