We seldom work alone in medicine. Instead, we belong. We belong to a unit, a team, a group. As a member of this network, we gain a sense of safety, we fit in, know our place and gain purpose from it.
Maternity leave made me realise how important it is to belong. Within a few weeks of being away from work, I realised that I wasn’t indispensible, the ward got on perfectly well without me. This was a bitter pill to swallow. It’s not that I had grandiose ideas about my role within the team but somehow I had hoped that I would be missed. The reality is, that someone replaced me and life in the paediatric department went on. But if that was the case, if I no longer belonged there, then where did I fit in?
I am not naturally one of these yummy mummies; the ones who look fantastic in the park pushing their fancy prams in their super cool sunglasses and skinny jeans. In fact, I am the one who always looks completely frazzled, hair scraped back, child number one’s snot on my sleeve, child number two’s toothpaste smeared on my thigh, generally shouting “hurry up!” or “where is your shoe?”. I found baby groups and other such events pretty intimidating and as slipped into the darkness of postnatal depression I felt less and less like I belonged to the “Mummy crowd”.
Part of my recovery from PND involved returning to work. Once I got the sense of belonging back, my confidence grew and I regained a sense of purpose beyond just existing for my children.
Belonging as a trainee
As a trainee, it can be hard to feel like you belong to a particular department. It takes a while for people to get to know and trust you. Equally, you have to get your head around the workings of the ward, learn the names of all the team members, their roles and temperaments before you can relax into the job. And then, just as you find your feet and start to feel settled, the end of the rotation appears and you are expected to move on. This is particularly true for FY1 and FY2 doctors whose rotations are less than six months long and for trainees working less than full time who are not there as frequently.
So what can we do?
In order for trainees to regain a sense of belonging, departments should re-build a sense of community: sharing experiences, laughing together, eating together, crying together. In my first paediatric job, the whole team went for lunch together in the hospital canteen. It was fun; we would chat, laugh and take the piss. No one talked about work. As such we got to know each other well and created friendships beyond the job. This hasn’t happened in my last few rotations. Lunch has generally wolfed down during an x-ray meeting/ journal club or not eaten at all. There is nothing sociable about it.
Unless we all take steps to rebuild this sense of community, trainees will continue to feel undervalued and “used”. Here are some simple things we can all do, from today, to make a start.
- Seniors, lead by example. Invite your juniors to join you for lunch: a trip to buy a sandwich together, a bite to eat in the hospital canteen. Not only does it give the junior staff permission to prioritise themselves for twenty minutes, it also allows you to get to know each other. I once found out that my 6 ft 4” male registrar was a champion knitter! #nomorestereotypes
- Make your colleague a cuppa. (There is something really comforting about someone bringing you an unexpected cup of tea). Notice when they haven’t eaten. Recognise when they are tired and allow them to get off home after a nightshift.
- Give your colleagues personal feedback related to something they did. Show appreciation. For example “Thanks so much for trying that cannula earlier while I was busy. I know that wasn’t a great situation to put you in, but you did really well.”
- Try to make sure everyone gets something positive out of a day at work; this may mean pointing out learning opportunities, completing assessments or offering ad hoc teaching. This is about giving trainees some freedom to highlight their own needs and learn accordingly. We are all adults after all, not school children!
- Nights out are always a great way of sharing fun. Similarly, day time events outside of work offer similar opportunities for building team cohesion. The key here is to make sure it isn’t just a bunch of friends sitting in the pub together. Invitations need to be opened up to people who wouldn’t normally come out. These people may need some support or encouragement, but being included may really help them regain that sense of belonging. I am one of those people.
There are lots of other things we can do to make our trainees feel as though they belong. The key is starting now. I would be really interested to hear other people’s ideas on this topic. Please comment below.