This group of RMOs have volunteered to wear the Red Resident Lanyard, which identifies them as someone who is prepared to be approached for help. In reality, Most of our RMOs are friendly and more than happy to help you in any event, but sometimes the question seems so basic that you’re afraid to ask, or you need help but your own team is tied up and your hesitant to approach a random stranger.
Well if they are wearing the red lanyard, they are not a random stranger – they have committed to being available for you in just this circumstance. Sometimes it's not the answer to a question that you’re after – its just an opportunity to debrief. “Is it always this hard, or is it just me?”, “does it get better”, “how long until I’ll start to feel like I know what I’m doing?”
All of you will be assigned to a mentor group. We usually have groups of between 4-6 interns matched up with a pair of RMO Mentors. This is a voluntary process, but we work on an 'opt-out' basis. You will be asked if you have any objections to participation and then assigned to a mentor group.
Your mentors will try to contact you either the week before Orientation or during Orientation week and will then plan opportunities to meet or touch base individually and as a group throughout the term.
Issues discussed with you mentor will always be treated confidentially.
The pressure on new interns is well described:
- The heavy burden of responsibility for patient safety
- The ever-present possibility of making a mistake
- The potential to take on, or be pushed into taking on, responsibility beyond the level of your training and experience
- The long working hours
- The shift work and disturbance of sleep and eating patterns
- The intense competition for jobs
- Interdisciplinary and inter-departmental rivalries
- A culture which has tolerated bullying and harassment
- The difficulty in maintaining a sensible work life balance with the impact this can have on relationships
When asked why interns choose to come to Westmead, the most frequent response is that they have heard of Westmead’s reputation for hard work and have decided to challenge themselves, hoping to become a better and more experienced doctor in their first year compared to interns from other hospitals. These expectations are often met, but this can come at a cost. Few interns are not impacted by this and some are impacted significantly.
Over the past two years, there have been a number of large JMO surveys which have explored issues of JMO wellbeing and the results have not been encouraging - for Health as a whole and for Westmead in particular.
For this reason, this topic has been the subject of considerable discussion and activity among Westmead's senior managers in recent times. The hospital accepts that it needs to improve and is committed to doing so.
In considering the issue of JMO wellbeing, apart from a hospital response, there are three important ways in which JMOs can contribute:
- Looking after yourself – being aware of your own physical and mental state and the range of available resources for help and support should you need them. A list of externally available resources has been compiled elsewhere under JMO Wellbeing.
- Looking out for your colleagues – checking to make sure your mates are OK and taking action if you have concerns. Being available for support, debriefing, and sharing common experiences.
- Getting involved – hospitals are large, bureaucratic organisations and change requires conscious effort. The more involved you can become in promoting and assisting change, the more likely it will occur. There is always a wide range of opportunities for you to become involved in improving your own working conditions.
Bullying is known to be a problem across the health sector. At Westmead, our senior medical manager Dr Ros Crampton has been a fierce advocate for trying to improve the culture and address this problem.
NSW Health has a generic Policy for Prevention and Management of Bullying,
and there is also a separate Policy addressing Bullying and JMOs
which makes reference to all hospitals needing to nominate a "JMO Support Officer". At Westmead, these roles a fulfilled by
- Dr Ros Crampton, Chief Medical Advisor firstname.lastname@example.org
- Dr Andrew Baker, DPET email@example.com
Sometimes bullying is obvious but it can also be more subtle. The following basic information has been extracted from the policy document to help you understand what bullying is and how it might be expressed.
Bullying is defined by Safe Work Australia as:
“Repeated and unreasonable behaviour directed towards a worker or a group of
workers that creates a risk to health and safety.”
Repeated behaviour refers to the “persistent nature of the behaviour and can involve a range of behaviours over time”. This includes repeated behaviour directed towards one
individual and single incidents of behaviour involving separate individuals and can involve a range of behaviours over time.
Unreasonable behaviour means “behaviour that a reasonable person, having considered the circumstances, would see as unreasonable, including behaviour that is victimising, humiliating, intimidating or threatening”.
Workplace bullying will generally meet the following criteria:
The Safe Work Australia Guide for Preventing and Responding to Workplace Bullying
provides the following examples of bullying
- It is repeated and systematic (a single incident will generally not meet the threshold for bullying but should be addressed to prevent escalation or repetition)
- It is unwelcome and unsolicited
- A reasonable person would consider the behaviour to be offensive, intimidating,
humiliating or threatening.
- Abusive, insulting or offensive language or comments
- Aggressive or intimidating conduct
- Unjustified criticism or complaints
- Practical jokes or initiation practices involving abuse or humiliation
- Deliberately excluding someone from workplace activities
- Withholding information that is vital for effective work performance
- Setting unreasonable timelines or constantly changing deadlines
- Setting tasks that are unreasonably below or beyond a person’s skill level
- Denying access to information, supervision, consultation or resources to the detriment of the worker
- Spreading misinformation or malicious rumours
- Changing work arrangements such as rosters and leave to deliberately inconvenience a particular worker or workers.
- Bullying may also be discrimination if it targets a person on the basis of their age, gender, pregnancy, race, disability, sexual orientation, religion or certain other protected attributes.