The day before yesterday I wrapped myself in a scarf, leant into a snow storm and battled the elements across London.
Today, I’m writing this, sitting in the sun.
What are we to make of the weather?
The Duchess (Roy’s mother) used to say; ‘we must weather the weather, whatever the weather, whether we like it or not.’
She was nothing if not resilient. She probably didn’t know she was resilient.
‘Resilient’ wasn’t a thing in those days. She was stoic and had arrived at a state of mind where you just have to get on with life.
An enviable place to be.
I’m not sure how I feel about ‘resilience’.
Encouraging resilience is generally seen as positive. There are classes on the topic. On-line courses and conferences…
… but I’m left wondering, if the NHS was a better employer, if conditions were more humane, if the work was less toxic and management more civilised, would we need to worry about being resilient?
Over-emphasising resilience leads to people feeling pressured to ‘tough it out’. Ignoring their genuine struggles. I get the feeling that’s what happens every day at the sharp-end of care… where the real work is done.
Covid spawned the idea of ‘wobble rooms’, where people stressed and distressed by their work and experiences could retreat for some out-time, to decompress, have a cry, a shout… one wobble room had boxing gloves and a punch-bag!
There is no doubt the day-to-day work of the NHS with its emotional ups and downs was amplified during those dreadful days. To be honest, I doubt much has changed.
It’s not just clinical staff. Managers are likely to be under just as much pressure.
Silly-Boy’s (Wes Streeting), dad’s army of advisors and the bewildered is pushing him towards league-tables. We all know within four years of Jumping-Jack-Flash’s (Alan Milburn) first go at them, they were abandoned…
… before the disappeared under their own weight of complexity, complication, conflict and confusion.
Add to that, the fact that we know from experience performance monitoring is;
- DH+ shoving NHSE’s arms up its back,
- who browbeat regional apparatchiks,
- who terrify Trust boards,
- who torture senior managers,
- who beat-up middle managers,
- who abuse everyone and bellow…
... ‘JYFDI” and ‘don’t bring me bad news’.
It’s not a very merry, merry-go-round.
Encouraging resilience might easily downplay or dismiss the challenges someone is facing. Worse, people feel isolated or believe they are to blame for their difficulties.
If you want to see what pushing for performance does…
… watch managers going home, struggling in the car park with a handbag, a briefcase, a laptop and a pile of papers. Then look at the time stamp on their emails.
If we are to be faced with another re-disorganisation, a shift in the direction or place of care, it can only be done on top of the day-job.
The pressure and responsibility of managing change cannot ignore the broader pressures such as waiting lists, winter performance and bringing organisations back into balance.
Unrealistic expectations leads people to feeling like failures if they struggle, compounding their stress.
It’s important not to ignore vulnerability… which is what the quest for resilience can lead to. Often meaning workplace relationships suffer because people ‘don’t want to let anyone down’… so they worry and stew, and tough-it-out.
Resilience is a polite way of describing constant perseverance, toughing it out…
… ignoring the fact have people have a job and a life and that’s why having a job for life is becoming a less attractive proposition.
There’s been a 67% increase in nurses leaving within five years of registration, and a 43% increase for those leaving within ten years. We know the reasons; burnout, poor mental, physical health, and staffing levels.
Similar concerns exist for doctors and allied health professionals, as vacancies and dropout rates remain high and the professions become less attractive.
Stomping around with messages like, ‘the NHS is Broken’ do terrible damage to recruitment and morale.
Working in the NHS is a great career but right now it’s a rotten job. My fear is it’ll get worse.
The NHS’ performance problems, the retention issues, arise from a workforce exhausted by effort, who come to work and endure it and are overwhelmed by the challenge of it.
We can change it if we create a workplace that recognises discretionary effort and creates an atmosphere where people are eager to come to work and…
… still enjoy the challenge.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
