The land of milk and honey

The Workplace Research Centre at the University of Sydney recently published a report on the working conditions of doctors and nurses in the New South Wales public hospital system. Commissioned by the Australian Medical Association (NSW), the Australian Salaried Medical Officers’ Federation (NSW) and the NSW Nurses’ Association, the 2008 report asserts that almost two-thirds of doctors and nurses in public hospitals had seriously considered abandoning the NSW public health system in the previous 12 months. Workplace discontent among doctors was highest among visiting medical officers (69.6%) and staff specialists and career medical officers (64.6 %), followed by junior doctors (50.9%). Senior nurses and enrolled nurses had similar levels of discontent and disillusionment. It is more than likely that similar results would be found nationwide.

Symptomatic of this discontent are perceptions that managers of hospitals or services are untrustworthy, that consultation on matters affecting staff is either suboptimal or non-existent, and that bureaucratic expectations of staff far exceed the rewards for service.

This widespread malaise has many causes, including an appalling absence of both vision and leadership. Indeed, vision has been sadly subsumed by inquiry after inquiry, and leadership mired in a morbid reluctance to begin the reform journey. The situation in which medicine now finds itself is reminiscent of the 40 years that Moses and his people spent wandering the Sinai desert in search of the promised land of milk and honey. This begs the question: just how long must we continue our wandering?

It remains a mystery why doctors and nurses persist with a system that fails to value them, especially when working in this environment may also affect their own health. Given their obvious commitment to and love of their profession, why do they continue to wander in this workplace wilderness? Could it simply be that they are awaiting the arrival of a modern-day Moses?