Where is the line?

Life is hard. I plod through day after day. Family and friends sometimes worry about me.

But I’m fine really. Just busy and tired but everything’s OK.

*****

A day at work

Rudely awoken by the loud noise of young children waking up then immediate loud demands. Wishing for a bit longer of rest and quiet but it’s not to be.

Then a race to get everyone washed, dressed, breakfast eaten, bags packed, shoes on and into the car.
All the while involving battles, tantrums, cries, noise and demands.
And no time for breakfast for me.

Drop them off at nursery – hard to do; they cling and cry as I leave which breaks my heart even though I know they’ll be fine in a few minutes.
Time to get to work.

Into the car and savour the few moments of quiet and no battles, tantrums, cries, noise and demands. The day has felt like a challenge already and it’s barely begun.

Get set up at work. Make a cuppa. Find something to eat. 8 minutes to go until first patient arrives. Build myself up for it. Once I start, I know I just have to keep going for several hours without a moment to spare.

Then patients start arriving; and some of them late, bringing lists of problems, pouring out their souls through floods of tears. Expectations, sometimes demanding. Once again, I end up running late and get increasingly stressed. Patients get disgruntled; my apologies seem pointless – there’s nothing I could have done and they don’t seem to understand why they’ve had to wait – it’s not my fault. The emotional content of the morning eats into my energy as I empathise with sadness and try to sort out the complexities presented to me. My inner feelings run between frustration at use of appointments for very minor things and ‘DNAs,’ then helplessness when I can’t solve the issues in front of me; either there is no simple solution or the system is too restricted, pressured and failing to allow me to act in the required way. No time to stop to get a drink or go to the loo…keep pushing through…I can pause soon.

Finally, the last patient leaves. Phonecalls to do then out on the visits. Pause for a moment of quiet first; check a few blood results in peace and read about the patients I will be visiting. The 4 walls of the morning are feeling oppressive now; get out of the room, say hello to some colleagues. How can you feel lonely when you’ve spent all morning talking to patients?

Time is going on; must get out on the visits to do them in time to get back for afternoon surgery. Make a dash out the door. Visits get done trying to balance giving the time they need with the lack of time available. Get back with 15 mins to go before the first afternoon patient. Just enough time to nip to the shop and get some lunch.

Here we go again. The morning scenario all over again. I’m not sure I can do it. Brace myself once again. Not had time to write the visits up and action them yet or eat lunch – just end up grabbing a bite here and there between patients.

At last the last patient leaves and the phone calls are done. I’m utterly drained. Now there’s just all the admin to do; prescriptions to sort, bloods results and incoming letters to read and action, referrals to do, medical reports to write. Before I know it, another 2 hours have passed and I’ve still not finished. But I’ve worked 12 hours and I really can’t face any more today. I head home knowing I’m still behind and this weighs on my mind. The children are already in bed; and part of me is glad because I missed more of the battles, tantrums, cries, noise and demands which I know I would have struggled to cope with.

Now to get stuck in to a couple of hours of housework before bed. No energy left to make dinner – something quick to grab will do.

But I’m fine really. Just busy and tired but everything’s OK.

*****

Another day at work

Here we go again. Have I actually been home?

The morning goes similarly to any other, but then it’s my turn to be on call.

Make sure a cup of tea ready before I get started. And preferably some chocolate to keep me going and cheer me up.
The phone call requests come in thick and fast. My heart sinks as I wonder how I will ever get through them all. I look at the appointment screen to see what we might have to offer; there’s only a few slots left. Fingers crossed I can deal with most of it on the phone.

Let’s get cracking. 6 phone calls down. It’s going OK.
A knock at the door. An urgent prescription to sign.
On we go. Into some notes and pick up the phone.
A knock at the door. Put the phone down. Some paramedics are with an unwell patient – phone them next. Swap the record in front of me. Sort that out.
On we go. More tea and chocolate.
A knock at the door. A district nurse needs a palliative care drug chart writing straight away.
The screen is filling up with work to do and I can’t keep up. Scan through to see which ones look most urgent and may need the remaining appointments.
On we go.
Somebody has walked into reception with a bad asthma attack.
Drop everything to get them sorted. Half an hour later and we’ve got on top of that interspersed with the odd phone call.
On we go. No appointments left and there’s still 2 hours to go.
Keep going, keep going. More tea. More chocolate.
Willing 6.30pm to come now so the phones go off and no more can get added to the list as I’m flagging.
On we go.
Sigh of relief; it’s 6.30pm. It can’t get any worse. Now just to get through what’s left to do. Still going through the list an hour later; most of the patients don’t seem to notice that you’re phoning after ‘work’ hours.
Then all the usual admin.
Late home again.
Missed the children’s bedtime again.
More housework to do.
Then flop into bed.

But I’m fine really. Just busy and tired but everything’s OK.

*****

A day ‘off’

Rudely awoken by the loud noise of young children waking up then immediate loud demands. Wishing for a bit longer of rest and quiet but it’s not to be.
Yes, the same as every day.

No work or nursery today.
Soon starts the battles, tantrums, cries,ย noise and demands. They are only little – it’s not a surprise. But I’m just so tired, it’s hard not to handle it badly. I have so little patience and energy. I feel I gave everything to the patients and there’s not much left for the family.

The day goes on with more battles, tantrums, cries,ย noise and demands.
Interspersed with housework. Always so much to do. Always such mess. Often ignoring the children but it has to be done.
What a terrible parent; we’re doing so little. The TV stays on too much; it’s the easiest way to get through the day. The only way the toddler stops the constant loud demands over and over again. I just want a break from all the noise.

Eventually bedtime. Thank goodness for that. The end of the battles, tantrums,cries, noise and demands. At last quiet. What guilt to be glad to be away from the children.
More work to do until time to stop to sleep. No time for myself or relaxation.

Prepare for another day at work tomorrow.

But I’m fine really. Just busy and tired but everything’s OK.

*****

Back to work

Prepare to get stuck in as normal.
But something feels different today.

My colleague says hello first thing and asks how I am. I start crying. Where is this coming from?
Manage to pull myself together and get through the morning.
Another colleague asks how I am at lunchtime. I cry again. What is going on? She takes me to her room and I weep for a while.
She thinks I’m low. Maybe I am.

But I think I’m fine really. Just busy and tired but everything’s OK.

*****

A few days later, I run out of steam.
I stare at the computer screen and pile of paperwork and can’t make myself do anything.
Eventually I give up as I’m not achieving anything. I pack up my things and put the paperwork back in my pigeonhole.
Then I realise the children won’t yet be in bed. How awful, but I can’t face coping with those battles, tantrums and cries.
I’m fed up of constant noise and demands. All of my life feels like noise and demands.
I sit down in reception. Suddenly utterly drained. Weak tears. Stare into space. There’s nothing left. I’m empty.

The balance has tipped. I’ve reached the edge. I’ve crossed the the line.

I’m not fine really. More than just busy and tired. Everything’s not OK.

3 thoughts on “Where is the line?”

  1. Very moving and equally disturbing that this must be the reality for many GPs. Such a stressful and important job, long training, massive responsibilities. Really valued by many of us but sadly used and abused by others. We need to train more doctors so that the weight of care can be shared out, allowing more quality patient/doctor time and a better work/ life balance forGPs. Thank you to all health professionals who do an amazing job under very difficult circumstances.

    Like

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