Occupational Balance: do we practise what we preach?

Walking into the hospital where I work this morning I noticed a sign telling anybody with respiratory tract infection symptoms to stay away, to avoid infecting patients. I walked past the sign with a small cough and then blew my nose at the first available discreet opportunity. It seemed like the sign did not apply to me; it only applied to the public. During my first hour at work today I noticed a physiotherapist with a cough and a healthcare assistant with a cold. The only person to bat an eyelid at my coughing for the last two weeks was a Sister. She rewarded me with a dirty look, but said nothing. Despite frequent hand-washing, the likelihood is that I was infected by a colleague and my inconsiderate behaviour will have in turn infected many of my colleagues. The next person to use this keyboard will probably be infected, as will many others afterwards. Why have I come to work then?

If I stayed off work until free of infection, I would have been off for 3 weeks so far. I am afraid that I would have been marked as ‘a skiver’. In contrast, it seems to me that people that come to work when they are very ill (and highly infectious) are seen as heroes. Far from it, they are villains, just as I am a villain now. The right thing for me to do would be stay at home to protect other people from my germs, and not worry about what people think. Disregarding my sense of morality I have come to work to protect my reputation and career; this is purely selfish and does not reflect ethical reasoning becoming of a health care professional. This behaviour also neglects the likelihood that rest may have shortened my illness by increasing my ability to fight the infection. Why am I thinking like this?

It feels to me like NHS staff are being blamed for their sickness[1]. Smoking and obesity trends amongst NHS staff have for example been highlighted in the national press[2]. Well, I can honestly tell you that I have never smoked or been obese. Perhaps my sickness has more to do with working in a pathogen-rich environment with infected members of the public and staff that (just like me) continue to come to work even when they are sick. Being underpaid for the amount of stress I endure at work might also have something to do with it[3].

Speaking of high stress for low income leads me to reflect on work-life balance. Do you actually get any time for continuing professional development during your working hours, or do you do it at home? What about research analysis and all that other stuff we are expected to do? How often are you really given any time to do that at work? Are you expected to take your occupational therapy career home with you? Looking at some very basic health advice, I cannot even afford a mortgage (this is itself a significant risk factor for poor health[4]) so I am sacrificing my diet to save money (no 5 portions of fruit a day for me[5]), and as for 30 minutes of physical activity at least 5 days a week[6], errrm, do I have 2 and a half hours to spare? Perhaps, but at the moment I feel a little like the cardiologist I watched eating a full English fry-up for breakfast in the hospital canteen this morning. I find myself needing to drink Coca-Cola to get through my working day. I consider this to be caffeine abuse[7]. It is a sign that I am not taking enough rest. To top it off, after a particularly hard day at work, there is nothing I look forward to more than rich chocolate ice-cream and Armilar tawny port. These are maladaptive compensations for not having enough fun in my life and not being able to relax naturally. Occupational therapist, treat thyself!

References :
1. BBC (2006) NHS staff 'take more sick leave' Available from: http://news.bbc.co.uk/1/hi/health/5052160.stm Accessed: 10:01 18/2/2010
2. Walker P. (2009) NHS staff sickness rates 1.5 times private sector level, health report finds. Available from: http://www.guardian.co.uk/society/2009/aug/19/nhs-staff-sickness-rates. Accessed: 10:03 18/2/2010
3. Venth (undated) Occupational Therapy First - It is time for our profession to lead; not follow. Available from: http://www.metaot.com/blogs/%5Buser%5D-6 Accessed: 10:06 18/2/2010
4. Mailoo V.J., Abrahams P., Warner E., Wickham J. (2005) Council housing: getting what your service user needs. Therapy Weekly 31(29):11-14
5. NHS Choices (undated) Healthy eating self-assessment. Available from: http://www.nhs.uk/Tools/Pages/HealthyEating.aspx?Tag= Accessed: 10:10 18/2/2010
6. NHS Choices (undated) Fitness self-assessment. Available from: http://www.nhs.uk/Tools/Pages/Fitness.aspx?Tag=Fitness+tools Accessed: 10:15 18/2/2010
7. Hitti M. (2006)Caffeine Abuse: Buzz Gone Wrong. Available from: http://www.webmd.com/food-recipes/news/20061016/caffeine-abuse-buzz-gone... Accessed: 10:12 18/2/2010