The other day I sat next to a senior midwife who told me that none of her fulltime staff is under 45 years of age. The younger midwives find fulltime work too tiring. Another told me that she was at the conference in her own time, and that midwives who want to attend a function I am organising in a couple of weeks will need to do so on their days off. The midwife establishment and staffing levels just don’t allow for much in the way of release for training, sickness or days off. On Thursday I needed to speak to a local Head of Midwifery, her PA told me that she was on annual leave, she had been into the unit that morning till 11am but had gone home now (it was about 1pm at the time). Nurses who blog on the internet also describe a long hours culture, one where people take no breaks and hardly have time for a glass of water or trip to the toilet in 12 hours. Even within the office environment it is considered more important to meet your deadlines than anything else even if meeting that deadline means staying till 6pm or more likely taking the work home and spending your evenings or weekends doing the work.

I am pretty sure that the individuals working long hours in the NHS do so without particuarly being TOLD to stay behind, to work in their own time, but it becomes an unwritten rule it becomes part of the culture. One where if you don’t work in the same way as those around you then you won’t fit in, maybe the opportunities for promotion won’t occur and maybe that promotion would just involve even greater long hours working. What happens if the responsibilities you have outside of the workplace mean you actually need to leave on time? What happens if you have a medical condition that means missing meals or fluid are detrimental to your health?

Yesterday I visited my husband’s elderly granny in a hospital not far from here. The ward was full of elderly ladies, most of whom looked as if they had high levels of dependency. When we arrived her IV had tissued, the nurses came to her speedily, they took her observations, made adjustements to her care and detected that she was becoming hypothermic and acted accordingly. While this was going on, I saw only one other member of nursing staff on the ward. The care seemed to be good but I have to wonder about the pressure the staff are under on that ward. I came away, as I often do, wondering if I shouldn’t get back into clinical practice and do some shifts on a unit like this. Trouble is, my working week is pretty intense as it is. I have deadlines to meet, I can’t take breaks, though because I am desk (or meeting bound) there are opportunities for food and drink to be consumed. When I get home I am tired and sometimes there is work still to be done. Why on earth would I work extra in those kinds of conditions when I could be at home ironing and cleaning?

If the NHS pretty much functions on goodwill, what then will happen if that goodwill runs out?