NHS junior doctors suffer panic attacks and feelings of desperation because they get so stressed from the pressure they are under at work, research has found.
Some also experience intrusive thoughts, migraines and hair loss as a direct result of trying to give patients high-quality treatment in hospitals struggling with serious staff shortages.
The author of the study said some of the detailed accounts provided by junior doctors from across the UK of the realities of working in the NHS were “harrowing”.
Audio diaries recorded by 58 junior – or trainee – doctors over two months showed that the four leading causes of stress in their working lives were heavy workload, understaffing, a lack of support by senior medical colleagues (consultants) and conflict at work.
Together, those could leave junior doctors feeling anxiety and despair, said Sanjay Popat, a doctoral researcher into occupational stress at Leeds University business school. “The findings overall paint an alarming picture of the plight of today’s junior doctors. They highlight the harsh and unsustainable working conditions that junior doctors face in the UK, and show just how close many are to burnout early in their careers,” Popat said.
In 745 audio diary entries they recorded, the 58 medics mentioned high workload more than anything else – 339 times. That included the “excessive” administrative duties, large numbers of patients and long working hours they faced. The cumulative effect was “panic, despondence and desperation”, Popat said.
One doctor said: “It made me feel very panicked because they were all very ill. And they were close to dying, essentially. There was four patients that I was trying to handle at the same time; one that I was physically with, who was imminently in danger, and three others that I was trying to manage, like over the phone with nurses on the ward.
“And I just … felt like I was spread way too thin.”
Lack of backup from consultants often forced trainees to make complex clinical judgments they did not feel equipped for. The trainees felt “shock, guilt and panic” at how a shortage of staff was leading to poor patient care.
Surprisingly, though, pay – the issue that prompted the current three-day strike by junior doctors in England – was only the 18th most common source of stress participants mentioned, referred to only six times.
Those who did mention it said they felt their pay showed how little they were valued and that they did not feel recognised or appreciated for their work.
“I don’t get paid enough to have people die on my watch. And be like verbally or physically assaulted by patients … I know there is pay progression as you go up, but I don’t think it’s enough,” one foundation 1 junior doctor said.
Another said: “It’s that sort of feeling of, like well, we don’t value you, we don’t value your time, [and] we don’t value your night.”
The findings tally with those of a recent survey of 2,989 junior doctors in England by the British Medical Association, the main doctors’ trade union.
It found that 78% of junior doctors had felt unwell in the previous year because of work-related stress and that 51% said their desire to work in the NHS for the next year was “low” or “very low”.
The NHS in England is finding it “difficult” to cope with the ongoing 72-hour strike by junior doctors, which is delaying patients getting into and out of hospital, a health service leader has said. “So far, so difficult for the NHS”, said Sir Julian Hartley, the chief executive of hospitals group NHS Providers.
“Senior doctors are stepping into the breach but it isn’t business as usual. For hospital patients that means it’s taking longer for admissions and the discharge process is also slower. Ambulance handover delays are up too.”
But consultants filling in for junior colleagues “isn’t sustainable. We can’t go on like this”, Hartley added.
A spokesperson for the Department of Health and Social Care said: “Supporting the mental health and wellbeing of the NHS workforce is a priority for this government.
“The NHS is providing ongoing mental health support for staff, including targeted psychological support and treatment and a national support service for those with more complex mental health needs.
“The NHS will publish a long-term workforce plan this spring to recruit and retain more staff and make the NHS a great place to work.”
