A little insight into the ineffectiveness of NHS managers, bearing in mind that this is Maternity Services and pregnancy is our speciality.
Last autumn, one after another, 9 midwives announced that they were pregnant and would be going on maternity leave, for at least 6 months, March/April time. Congratulations flowed, and then the impact on the service began to be anticipated and we began to mention to managers that we could be in trouble if something wasn't done about covering the departing midwives hours. They did.................nothing, except send round a questionaire as we had been identified as being the employees most at risk of stress.
Then, finally they acted. The antidote to the loss of 9 midwives, or 45 shifts per week, is to command the community midwives to each work a shift, per fortnight, in the unit. Brilliant solution, what genius came up with that, it's really going to help, 10 community midwives, that equals 5 shifts per week, only another 40 to cover. There is a problem with this, I cannot adequately cover my caseload as it is, I'm constantly working an extra 2 hours here, half a day there, doing my paperwork at home, in my own time, and now they want to take a day away from me, it's not them who receive the brunt of this from women complaining about not being able to see me. They have shifted the majority of the care into the community as it is, our women rarely see their G.P's about the pregnancy, consultant appointments are rare, women are discharged earlier from hospital following the birth, even section Mum's go home after 2 days, of course this has impacted on our workloads, if they are not in hospital, we are visiting them at home. We have increased the homebirth rate as well, it's gone from about 1% 3 years ago to 8% now, who do they imagine staff these events, and who they think covers the work the attending midwives cannot cover due to being at a homebirth? Both within and outside the unit the midwives are stretched to the limit at the moment, and the result, the women do not receive the care they are due. It's not dangerous, lives are not at risk, but corners are cut, and the staff hate it. For the majority of midwives it is the care they are able to give which is the most rewarding, most satisfying part of the job, if we feel we are not able to give this we become disheartened. If we are racing from one woman to another care suffers, the woman suffers, and ultimately the service suffers as we will leave.
So congratulations managers, a pat on the back to the trust board. You had time to act, we all knew a 'crisis' (their word) was imminent, but you did nothing, not a thing. Now you have a service approaching meltdown. As you sit in your gilded tower, watching us little ants chase around trying to patch-up and cover for your ineptitudes, congratulating yourselves on what good little workers you have, don't think you won't feel the repercussions. It will be to you the letters of complaint are addressed, we will make sure of that. It will be on your desks that the resignations, notifications of retirement, and sick-notes, citing stress as the cause, will land, I expect that you already have the excuses, but we will know the real reason, your failure to plan effectively. Why should that surprise me?