When admin gets in the way of real work
For those of you who don’t know, [CM] is a doctor and works at a particular Sydney hospital.
Healthcare, as a system, has always been this complicated mess of institutional problems due to a hundred different agendas. It doesn’t help that hospitals are festering grounds for bullying, sexism, and racism as well.
Yes, you hear a lot of great stuff on the news about happy stories– miracles and good positive things that make you feel good to your core. But the everyday churn of hospital work is a very complicated love-hate relationship.
A few months ago, CM messaged me, in a tone where she uses my first name and I know either she’s really mad at me or something is wrong.
Turns out she was crying.
A particular administrative department which is meant to support residents had scheduled her so that she was was working night shifts up to the day that she would be taking her vacation time for our wedding celebration.
Normally, if you do a week of night shifts, the hospital can’t schedule you to work for one week. It’s the “7 days on, 7 days off” rule. CM had scheduled a work week off leading up to the wedding so that she could spend time with out of town guests and simply make last minute preparations. She’d specifically requested the week off, giving the admins the explanation that she needed time to prepare for the wedding, etc.
But what the admins were basically doing using the normal 7 days off to overlap on her paid days off. Which is bullshit. Basically that means, “Oh, you’re taking 7 days off? Why don’t we ruin all of that by making you work nights in the week leading up to it, so you’ll just spend those 7 days being jet lagged and sleeping during the day. And since you’ve already requested to be off, we won’t even have to give you any extra time off (paid or otherwise).”
It’s a pretty dick move to do.
But that’s just the start– when she called the admin department and asked how they could do that to her– where was that 7 days on 7 days off rule? They blamed CM for not having made a special request to not work nights.
So… do the wrong thing by your own internal policies, and then blame the victim. Yeah, good job, hospital.
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I started working in hospitals in the early 2000s, and only stopped working in hospitals about a decade later when I moved to Australia. If you go through the extremely old archives of this blog (the posts that were conversions of my old archives from Xanga) you can even find quite a few of my stories from working in hospitals– it is gut-wrenching and soul-crushing at times, and I largely think that working in that environment shaped me to be the person I am today.
I’ve only now thought about it, but one of the reasons why I was so guarded about what I would post about my work in hospitals was because of the fact that I was afraid of being fired. Actually, I twice had to make decisions to work in different units after significant policy arguments I had with my managers.
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I’m no longer in my 20s, and I’ve been working as a full time lawyer for some time now. Now that I’m older and have been around the block more, I understand now that fighting the system from the inside isn’t the only way to do things. In fact, it’s a hella lot of work and if the right people aren’t listening, you’re just going to get marginalised as a troublemaker. Actually, because I stood up about employmee rights issues and bad management, I was essentially forced to switch hospitals once, and to change departments twice.
There was some truth to what I was complaining about, but it’s more easy to see in retrospect, especially from the eyes of an employment lawyer, how these are institutional issues that are coming into being because of the corporate structure of the typical hospital system. It’s even more obvious now that I’m out of hospitals and work in law fulltime, with only CM’s stories about how things play out. When we have dinner with other doctor friends, 1 time out of 4, someone will be asking me “Can they do this to me?”
The answer is, yes, they can. But not legally. But the problem is always going to be that delicate balance between what weighing up your rights versus how far you want to get in your career.
At a motivational speech when CM was still in med school, one of the female speakers recounted how she was sexually harassed and bullied by a doctor during her early years. She spoke up about it, and went through the whole process– and then, her career never went forward. She was passed up for promotions and research opportunities. Her advice to the audience? “Don’t complain.”
Which is ridiculous. Hollywood is largely to blame for this idea that doctors are godlike beneveloents whose only worries are personal dramas and saving patients– in reality, a lot of the everyday is struggling against the institution to simply be allowed to do your work in a safe environment.
I’m not making this stuff up either. I’ve recently been made aware that one of the hospitals that CM worked at actually has a webpage about it: http://www.westmeadhospitalwhistleblowers.com/ “Westmead Hospital Whistleblowers”.
Have a look, and understand why when you go to a public hospital, sometimes the service is simply shit.