Christmas 1976: my father was covering the labour ward for our local hospital. Stories of that time recall a collegiate feeling around the hospital – a full roast turkey with all the trimmings brought on to the ward courtesy of the hospital. My father, being given a chef’s hat, an apron and a knife and asked, as the surgeon, to carve the turkey for all the patients and staff on the ward for a meal together.
From my father’s wistful description, it sounds altogether like a jovial occasion where, despite being at work, the system recognised that Christmas was different. Obviously there was a sense of duty but also a real recognition that being at work when everyone else was with loved ones was also a sacrifice. Staff were not paid more for working over the festive period – but they were made to feel valued.
Since becoming a doctor a decade ago, I have always expected to work over the festive period and bank holidays. In some ways, I have seen it as a valiant effort and, from my father’s experiences, believed that a working Christmas would be spent in that fuzzy, warm, joyous environment, even if it was away from my loved ones.
But much has changed over the past 40 years since my father was that doctor in the NHS. The environment and expectations are sterner, tougher – and resources are scant.
There is always frenetic activity in the weeks leading up to Christmas. Clinics are overbooked and often overrun to counter the impact of reduced routine services over the festive period – and of course there’s the constant pressure of ensuring emergency services are adequately staffed.
This year in the run up to Christmas, NHS England has asked hospitals to defer routine surgery so that overnight stays for patients can be reduced to make space for emergency admissions. This is a reflection of our ageing population and the mismatch between the health and social care system, which struggles to either send patients home with care packages or keep them at home with chronic conditions.
NHS staff are often in “survival mode” trying to keep the system afloat and this can become particularly evident at Christmas. Anyone who is in hospital over the festive period – whether it is as a patient, nurse, doctor or any other member of staff – would generally much rather be somewhere else given the choice. However, the vocation and the recognition that you can make a difference for someone lessens the blow of missing out on Christmas dinner and precious time with loved ones.
This Christmas, I will once again be the junior doctor on the labour ward – as I have been for many previous years. My time will be spent on the shop floor with my medical and midwifery colleagues looking after women during labour, delivering babies safely and caring for them after delivery. The labour ward is generally a joyful place at any time of year, but over Christmas it does have an extra special significance as we often make an extra fuss of the Christmas newborns, with hampers or gifts. Saying that, there can also be the less happy stories and all staff will do their very best, as they do at all times, to support the patients and try to make the sting a little less sharp.
There will be hampers of food that the hospital will provide to all wards, which contain the usual festive regalia of biscuits, nuts, crisps and chocolate. Some hospitals may even provide a canteen Christmas meal free of charge for staff – which from past experience is certainly not a roast turkey with all the trimmings but at least it’s a small gesture from your employer. We sometimes don our Santa hats or some tinsel to decorate our scrubs, and everyone brings in some festive food. There may even be some non-alcoholic bubbly around.
I may not have had the exact experience that my father did when he was a junior doctor, but the heart that keeps the NHS running is still there – from the porter, to the healthcare assistant, the cleaner, the nurse, the midwife and the doctor who will be working to care for those who might be welcoming their baby into the world, nursing their relative who is not fit enough to go home or managing an acute emergency. The NHS is 24/7 and despite all its flaws it will serve its patients on every day of the year, without fail.
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