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Living costs: how much do you spend?

Discussion in 'Real Life Discussion' started by Taure, May 12, 2017.

  1. Silirt

    Silirt Auror DLP Supporter

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    How's working for NHS? What are your thoughts on it?
     
  2. Blorcyn

    Blorcyn Unspeakable DLP Supporter DLP Silver Supporter

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    The NHS is a big institution, one of the biggest. Is there anything in particular you're curious about?

    Firstly, I appreciate that I'm very privileged in the modern world to be in a job for life, barring gross misconduct, with high prospects of progression, in some form or other. Secondly, I certainly love the principle. I'm glad I don't have to be more closely involved with any of the choices about who gets medical care, and the degree of medical care, that other nations health care staff do. I enjoy aspects involving patient care greatly, using skills and figuring things out and dealing with emergencies. However, bureaucratically the NHS can be very frustrating, its size means it can be difficult to sort things out and there's very much a like it or lump it attitude when administration aren't living up to their contractual obligations. Furthermore, the rota gaps drain enthusiasm for a job that would otherwise be really rewarding. If someone tries to die, no one in a hospital is going to give a shit about staying as long as it takes to sort things out. When you're staying four hours late (as I did the last three days) because of rota gaps that they've had months to try and fill but have been unable to, without making any concessions in the work load. That is really shitty. And again there's a like it or lump attitude from the higher-ups. And, when many do consider lumping it they're very aware that they're only going to be creating more gaps and leaving their fellows in the lurch - it's very difficult to say no to the patients and colleagues that are depending on you, in the moment. I also resent the fact that necessary courses and exams and regulation are paid for out of our own pocket, because no other profession in the UK seems to do that (or at least that's what we all tell each other).
     
  3. Silirt

    Silirt Auror DLP Supporter

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    At the moment I'm interested in the gaps that they're having problems filling. I knew a fair few doctors and medical professionals growing up, a couple of whom were brain drained from Nigeria, though in recent years we've been getting more Canadians. Is the work in NHS just so shitty that you're not getting enough people who really want to do it? Everything I've heard suggests it's a terribly demoralizing work environment. Additionally, if there's a line, is it first come first serve with emergencies factored, or is it entirely based on how serious each case is perceived to be? You've said you don't make this decision, but it was something about which I was curious, since I've heard different things in different places.
     
  4. Blorcyn

    Blorcyn Unspeakable DLP Supporter DLP Silver Supporter

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    Ah I see. So there's little evidence in my reply here, just my guess.

    My understanding is that the largest demand on services is emergency related, for which the hospital doesn't really get central funding in anyway related to workload. It's also where most of the junior clinical staff go.

    Ward work pays a bit. Then elective surgery and clinics are where they make the hospital makes their money by work rate/total work. You can't do that stuff until after quite a lot of training, years post medical school, and it's probably why there are less training posts than would meet demand for all this emergency work. Training juniors is expensive.

    The gaps make it a terribly demanding job, because, actually, some of the patient contact reminds me of nothing so much as when I was a waiter in sixth form. Customer service is pretty horrible when people have been waiting five hours.

    Care is by priority and then time order. In my job last year when I was working 15/16 hour on-calls, I would be the single doctor covering the emergency department, the ward round and the emergency clinic (where six people could be booked in for 10-2, for problems that needed to be seen quickly according to GPs). Id also be the person taking those phone calls from the GP and the other hospitals a and e (I covered two EDs, oh yeah). The bleep would probably go off on average every five minutes. I remember multiple occasions where phone calls would pile up quicker than I could have one or two minute conversations, and that was all time where these patients already in the hospital weren't being seen. No lunch, no time to drink or piss on a number of occasions.

    You have to really love what you do to do it for a long time. And it means the hospitals with the most need lose the most staff and struggle to recruit the most.
     
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