During the past year I have habitually been leaving work at 8pm every day. It takes me about half an hour to drive home, but by the time I arrive my younger children are already in bed and my spouse is tired and harassed. As a result, he is becoming increasingly irritable with me. What can I do?
A GP’s view
Dr Louise Warburton, GP in Ironbridge, Shropshire
Recognising the problem is half the battle. There is not a GP who has not experienced a similar problem at some time and most colleagues will be sympathetic. I would go to a friendly partner or colleague in the practice and tell them about the difficulties.
A strategy needs to be drawn up to address all the issues. The main issues are: is your workload too large? Why are you staying so late? Are you filling this time with genuine work or are you wasting time? As one gets tired at the end of the day, efficiency falls and it can take much longer to do simple tasks.
Are you avoiding going home? Are the children getting on your nerves? Are relations with your spouse less than ideal? Is it a combination of all of these? Are you depressed and not coping well with any aspects of your life?
The other person you need to speak to is your spouse. It is no fun coping with young children on your own at the end of a tiring day. He may be feeling neglected and lonely. As a matter of urgency, I would arrange for a babysitter and take him out for the evening, or better still, away for a break. Try and talk about how he is feeling and the issues affecting you both. He may be depressed as well.
It is difficult to invest the time in your relationship when you are tired and over-stretched, but it needs to be done.
Try to think what your priorities are.
If you decide that home life is important, arrange a holiday and get away from work for a while with the family. This will give you a new perspective.
When you return to work, ask one of your partners to be your mentor and have regular discussions about how to avoid the late nights and over-obsession with work. They may be able to help with time management as well.
A medico-legal opinion
Dr Graham Howarth, medico-legal adviser at the Medical Protection Society
There are no obvious medico-legal issues here.
However, to be able to work effectively you should try to decrease avoidable tensions leading to stress at work and redress your work/life balance.
If you feel that you are under unreasonable stress as a result of working too hard or other factors that are adversely affecting your health, you should approach your GP for medical assessment and should definitely not self-medicate.
The problem relates to the past year and you will have to assess what has happened that means you now habitually leave work late.
One option would be to consider delegating some of your responsibilities to others. If this involves patient care you must remember that although you would not be accountable for the decisions and actions of those to whom you delegate, you would remain responsible for the overall management of the patients.
You must be satisfied that the person to whom you delegate has the appropriate qualifications, experience, knowledge and skills to provide the care or treatment required.
You must also ensure that the person to whom you delegate has adequate information about the patient and is aware of what treatment is expected.
If the problem is workload related and delegation is not possible or is inappropriate you should approach your employer or contracting body to discuss ways in which to resolve the problem. This is a professional obligation wherever patient safety is at risk.
A patient’s view
Ian Semmons, Patient Partnership Group
You have got yourself into a mess — your balance of priorities is totally distorted with an overemphasis on work at the expense of family life. Not only do you not see your children, but your partner is getting fed up with you, which is hardly surprising. How did you get yourself in such a mess and why did you not see it coming?
Can you honestly say that you need to be at the practice until 8pm each evening? It does appear that your ability to manage your time effectively is poor and one can only wonder just how effective you are within the practice. To work in such a disorganised way and then come home to a dysfunctional family life is a recipe for disaster both in the workplace and within the family.
The situation sounds like it is all a question of setting goals and prioritising your workload to establish a system that is effective for you, your patients and your family.
Are you able to delegate or do you feel that you must do everything? When did someone last assess your work?
There is a wonderful statement that is so applicable here: ‘fail to manage, manage to fail’.
The driving force for change in the workplace must be the potential to compromise patient safety through making mistakes because of stress and tiredness, with obvious implications.
What is obvious is the stress levels of both you and your spouse are at breaking point and that you are missing out on prime time with your children that can never be replaced.
The whole stability of your family life is severely compromised and you owe it to them and yourself to resolve the issues. It may be that there is something in your domestic life that keeps you at work.
Either way, it needs sorting and sorting fast. It is entirely in your hands to make the first positive move.