The Nation's Health

Stressed Out

You'll find that normally, when I'm talking about the Daily Mail, it's under the heading of the 'Daily Fail' and I'm generally less than complimentary about their flawed research and criticism of people who should be getting praise. This time however, their article about sick leave for stress in the ambulance service is mainly factual and really highlights the issue. Obviously, the headline calling us all 'ambulance drivers' made my blood boil but that rant is for another day! So, the article in full.....


The number of sick days taken by stressed-out paramedics has soared by 40 per cent in two years.
New figures released by ambulance trusts show they took 43,680 days off because of stress during 2011-12 compared with 31,268 in 2009-10.
The number of ambulance workers suffering from stress has also increased by 42 per cent during the same period, from 728 to 1,035.
Union bosses say the widespread closure of hospital A&Es and rising numbers of 999 calls has taken its toll on ambulance crews, who are breaking down under the stress of the extra workload.
Research by The Mail on Sunday has revealed 33 casualty units across England and Wales have either already closed or are under threat of being closed or downgraded.
The number of 999 calls has also risen by more than ten per cent in a year for most ambulance trusts across the country.

Adrian Gilbert, Acting General Secretary for the Association of Professional Ambulance Personnel, said: ‘Ambulance staff are run ragged on shifts and it’s no wonder the number of staff off for stress has increased.
‘They are coming in to do a 12-hour shift and instead it has gone on for 14 hours. You have got hospitals closing A&Es across the country and this means ambulances are having to go farther afield.
‘So instead of a five-mile journey to the nearest hospital, it can sometimes be a 25-mile journey.
Threat: There are growing concerns that closures and increasing numbers of calls are having an affect on drivers, as research shows that 33 casualty units across England and Wales have either already closed or are under threat.
‘If there are three or four vehicles out of the area, it means the ambulance crews who are still in the area are being run ragged.’
The new figures come after a Freedom of Information request to England’s 12 ambulance trusts.
Last week Shadow Health Secretary Andy Burnham revealed ambulances were being forced to wait with patients outside A&E for more than five hours – because of congestion inside.

It is a massive problem and one which can't be ignore, however, I don't think it's as simple as blaming it on being run ragged. There are a number of factors involved in the high and rising amount of stress leave taken, some that won't change and some that will.

As eluded to in the article working conditions plays a huge part. 14 hours without a recognised break is a major problem and as highlighted in various news articles about crews being on rest breaks, there is no easy solution. Well, there is, give us breaks! Playing devil's advocate though, for so long, the ambulance services have become accustomed to have the staff available all shift, that if you suddenly take them away, there would be a huge shortfall in resources.

Being at work with no breaks, alone, isn't the cause of stress but the culmination of things that are done to make our days harder all add up. Waiting for hours in the corridor in hospitals is frustrating. Not our fault or the hospitals but for the hospitals to ban ambulance staff from drinking tea or coffee and refusing to allow us to heat up food in their microwaves means we are left with only cold food and drink for 14 hours when it's minus 3 and we have to wear short sleeved shirts!

Then there is the job related problems. Arriving at scene 3 hours after someone called an ambulance and getting the ear bashing. Chasing your tail for hours on end with cancellation after cancellation, being refused to be stood down to go to the toilet despite not being at a hospital for 5 hours. Being made to transport patients with the fuel light on because you've had 4 requests for fuel turn down. Having your activation times monitored, being harassed to make yourself available quickly at hospital and being badgered when you have spent to long on scene with a patient. Then there is being rushed out at the start of the shift without all the kit you need and the guarantee of NEVER finishing a shift on time. EVER. On their own, they are no real biggie but when it's ALL happening every single day, combined with some of the horrors we see, the abuse we take and the emotional turmoil we can be involved with, it is of little surprise so many are off sick. Or even worse, throwing the towel in all together.

Finally, there is the issue of sick leave in general. The ambulance service has a tradition of high sick leave. No surprise when we are around sick people all the time and don't eat properly but also because of the way sick leave is managed. There is a huge fear of being off sick because of the disciplinary procedures that are in place. If you are off for a week with Norovirus in December and then in January you get another bout of D & V and are off for another day, you start the disciplinary procedure. Another other time off in the next 12 months and the disciplinary process will be escalated. I was hospitalised whilst at work a while ago and came back to a rather threatening letter in my pigeon hole. This is just one example of many which I think go a long way to causing people to work on regardless until they are burnt out. The other issue this policy raises is that of people playing the system. Across every service there are the people who are off for long periods every year, often with stress, and do so year in and year out. Stress is something that can easily be faked and allows people to be off for considerable time with little consequence. The ambulance service has become a victim of it's own management strategy which targets the wrong people.

With all factors at play the amount of sick days will continue to rise year on year. Like everything within the NHS there is too much focus on cure rather than prevention and because of that, it's the staff that are targeted for multi-agency failings and this in turn leads to a workforce of disillusioned, down trodden, tired people.

http://www.dailymail.co.uk/news/article-2272517/Stressed-ambulance-drivers-43-680-sick-days--40-rise-years.html#axzz2Jp4ocYMu