The RCSI recognises that Surgeons and Emergency Medicine doctors may face stressful situations on a daily basis. Coping with the demands of a busy profession, maintaining skills and knowledge and balancing family and personal commitments can be difficult.
Doctors like the rest of society, can struggle with depression, anxiety and poor mental health. The work environments Surgeons and Emergency Medicine doctors find themselves in may also contribute to high levels of stress due to administrative processes, fear of litigation and inappropriate behaviour such as bullying, discrimination and sexual harassment.
Generally speaking, we find ways to bounce back with little to no assistance, however, if problems are persistent, we recommend that you take action to restore your wellbeing. Below is a list of resources that are available to you to help you deal with these situations as they arise.
Register with a GP who is neither friend nor family and who will ensure that professional boundaries are maintained in all decision making.
Though you will have your own thoughts on diagnosis and appropriate interventions, bring an open mind to the consultation and just ‘be a patient’.
An Irish study on GP trainees found that 57% had informally consulted a colleague regarding their health needs and 35% had referred themselves directly to a consultant, bypassing their GP. Furthermore, 92% had self-prescribed on at least one occasion. This is ill-advised as it results in compromised level of care.
Most GPs are very comfortable with treating doctors as patients and are registered with the HIP Network (http://www.icgp.ie/go/in_the_practice). You may contact the network to find the name of such a GP in your area if you have not already registered.
Additionally, the service:
The service, which is free of charge to all HSE Employees, is provided by trained and experienced counsellors who are professionally qualified and bound by the codes of conduct to the professional bodies to which they belong. There are three pathways by which an employee may access the employee assistance service:
Matters raised in individual cases are confidential and are not discussed with managers.
Your line manager will advise you of the contact details for your local service.
For further information please visit Employee Assistance and Councelling Service
All public hospital employees in Ireland now have access to occupational health services. These are based on site in the larger hospitals or accessible off-site in some areas. Each is clinically led by a specialist / consultant occupational physician who provides a service with a team of nurses and administrative staff. All work closely with physiotherapists who can ‘fast-track’ access to treatment for musculoskeletal disorders (MSDs) and also have access, directly or indirectly, to counselling support services, which may or may not be on site.
Occupational health deals with the interface between health and work but encompasses a broader remit of work and work environment (including psychosocial environment), health and ill-health as well as life and lifestyle.
A very strict code of ethics underpins occupational health practice). Occupational health professionals are mindful of the importance of respecting confidentiality. They have a particular skill in communicating effectively with employers and managers on fitness for work issues without disclosing confidential health details.
The Occupational Health Physician is a doctor who has a specialist qualification.
Occupational Health Physicians use medical expertise to assess fitness for work, advise on workplace adjustments, prevent ill health and promote health and wellbeing.
They play a key role in rehabilitation by advising on optional treatment strategies.
The Occupational Health Nurse is a nurse with additional qualifications who specialise in the provision of occupational health services in the workplace. They provide advice and support on the management of health and wellbeing in the workplace. They are specially skilled in the areas of health leadership and management, fitness for work, health risk management and employee wellbeing.
The full listing of occupational health services for each Community Health Organisation and Hospital Group is available by clicking on this LINK.
If you have any queries in this regard, please e-mail hr.wellbeing@hse.ie
There are two pathways to availing of the Occupational Health Service; you have the option to refer yourself directly to the local service or through management referral.
To 'self refer',simply contact the clinic directly.
To 'self refer', simply contact the clinic directly. For a management referral, CLICK HERE to download the standard management referral form.
New national standards for quality and safety in Occupational Health Services were launched in 2017 at the first annual conference of the Workplace Health and Wellbeing Unit. Click here to read or download this report.
Absolutely, as a staff member you can contact the clinic directly to avail of this free service.
Your file has been referred to the OHS by your manager for the purpose of an independent review of your health in relation to your work.
Sometimes it is not necessary and OHS can make a decision on whether is necessary for you to attend or if a paper based decision can be made about your fitness for work.
You will attend an Occupational Health Practitioner either a nurse or a doctor - whose area of interest and qualification is work, health, ability & disability and any circumstances where work and health interfere with each other.
Most people are happy to attend OHS, and find the consultation very helpful and supportive. If you decide not to attend, your manager will be informed of your decision. Your case will be further progressed by your manager without the benefit of medical advice.
It is likely the Occupational Health Practitioner has been sent a referral note by your manager asking him/her to address certain issues relating to your health and fitness for work. The Occupational Health Practitioner will start the assessment by discussing your role in work and your occupational history and will then proceed to assess the reason for your referral, the nature of your medical complaints and associated work absence. At the end of the history taking, if it's appropriate the Occupational Health Practitioner may do a physical examination.
Everything that goes on in the assessment is entirely confidential, between you and the Occupational Health Practitioner. You can tell the Occupational Health Practitioner anything you like during this assessment and you may be reassured that nothing will be disclosed to any other party without your consent. In the report to the manager the OHS will not disclose personal or confidential information. The OHS does however provide an opinion and relevant details including fitness for work and necessary restrictions and accommodation in the workplace.
Please bring with you the name of any medication you are taking, details of your GP and hospital Specialist, copies of any letters written to your GP by the Specialist, if you have them.
The Occupational Health Practitioner will write a report to your manager that will include, recommendations regarding your fitness for work and likely timescale of return to work and any adjustments/restrictions required. This will help your manager to know how to accommodate your needs in the workplace.
Yes, you may request a copy from your manager or you may request a copy of the report on applying to the Occupational Health Service in writing, citing the Data Protection Act.
Yes, you are welcome to take a friend or relative with you if you like.
The National HR Employee Helpdesk aims to provide individual employee support in partnership with local HR Offices and the Employee Relations Advisory Services (ERAS) and to serve as an additional conduit for keeping employees informed, involved and included. The Helpdesk is in the early stages of development. There are significant opportunities to grow the portfolio of services available to employees throughout the HSE and to tailor services so that they maximise potential benefits from using social & digital media to communicate with all staff. In developing a professional HR Service that is technically competent and responsive to the needs of the organisation, the Employee Helpdesks initial focus will be to serve as a primary HR point of contact for any employee regarding benefits, terms & conditions of employment and grievance and disciplinary processes. The objectives of the Helpdesk are to:
Contact the Helpdesk on 1850 444 925, Monday to Friday, 8am to 5pm or email ask.hr@hse.ie They are also on Facebook – search for HSE HR SAYS.
The Workplace Health and Wellbeing Unit aims to improve the general health and wellbeing of staff in the Health Services and support more people with health conditions to stay in work or enter employment. It works to create healthier workplaces, improve occupational health services and rehabilitation support, and increase employment opportunities for people who are not in work due to ill-health or disability. It aims to implement all elements of a positive workplace, including appropriate supports for both staff and management in relation to stressors in the workplace.
For further information please visit:Workplace Health & Wellbeing
The Medical Council has established a Health Sub-Committee which monitors and advises Council about the health of individual doctors who have relevant medical disabilities.
The Committee was formed under Section 20(4) of the Medical Practitioners Act 2007 to support and monitor those medical practitioners
The underlying principle behind the establishment of this Sub-Committee is to support doctors in the maintenance of their registration during illness and recovery, where there is no patient risk that could be subject of a complaint.
As such the Sub-Committee also continues to offer its support and advice to medical practitioners referred through third parties or self referrals. Referrals are treated as confidential within the Sub-Committee, and may be useful as a support not only to the doctor with an illness, but also to their treating doctor
There is good evidence that doctors with health related problems, especially substance misuse, have good outcomes with the correct interventions, balanced on occasion with the involvement of the relevant regulatory authority.
Fortunately, most doctors are in good health, but they are subject to the same illnesses as their patients. Doctors are not immune from an array of illnesses, for example, infectious disease, cardiovascular disease, neurological disease, mental illness, addictions such as alcohol and drug dependence, nor indeed ageing and cognitive decline.
Most doctors who suffer illness will recognise that they have an illness, will attend their General Practitioner, Consultant or Occupational Health physician and comply with the appropriate treatments and recommendations. This may include taking time off work or indeed changing the nature of their work, either temporarily or permanently.
The majority of doctors with health problems will therefore have no need to have any involvement with the Medical council or it’s Health Sub-Committee. Unfortunately, some with illness will not have such insights, may be in denial, or delay seeking treatment for some other reason. In such cases, their illness may impair their practice and indeed harm patients. It is this latter group of doctors who may be reported or referred to the Medical Council’s Health Sub-Committee.
Are you concerned about your health or the health of another doctor?
If you have concerns about your health or the health of a doctor you know please consider the following options;
The Medical Practitioners Act 2007 (MPA) sets out in a very formal way, the regulatory pathways of referral to the Health Sub-Committee. The underlying principle behind the establishment of this Sub-Committee is to support doctors in the maintenance of their registration during illness and recovery, where there is no patient risk that could be subject of a complaint.
As such the Sub-Committee also continues to offer its support and advice to medical practitioners referred through third parties or self referrals. Referrals are treated as confidential within the Sub-Committee, and may be useful as a support not only to the doctor with an illness, but also to their treating doctor.
The Sub-Committee has a wide range of expertise amongst its membership but especially in relation to mental health issues and addictions. There is also a range of external expertise available to the Sub-Committee for a variety of other illnesses, if required.
Due to the wording of the MPA, any complaints regarding medical disability must currently be referred to a ‘Fitness to Practise Committee hearing’ by the Preliminary Proceedings Committee. In cases where a referral to a ‘Fitness to Practise’ results the doctor can apply for the hearing to be held in private.
A third party referral or self referral to the Health Sub-Committee is not subject to Fitness to Practise procedures, unless there are patient safety issues involved.
For a guide to the Health subcommittee click the following LINK
www.mitss.orgis a non-profit organisation that supports clinicians and patients who have been involved in clinical errors or adverse medical events. They also have good support tools for organisations hoping to implement support services.
Beaumont Hospital’s Mindfulness and Relaxation Centre has good information and downloadable apps found HERE
This is an interesting training programme from the US for Anaesthesia trainees using Pearlin and Schooler’s hierarchy. Details can be found HERE
Psychologists at the Australian National University have developed MoodGYM, an online resource that teaches cognitive behavioural techniques for the management of depression and anxiety. This is available free of charge to registered users. Details can be found HERE
Counselling or psychotherapy can help to improve coping abilities and reduce stress. Information on local services is available from your occupational health department.
The Money Advice and Budgeting Service (MABS) is the State’s money advice service, guiding people through dealing with problem debt for more than twenty years.
They have a proven track record in helping people get back on their feet. All kinds of people, with all kinds of debt go to MABS. Their expertise is with personal and consumer debt; while they can give some limited help with debt arising from a sole trader or partnership business and also make referrals to CAVA, they cannot advise on company debts or on the accounts of a business.
You can use the many valuable tools and resources on their WEBSITE if you think that you would prefer to manage things yourself.
Their Helpline is open Monday to Friday, 9am to 8pm (0761 07 2000) if you would like to have a chat. Many of their clients use a combination of web and Helpline to negotiate themselves with their Creditors, whilst others use these as a first step to attending at one of their offices.
Their face-to-face service is available in more than 65 locations nationwide. Due to heavy demand, from time to time, there may be a waiting list; in truth, no one in crisis ever has to wait.
When you call the Helpline, or call one of the offices, you will be asked for a little information about your situation. This is done to help them determine how best to help you, and how urgent your situation is, so you see, if you are in the middle of a crisis, you will not be left waiting.