Why do those who work in healthcare, some of our most compassionate people, lose their empathy?

In her TED talk Sammy reveals how tough things are on the frontline for NHS doctors and speaks candidly about her struggle to keep patients safe.

The first NHS winter crisis had hit and it was a war zone. The waiting room was standing room only. Trollies lined every corridor. Resus was overflowing. Ambulances stacked outside the doors. Every shift was fighting fires we could never get on top of. I lived in constant fear, knowing, as exhausted and run ragged as I was, eventually I was going to miss something. And boy did we have our near misses.

Dr Samantha Batt-Rawden TEDxNHS

Sammy explores her research into empathy, and explains how and why doctors’ empathy takes a hit during the early stages of training, and never fully recovers. Introducing the concept of moral injury Sammy explains the psychological toil that working in a broken systems takes on a doctor. She suggests that being unable to provide patients the with the care they need results in moral injury, and over time this leads to burnout and a loss of empathy.

Take a bright eyed healthcare student and put them into a healthcare system. It will change them. Sleep deprivation, long hours that isolate you from your friends and family, the blame culture, bullying…the dark side of medicine. It’s the best job in the world, right? But it comes at a price.

Dr Samantha Batt-Rawden TEDxNHS

Speaking of her own experience of burnout she argues that the resilience movement has placed too much onus on individual doctors, allowing the system to avoid all accountability for putting employees into a broken system and blaming them when ‘they inevitably break’. She argues that resilience should not be simply a personal responsibility but a ‘team sport’. Calling for a widespread culture change Sammy argues that unless we start looking after our doctors, we will have no-one left to look after our patients.

Speaking about her own journey, Sammy talks openly about finding herself on the other side of the NHS after going into premature labour as an A&E Registrar. After her son Joshua was born at 27 weeks, Sammy talks through the worst day of her life, when her son needed to be resuscitated and his life was in the hands of her colleagues.

Then a face around the door. A consultant we had never met in. “I’m sorry, I’ve not got good news”. With boundless compassion and endless empathy he told us what had happened to our son.

Dr Samantha Batt-Rawden TEDxNHS

There was not a dry eye in the room as Sammy talked through Joshua’s heartbreaking journey through 3 months of intensive care. Paying tribute to the doctors and nurses whoshowed her family so much kindness, Sammy explains how this has forever deepened her already deep appreciation for the NHS, which saved her son’s life. After bringing Joshua home Sammy founded The Doctors’ Association UK, determined to fight for the NHS.

Watch the full talk here on the TEDx platform:

Dr Jenny Vaughan, DAUK’s Law and Policy Officer and Learn Not Blame Lead spoke at SMACC in Australia about the blame culture in the NHS and when healthcare becomes a crime. Listen to the podcast below on the Coda Change platform with accompanying slides.

Speaking to EM trainees and the Royal College of Emergency Medicine alongside EMTA rep Dr Mark Winstanley, Sammy argued passionately that the resilience movement puts too much blame on individuals whilst “allowing organisations off the hook” for putting doctors in poor working environment.

She argued that teaching doctors to be less upset and angry working in broken systems is not resilience, but compliance, and does a disservice to our patients who need us to speak up about unsafe working conditions.

The debate saw “most minds changed” and the motion ‘resilience is rubbish’ was passed 60% to 40%.

DAUK will continue to work with RCEM. It was an excellent 2 days organised by EMTA and we were delighted to be invited to attend.

More about EMTA and the brilliant work it does on behalf of trainees here:

http://www.emtraineesassociation.co.uk

Dr Batt-Rawden was also to join a panel on patient safety, which Jeremy Hunt was also scheduled to appear at, but unfortunately the former secretary pulled out at the last minute.

In her speech to the Westminster Health Forum Sammy outlined the Bawa-Garba case, which saw a paediatric trainee scapegoated for widespread system failures. She went on to explain how this became a lightning rod for the medical profession, with doctors feeling ‘on any given day in the NHS that could have been me’.

Sammy went on to explain that the fall out from this case has been disastrous; that DAUK had heard from hundreds of doctors wanting to quit, or had quit the NHS saying it was “no longer worth it”, doctors leaving specialties deemed “too high risk”, specialties like Emergency Medicine, Intensive Care, General Practice, which are already short and desperately need them.

Sammy made the point that the blame culture is no doubt a cause for low morale in the NHS and likely contributing to a staffing crisis, which is being compounded by a punitive pensions tax.

Outlining the impact on patients, Sammy explained that the blame culture is changing the way doctors practise, and making the NHS a less safe space to speak up when things go wrong. Sammy also spoke about our Learn Not Blame campaign and what DAUK has been doing to address the blame culture in healthcare.

The session was an overwhelmingly positive event, with many speakers including Leslie Hamilton referencing Learn Not Blame and our work in this area.

You can now listen to Jenny’s full speech as a podcast on the ICS site, including advice on how doctors can avoid litigation.

Dr Vaughan said ‘My main message is watch out for that first SUI and check any statement with your defence organisation. Watch out for any manipulation of the process and ensure you see a copy of the draft report before it’s finalised. Do not get stuck in staff canteens with seniors who ask you to admit your errors. Seniors must support trainees and they have a supreme duty to train and admit their own shortcomings as part of #LearnNotBlame.”