The Operating Theatre Journal - Journal - Page 27
Puzzle
Number
02
Most UK doctors experiencing moral
distress,
survey shows
Nearly four out of 昀椀ve (78%) family doctors across the United Kingdom are experiencing moral distress while caring for their patients.
New research conducted by the medical defence organisation MDDUS
revealed that doctors are emotionally burdened from being unable to
provide the care they want and expect to deliver due to issues such as
lack of resources and delays.
“Being1 a doctor can, and should, be one of
2 the most ful昀椀lling jobs in
the world. But right now, the scale of the pressure on the healthcare
system is preventing doctors from being able to care for their patients
the way they want to.
Moral distress occurs when the gap between what professional
3
judgment dictates should be done and what the healthcare system
currently permits is wide.
“The results reveal the full extent of the psychological damage a
worryingly large number of doctors experience because of problems
they encounter in their working lives that they feel powerless to 昀椀x.
Among doctors as a whole working in hospitals and GP practices, 65%
said they had experienced moral distress while working5 in the NHS.
“The range of issues doctors face as a byproduct of their moral distress
is extensive, including anger, sadness, insomnia, relationship dif昀椀culties
and more. And what’s most concerning is how this can impact doctors’
safe practice.
Of doctors who said they were experiencing moral distress 83%, said it
was due to the current challenges facing the NHS.
4
The impact of the cost-of-living crisis is also contributing to this distress,
with 65% of doctors saying that patients are presenting with conditions
that are preventable through better diet and living conditions.
“The situations facing patients that frequently trigger feelings of moral
distress
6 in doctors include waiting times, lack of beds, understaf昀椀ng
and having to practice medicine not to professional standards due to
system constraints.
The most prevalent are new severe psychological problems, with 76%
of doctors saying they’ve encountered this. Doctors have also seen an
increase in the Victorian-era illness scurvy (14%).
“This research paints an alarming picture of the impact on both doctors’
professional practice and personal wellbeing.
The impact of the cost-of-living conditions on children’s health
has particularly affected doctors. One said their patients were in
“inappropriate housing that was unsanitary and unsafe for a toddler”.
Another described treating “unkempt children with poor 昀椀tting shoes
causing blistering and sores”.
Other preventable and treatable conditions doctors said they have
come across included:
• Asthma (53%)
“The emotional toll of moral distress should not be downplayed, as
it has the capability to erode the morale and resilience in already
overburdened doctors.
“With an NHS staf昀椀ng crisis ongoing, we absolutely cannot afford to
lose any of our highly skilled doctors.
“Our healthcare system needs adequate funding and resources to be
able to provide the care patients deserve.
7
“Doctors also need to feel empowered to speak up and challenge
issues.”
• Folate de昀椀ciency (46%)
• Other vitamin de昀椀ciency (50%)
The 昀椀ndings have also highlighted the impact moral distress could have
on the retention of NHS doctors, with 40% saying they have considered
leaving the medical profession altogether or retiring early due to the
burden.
MDDUS also asked questions about being unhappy at work to explore
how doctors’ feelings about this impacted their personal lives.
Of the doctors who said their moral distress was due to the current
challenges facing the NHS, 70% reported feeling unhappy at work,
which led to trouble sleeping at night. A further 53% said they were
having more arguments with friends and family.
Puzzle Number 03
Answers
to Puzzle
Number
Puzzle
Number
02 03
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Doctors told MDDUS:
eo l
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• “Asking patients to choose between a prescription or heating causes
i
me moral distress.”
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g
• “Patients (particularly the elderly) lined up on trolleys along
m
c
hr
corridors asking for help when you walk past is probably the thing
ta
e
that distresses me most about work at the moment.”
Across
• “Years of underfunding in NHS, not enough healthcare professionals
p
1. The vocal ligaments attach to the thyroid cartilage and what
and poor mental health services causes me moral distress.”
The vocal ligaments
attach
the thyroid
Of all the muscle
hrelaxants, this one rocks
other pair
of to
cartilages?
cartilage and what other pair of cartilages?
• “Patients who can afford to go privately are able to quickly access
a picture of atrial activity (1,4)
5. Heart Rate7d
x Stroke
i= (7,6)
aVolume
t =h(7,6)e r m y s m o k e
multiple services and will likely have much better health outcomes.
Heart Rate x Stroke Volume
Meanwhile, 81% of doctors struggling with moral distress due to the
challenges facing the NHS said their unhappiness at work was affecting
their mental health, and 74% said they were concerned that their
5y
unhappiness could have a detrimental impact on their safe practice.
4
alcohol doesn't kill these
6. Thewhich
membrane
which lines the abdominal cavity
This is due to both cost of living crisis and lack of resources in the
The membrane
lines the
In paeds,(age + 4) x 2 relates to what?
NHS.”
abdominal cavity
8. catgut is an oldskool type of this
catgut is an oldskool type of this
• “I work in a deprived community who faced all the problems
Down __________ manoeuvre, for laryngos
perform this if systolic BP drops
described before the cost-of-living crisis and impact of the
below 50mmHg
Of
all
the
muscle
relaxants,
this
one when
rocks this is lost, the epidural space is fo
2.
pandemic. It is worse now, and those at the margins (and beyond) of
colour of
adipose3.tissue
poverty previously, are now facing the pre-existing problems
faced
a picture of atrial activity (1,4)
an excess release of this causes
by the poorest patients.”
a common bronchodilator
4. alcohol doesn’t kill these
muscle rigidity in Malignant Hyperthermi
Dr John Holden, Chief Medical Of昀椀cer, MDDUS, said:
7. Incarcinogenic
paeds,(age + and
4) x 2 relates to what?
the 'T' in CT. The polo mint machine.
avoid inhaling this,
carries
“These 昀椀ndings tell us that a wholly unacceptable number
of viruses,
doctors allegedly (9,5)
- almost two in three - have experienced moral distress due to the costResus Tree Ltd: Jamie Macpherson 2023
of-living crisis and the challenges facing the NHS.
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Issue 400
January
2024
27