The tyranny of the working week

People who have greater choice around their working hours are more productive, healthier and happier

I psyched myself up with strong tea and low-GI organic granola (or whatever the Aldi equivalent is), put on my second-most comfortable shoes and braced myself for the week ahead. For the first time in more than 13 years, I was going to be working a ‘full week’ — that is, an eight-session, five-day week. Some of you will scoff at this being a full week — where’s my 10 sessions, plus two out-of-hours shifts, plus the nursing home round? But for me, this was a huge mountain of work to climb (thus the comfortable shoes).

Day one was okay. I took a stroll near the practice at lunchtime and the adrenaline of being a ‘real GP’ kept me going until about 5pm. Then the list of people to phone back and pharmacy queries and physio referrals and blood results and my partner’s blood results started to make me lose the will to live. I kept going until 6:20 and then just abandoned my post. Sure, wasn’t I going to be back again in 14 hours? I’ll easily catch up. 

Day two had less adrenaline, more phone calls, no walk and a mounting feeling of fatigue.

Day three started grinding to a halt, mentally, at about 2:30. Unfortunately, this was just when the fun was beginning, when I was the only doctor in the practice and every teeny-tiny issue had to make its way across my desk. ‘Could you sign this form?’ ‘Pharmacy on line 3.’ ‘A child is on their way down with a rash and a swollen head after eating scrambled eggs.’ My final patient had an extremely complex medical history but just needed his hospital prescription added to his GMS one. It took me about 20 minutes, and required all of his and my patience as I plodded my way through milligrams and bd and Fresubin shots.

He was very understanding. I couldn’t see straight on the way home in the car and had to leave the windows down, despite the lashing rain. It felt a lot like the chemo fog I had become accustomed to in the past — your body is moving and your mouth is talking, but the brain is only about 65 per cent charged.

The next day was a half-day. What a difference it made, to get all the jobs done by 12:45 and scoot out the door with hours of free time ahead of me. Got to pick up the youngest and have an easy lunch at home, then a stroll in the sunshine to collect the other two. Off with us to the supermarket to get the groceries (the joy of supplies!) and then pottering about doing the laundry (the joy of clean underwear!) before taking my time to make nice food instead of thrown-together muck. Another half-day to finish out the week meant that the weekend had started before I knew it, and the lie-in on Saturday was exquisite.

Part-time work has a mixed reputation. It is inevitably bound up with gender issues, as the majority of those of us who work less than full time are female. Why? Because someone has to mind the children, and society and our mothers make us feel bad if we leave that up to someone else (even if that other person has chosen to do so as a career, trained hard for it and generally enjoys it).

Men have far fewer opportunities to work a less-than-standard working week. They are not afforded the chance to spend time with their kids if they have them, or to just tinker away in their garden or on the golf course, without the frowny face of societal derision glaring down on them. Women without children also face approbation if they suggest that they might like to work a little less, to allow them to live a little more. Mothers face a damned-if-you-do paradox where they get the sly sneer if they neglect their children by working full-time, and the thin lips treatment if they rush out the door of the surgery in time for the school run.

For some people, these paradoxes lead them to either leave the workplace altogether, or to forge ahead with overwhelming workloads and MI-inducing stress levels, because they feel they have no other option. The GMS contract, and most other HSE ones as far as I am aware, are pathetically ill-equipped to allow for flexible working, despite the numerous studies over the years that show that workers who have greater choice around their working hours are more productive, healthier and happier.

Sometimes people may feel that there is no way in the world they could take a day off every week, or cut back to six or seven sessions. This might be for financial reasons, or because they are single-handed, or they are building up a practice and need to show how wonderfully available they are.

I am lucky. I have the bullet-proof excuse of stage 4 cancer. (No-one can argue with you when you have stage 4 cancer.) I do not need to justify my reasons for being unable to keep myself awake after nine hours at the coalface. I can legitimately say that I simply cannot work five days in a row, because of my residual fatigue and cognitive dysfunction. Boy, am I glad of that excuse. Because the alternative is very bloody hard work.