30 October 2020

Tiers for Fears


“I find it hard to tell you 'cause I find it hard to take, When people run in circles it's a very, very, Mad world”1


I have ill-advisedly waited until a few days into my attending stint on our inpatient leukaemia service to begin writing my bulletin, the plan being write to you all with updated understanding and enhanced solidarity. As it transpires, I am merely greeting you with a dull headache, from the day-long, vice-like grip of the plastic face visor which unexpectedly materialised in front of me at about Bed 10. “Here”, we were told, “put these on, we all have to, now”. As sudden and inexplicable changes to the rules go, one in which we added extra PPE seemed well worth going along with. However, the metaphorical implications struck me: clamp your head tightly in this uncomfortable situation and stop worrying that you can’t properly see or hear what is going on around you anymore.

Coupled with no proper break for a cuppa, the PPE burden makes rounding on lonely, sick people perpetually separated from their loved ones increasingly weary for the whole team. Whilst I personally plod the wards like a Northern pit pony, low-set and heavy-limbed, eschewing needless conceits such as eating during the working day, my ward round tea-break is sacrosanct. If you are tired of cramming your ward team into a lunchy-smelling, squishy-sofa’d microspace to consume a cardboard-inspired beverage, you are surely tired of life? But, as the Tierdrop Explodes across the UK, even the relief of the so-called breakroom has been denied us given that the spaces available do not permit a 2m distance between unmasked persons. Temporary demasking whilst standing rigidly in social distancing format down the forgotten end of the ward to gulp down a faintly unappealing liquid is all that I can offer the team for ward round comfort and solace. I wonder gloomily about the "loophole", which supposedly ensures that workers without access to office space can now hold a business meeting at an indoor hospitality venue, formerly known as going out to a restaurant with other people. Our junior doctors do not have office space – nor chair space, or even breathing space. Surely, they, of all people, would deserve to do handover or MDT at one of the fine central London restaurants currently accepting bookings from parties of up to 30 for that very purpose. Our nurses don’t have office space either… in theory, I could take the whole ward out for a meal and so long as we talk about work, we wouldn’t even have to wear PPE. Contemplating this bizarre anomaly cynically, I am temporarily buoyed by the idea that I can call this article “Tiers of a Clown”. I rapidly discover that this is not an original idea.

I increasingly worry what the BSH can do to help. BSH is a member organisation. In good times, BSH did numerous things that we know were important to you all. We brought you together in person to learn, to develop professionally and to foster cooperation. We have formerly had less need to speak out in public for you. However, circumstances suggest that this may need to change a little faster than we had intended. I have briefly written before about how the BSH might approach seeking to ensure that you have your voices heard, in order to protect you and promote the issues you care about in the workplace. Advocacy is something that the BSH has been carefully working towards including in its overall strategy. For this reason, I urge you once again to complete the survey we have sent around, so that we can base our advocacy strategy on the best information from you. Each member will have received a personal link and the survey takes less than 10 minutes to complete.

In terms of advocating more widely in society, BSH has signed up to be one of the 80 organisations brought together by the Royal College of Physicians who are currently asking that the government takes urgent action to address unfair and avoidable differences in health across the population, and between different groups within society. You can read more about this here: Inequalities in Health Alliance.

Finally, I hope you all can enjoy something from BSH2020 Virtual which starts on 9 November 2020. You can register here. All content, including the live sessions, will be recorded and made available online until November 2021 so that those that cannot spare time to participate on the day can benefit and gain CPD.

  1. Tears for Fears, Mad World, The Hurting, 1982, Mercury Records.