GP burnout: ‘My workload was massive and relentless… I eventually stopped caring.’ Zoe Norris qualified as a GP in 2007, working in a salaried position in East Yorkshire before moving to a […]

Zoe Norris qualified as a GP in 2007, working in a salaried position in East Yorkshire before moving to a partnership in Bridlington, on the Yorkshire coast, after she had children.

“That’s where it all went a bit wrong,” the 36-year-old tells i. “A lot of seaside towns have been early victims of the recruitment crisis. When new GPs qualify, quite often they want to work in big cities, not in somewhere away from good schools, culture and with a lot of deprivation. So practices are struggling to recruit and when I joined we were still short of doctors.

“I just burst into tears and couldn’t stop crying. I just thought I can’t do this anymore.” The i newsletter cut through the noise Email address is invalid Email address is invalid Thank you for subscribing! Sorry, there was a problem with your subscription. Dr Zoe Norris

“The workload was massive and unrelenting. I think our approach as doctors is that if there’s a problem, then if you work harder that solves the problem and that’s endemic throughout our training: you stay late and work on the wards, take extra on calls because that’s what you do.

“It reaches the point where you’re actually working as hard as you can and you’re still not solving the problem.

“I was meant to be doing three days a week with the other two days at home looking after my kids. But I would spend my time at home on remote access [email] to the surgery trying to deal with prescription requests, ringing patients to triage them, not really having that down time with my family.”

There was no capacity to deal with the sheer volume of patients and Dr Norris said she would feel guilty being at home, leaving colleagues back at work to deal with things.

Errors

“The days started getting earlier, arriving at work at 7.30am, and began finishing later too – often at 10pm at night. There’s only so long you can do that before it starts to take its toll. And I stopped caring. Patients would come in and tell me some horrific story, but I would just be thinking there are three other patients waiting and I’ve got loads of other stuff to do… we all started making mistakes. The number of prescription errors went up, significant events were happening more and more, there were more patient complaints.

“I was managing by drinking and eating badly, gaining weight, not having a chance to look after myself basically. I would come home and instantly need to destress. Every night it was a couple of glasses of wine to try and switch off from work. I wasn’t sleeping, waking up at 2am confused whether I was working the next day or not. I’d just lie there awake worrying about it.”

Her husband Tom, a teacher, was supportive throughout as the pressure kept building.

“He knows how committed, determined, ambitious and stubborn I am. And he was trying to be supportive as this was at a time I’d taken a step up in terms of being a partner [at the practice] and I wanted it to succeed. I wanted to give it my all.

“I do less clinical work now, because I can’t manage it.”

“I’d frequently ring home in tears at 8pm or 9pm saying I wasn’t going to be home and not see the children. By the time I got home I’d be exhausted and go straight to bed, then it would all begin again. I just hated it. I didn’t want to be a doctor anymore.”

It all came “crashing down” one Friday night in December 2015 when, amid ringing patients who needed appointments that day, doing triage, with more paperwork to fit in before leaving, Zoe rang a patient who sounded like he had a blood clot in his leg.

“He had a history that made him at risk and he sounded a ‘classic’ case over the phone. I looked at the clock and saw the day unit at the local hospital opened until 8pm and if I could get him there, then they will do the blood test and scans, they can treat him – otherwise I was going to have to go out and do a home visit and try and arrange all this out of hours over the weekend.”

The nurse at the day unit apologised saying it was about to close, so could not see him.

“I just burst into tears and couldn’t stop crying. I apologised to the nurse, put the phone down and rang my husband saying I’m going to be late again trying to sort these out of hours appointments over the weekend. I just thought I can’t do this anymore. I’m not the doctor I want to be.”

She resigned the following Monday with a plan to give up medicine and do something completely different.

Support

“Fortunately, I had a lot of good friends around who said this was not being a doctor, but being a doctor in that particular environment and encouraged me to take some time out and find my feet again. I needed to get help with depression as a result of it all.”

About six months later Dr Norris sought help for mental health issues and had some counselling via the NHS GP Health Service – a world-first nationally funded service for GPs and GP trainees suffering mental ill-health and addiction, which was created on 30 January 2017. It provides free, confidential specialist mental health support for a range of conditions.

“You do not want to be the 100th patient I see that day. You wouldn’t want your parents or loved ones to either, because that level of workload is just dangerous.”

She is one of more than 1,100 GPs who have sought help from the service in the 12 months since it was established, according to new figures.

“I realised I wasn’t the only one and there are hundreds of GPs needing help. I was amazed by the number of colleagues who said they felt the same. And this is how most GPs feel now. The amount of my colleagues and [GP] friends on anti-depressants and needing to see their GP… the norm is now that if you are a GP you are going to be on some form of anti-depressant and that is pretty worrying.”

Asked if she would still be a doctor today if it wasn’t for the service, Dr Norris says: “No. I’d have left medicine.”

New life

After working as a locum for 18 months, Dr Norris took on a two-day a week salaried position about five months ago at a practice in Cottingham, a village just north of Hull.

“I do less clinical work now, because I can’t manage it,” she says. “It’s a flexible contract and I don’t have to work in the school holidays. You swap earning more for stability. I’m also a GP appraiser because that’s something different, not face to face with patients, and I lecture on one of the GP education courses. It’s not that intensity of being in a practice every day, because everywhere is short. Everywhere is the same.

“I’d regularly be having over 100 patient contacts in an on call day. And the maximum number European countries say is safe is 25. And it affects your decision making. You do not want to be the 100th patient I see that day. You wouldn’t want your parents or loved ones to either, because that level of workload is just dangerous. You feel it and you know you’re missing things.

“My patch here – Scarborough, Bridlington, down into Lincolnshire – all of that area is just desperate in terms of recruitment. There are just not enough doctors, or nurses for that matter, to meet the demand.”