Wellbeing lead | Association of Anaesthetists

Wellbeing lead

Wellbeing lead

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A few years ago, the word wellbeing was a new entry in the medical lingo. However in a short period of time there has been an acknowledgement that wellbeing matters, and this has accelerated healthy changes in the way we work, the way we talk about fatigue, and the way we’ve started looking out for one another.

Sadly, there’s a sense that a lot of initiatives use all the right words but lack substance. We’re in danger of confusing the wellbeing movement as an insurance policy, so that if and when something goes wrong, organisations and their departments feel covered. Trust-wide initiatives often don’t seem to have the medical workforce in mind, even less so a unique speciality like anaesthesia.

One consequence of these hollow gestures has been to further cement scepticism. There is a compelling argument that the NHS functioned perfectly well (arguably much better) before we started worrying about one another as well as our patients.

Very early on during the pandemic I was asked by colleagues, as the lead for ‘Health and Wellbeing’, what I was planning to do to support the department? There was often a joke about massages, or aromatherapy, and I dutifully smiled back.

I really couldn’t see how I could do a better job than our excellent secretaries at keeping a finger on the pulse of the department - monitoring sickness as they always had done, advising us how to get a swab, and how long to isolate if we needed to. So after a brief flirt at helping with these side of things, I got back to the drawing board.

There was definitely a lot happening to keep the departmental wheels turning. Astonishingly complex rotas were churned out overnight with little or no dissent. As a large hospital in the North of England, we knew that things had been really tough for a lot of colleagues elsewhere. We made contingency plans, escalation rotas, started being first-on resident on-call, second on resident, even third on-call. I sat in meetings where stress levels were understandably high (the PPE scandal, the Italian experience etc).

This is a once-in-a-generation opportunity to take the wellbeing movement and ensure that, with the insights we have as anaesthetists, we contribute to it, shape it, and run with it.

Colleagues started getting tired, some were losing weight, some were clearly not sleeping well. A lot of fodder for the lead for support and wellbeing. The pre-COVID NHS wasn’t in tip-top shape - there was a level of psychological and emotional weariness, chronic frustration and low morale.

I racked my brains and thought about what could be done to best to support the majority. I liaised with our clinical psychologist who offered her skills, and we toyed with the idea of offering a debrief-style appointment to all consultants. We talked about adding a wellbeing component into staff appraisal. Nothing jumped out as being a great idea - we concluded that forcing psychological help on all is a great way of alienating those that really need it.

So what are the answers? I am afraid there are no simple ones. We’ve seen over and over again what happens when doctors sit back and let others, arguably less qualified, take the lead on shaping the way we work, the hospitals and systems that we use to look after patients. This is a once-in-a-generation opportunity to take the wellbeing movement and ensure that, with the insights we have as anaesthetists, we contribute to it, shape it, and run with it. It will be easier to let the managers and our nursing colleagues, and our juniors take it on - and I hope they all do. But if we remain as passive observers, we will alienate ourselves and exacerbate the problems that all anaesthetists face, now and in the future.

Like any overused phrase, the impact can be lost. That doesn’t mean that wellbeing, resilience, self-compassion and mindfulness have run their course. The last few months have been an opportunity to take stock, internalise, and assimilate good psychological traits. It may be yoga, improving diet, exercise, living alcohol-free, prioritising sleep, working a little less, or even a combination. The real benefit comes when we put it into practice, when we demonstrate it, when we look out for one another in an authentic, genuine and individual way. No system will ever substitute for this.

I am happy to hear from readers at: alex.bonner@lthtr.nhs.uk

Alex Bonner
Consultant Anaesthetist Lead for Support and Wellbeing
Lancashire Teaching Hospitals NHS Foundation Trust

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