Leadership, nhs, Uncategorized

Enjoy the Silence


I’m on holiday. Hallelujah!

When I eventually got home on Friday night I felt like I had literally crawled over the finish line and collapsed in a heap.

Cross covering colleagues immediately increases your workload however there is an understanding and clarity of what is expected during this time. My job is to keep our patients safe and lead the team.  I become much more directive Dr Copeland in order to manage my time to its maximum efficiency. This is especially important given I work 3 days. I also expect the team to know their role.  What is crucial is that we check in with each other just to make sure.

This clarification of understanding and expectation is something I do whenever I meet a new patient too. If you don’t and instead assume you will get something wrong.  I’m not talking about clinical mistakes where patient harm occurs. What I mean is the type of mental harm that comes from not explaining things properly or giving opportunities to ask questions.  Most importantly it is about setting expectations e.g. when a test will happen or when you might get home.

It also applies to non clinical situations.  This week I had the joy of manning the middle grade rota for the first time.  When I say manning, fire fighting is probably a more accurate term.  Without getting into detail, there have been issues.  I’ve done rota management in all of my jobs so this one didn’t particularly phase me. Yes, it’s complicated with all the rules around rest days, number of hours worked, days in a row, etc etc but not overly so.  What was surprising to me was the virtual tsunami of emails that came after it was distributed. No one was happy.

After a while a pattern emerged. It seemed to me what was missing was this fundamental clarification of understanding and expectation.  The specifics of promised swaps and annual/study leave requests while obviously important did not seem to be as important as acknowledgement of the request and when to expect a definitive answer.

I have come to hate the ‘death by email silence’ that occurs in the NHS.  In that vacuum a person can create all kinds of scenarios that may (or more likely) may not be happening in response to sending an email.  These assumptions can lead to all kinds of behaviours.  In a rota situation some may take that silence to mean ‘yes, have that week off’. Or it can have the opposite effect so the person can’t get to a family wedding, for example. Either way it leads to both an unhappy workforce and rota management team.  In my experience a simple ‘your email has been acknowledged. We hope to have an answer for you by X date’ can go a long way to defusing a volatile situation.

So as I put my out of office on there is an understanding that I will not be checking my emails.  My annual leave week is a time to relax in the company of family and friends.  The expectation is that when I get back to work I will be refreshed and ready to go again…

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