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3 Women Share Life in the NHS: Trials, Tribulations, and Tears

by in Lifestyle on 21st January, 2019

We have asked three Muslim women working in the NHS about their experiences:

Taslima RashidRole – Registrar: Specialist trainee in sexual health and HIV

Anika Rahim Role- A Junior Doctor, graduated from King’s College London.  She completed her Foundation Training in the Oxford Deanery and is now taking out a year to pursue a Masters in Tropical Medicine and International Health before further training.

Amina Hersi: Role- GP trainee

1. First realisation when you started practicing Medicine?

Taslima Rashid: One of the biggest surprises to me was how physically and mentally challenging the job was. I remember starting work in my first year and coming home, thinking to myself, ‘I’ll lie down and rest my feet’, and then waking up in my work clothes, boots, coat, scarf, work lanyard, at about 4 in the morning. I was so tired. You’re on your feet all day, on top of which you may end up sprinting to an arrest call, having a ward round that spans 12 floors, or straining with the nursing staff to get a patient into bed. It’s a daily work out (tough, given I NEVER work out).

Anika RahimI realised that even after six years of medical school and a week’s worth of induction, nothing can truly prepare you for working as a junior doctor. You’ve just got to dive in, realize that you’re learning each day and always ask for help when you need it!

Amina Hersi: Frankly, I had always assumed that other doctors were like me, people who wanted to work in a job where they help others. I remember how I was so disheartened when I encountered doctors who simply weren’t very nice people. The way we treat one another is sickening at times, thankfully this is starting to improve. But the job is hard enough, we shouldn’t make it any harder on each other.

2. How has race affected your experience?

Dr. Taslima Rashid: Registrar (GUM & HIV)

Taslima Rashid: The NHS has a zero-tolerance policy on racism and that includes if someone refuses to be treated by a POC 1. I once saw a man refuse to be treated by a black A&E doctor. He was promptly ‘red-carded’ and sent away as he didn’t have life-threatening injuries. The specialty I work in champions itself on inclusiveness and non-discrimination which is why I chose it. I’ve been very lucky in that I’ve never had my ability questioned on the basis of my ethnicity – but you will get the odd niggly comment.

Anika RahimI used to be thrown by the question ‘So where are you from?’ as a medical student. Since working as a doctor, I’m much more open about my British Bangladeshi heritage. I’ve realized that a lot of the time, people ask out of curiosity and I’d rather engage in discussion than taking offense. Consequently, I’ve learned lots about my patients’ and colleagues’ cultural backgrounds and life stories simply by talking to them!

Amina Hersi: I am of an black African background and we are still underrepresented in medicine. I would be lying if I haven’t had racist abuse from patients/relatives. But it’s the subtle comments that get me. I’ve heard
colleagues say odd comments, where they assume I'm lazy or aggressive because of my race or how I sound “white on the phone” as if I’m supposed to sound like a race.

3. What’s been your biggest challenge?

Taslima Rashid: Saying you work in sexual health can be perceived differently by different people. Friends think it’s a bit tongue in cheek but also empowering. Muslim people are generally really positive about it but can feel a bit nervous about talking to me about it.

I occasionally struggle to engage with men from similar ethnic backgrounds to me, because they might feel it’s inappropriate to chat about stuff like sexual risk-taking. I’ve never worked in Whitechapel (which has a large Bangladeshi population) but I can imagine it must be quite challenging.

Anika RahimI think professionally the biggest challenge has been finding what I want to specialize in clinically and balancing that with my passion for global health. In the end, I’ve come to the conclusion that Infectious Diseases/Microbiology would be really interesting so that’s the aim inshaAllah! I’m looking forward to taking out some time first to do a Masters in Tropical Medicine and International Health. Personally and spiritually, I find it uncomfortable having to rush prayers when I’m on call but I think the main thing is you’ve got to try your best in those circumstances.

Amina Hersi: Work can take so much out of you. I am generally very sensitive, I often struggle with getting caught up in the emotions and heightened situations that come with the job. I’ve had to work on my ‘housekeeping’ which is looking after ourselves too. Ensuring that I am able to find suitable outlets for my stress. I love giving everything I have to my job and so I experienced burn out quite a few times. I’m better now at recognizing the early signs and making sure I take a breather to recuperate.

Dr. Amina Hersi (General Practitioner trainee-GP)

4. How was Ramadan with work and life?

Taslima Rashid: It’s much more do-able when you’re not on call (the 5 pm till 9 pm shift) and covering emergencies! In the past, I’ve had to deal with incredibly stressful, life and death situations in the hospital, such as cardiac arrest calls. Luckily, I don’t have to do that as much in my current specialty, but I’ll still have the odd emergency situation with very sick HIV patients on my ward. I spoke to my family about it and made the decision not to fast on certain days, as 1 Person Of Colour I never want to put a patient at risk.

I used to feel really guilty because I know medics who fast regardless of the circumstances. I don’t think like that anymore. I’ve grown to realise that it’s my decision to make, and I have to trust my own judgment. I have a responsibility towards the patients in my care, I don’t take that lightly. On some days, for me, the stakes are too high to risk losing my concentration.

Anika RahimRamadan this year was an incredible experience and much more focused than my first Ramadan whilst working as a junior doctor. The on calls were really manageable and I was blessed with a really supportive team including a registrar who thankfully reminded me to break my fast on time whilst on call! I had a lot of patients and colleagues ask me about Ramadan and it was a great opportunity to explain its purpose. You’d be amazed by how many non-muslims have already tried fasting out of curiosity.  I even had a senior colleague join us in fasting out of solidarity (which lasted one day lol).

Amina Hersi: Ramadan has been a challenge especially the long hours, but I feel like the NHS has trained me well. Many a 12-hour shift has occurred where I have not had time to eat, drink or pee. I have not had a moment where I’ve felt it has impacted my work. Missing lunch has its perks, I can avoid that carb coma lull which comes after a heavy meal. Funnily enough, people think night shifts are good for Ramadan. However, you end up being so busy in the hours you CAN eat, you can’t have that coffee to help you survive the drive home. So its got its challenges. Obviously, if I felt unsafe/too tired I would take a nap before leaving. I’ve fallen asleep at the wheel once before (not in Ramadan) and it’s a terrifying the danger that doctors need to be mindful of.

5. Has there been a defining moving moment that put life into
perspective?

Taslima Rashid: Too many! I have watched too many young people my age die from HIV related illnesses. It was cruel and painful for them and their families. But the worst situations are when there are no family or friends.I recently treated a very young patient who passed away in incredibly sad circumstances. In the four months that we got to know her, not a single person came to visit. Her story upset me more than any other patient I’ve ever gotten to know, because she didn’t deserve to die like that, alone. We were there, we supported her and we cared for her very much – not as a patient but as a human being. Still, it wasn’t the same, and it wasn’t enough. You feel angry about it. It makes you grateful for having people around you that love you and would be there if you were sick.

Amina Hersi: I’ve yet to have a significant moment that has been life-changing. However, there are many moments where I have learned the fragility of life and how transient this world is. How someone can go from feeling fine, to dead in a few hours. I have worked tirelessly to save lives that I could not save. As a Muslim, I believe in destiny and how our time of death is part of fate. There are moments when I’ve felt entirely powerless and realized that destiny will always have its way. I lost my brother very suddenly earlier this year, I’ve felt a new sense of empathy since then, that has made me more compassionate towards families who are dealing with unexpected losses. I think experiencing grief first hand has made me stronger and better equipped to be there for my patients and their families.

6. Were you supported or did you feel any opposition when pursuing
this career (family, friends, and community)?

Taslima Rashid: My parents were never opposed to my decision to go into sexual health and HIV. They trusted my judgment in choosing a career; it felt right to me in terms of work-life balance, beliefs, and interests. Obviously, it would be disingenuous of me to say that my parents scream from the rooftops that their daughter looks at genitals all day, but they are proud of where I am.

Anika Rahim: Family and friends have always cheered me on which has been a blessing and their uplifting words are a great source of motivation especially during challenging times. I think it’s really important to have medical as well as non-medical friends – both keep me sane. My family are non-medics so when I come home, it’s really easy to switch off and talk about normal things.

Amina HersiI remember my parents were very surprised with my choice but they have always supported my dream. I heard lots of discouragement from my school. I was told I would never get in, that I should seek an alternate career.  I remember certain teachers who would try to derail my plans. One of whom tried to predict me a grade below what I’d actually attained in AS levels. I even remember being interviewed by medical students who also told me not to bother. I was actively told not to apply. Out of the 15 medical applicants from my school, I was the only one to get and meet my offer to medical school. But I also remember those who supported me tirelessly, mum and dad and shoutout to my biology teacher Mr Wood! And many others along the way. Moral of the story, don’t let anyone tell you can’t do anything! If you have a dream, grasp it with both hands and don’t let go.

7. When did you realise you wanted to be a doctor?

Taslima Rashid: I was in my final year of medical school and had to choose from a list of topics to study as a specialist interest for about 4 weeks or so. I thought ‘we never learn anything about HIV and I’d like to learn about it more’ – and I’ve never looked back. I sat in on clinics and learned so much from the team, who were brilliant. I ended up presenting a poster at a national conference and an oral presentation at the World AIDs Conference. For a lowly med student, that’s pretty epic.

Dr. Anika Rahim (Junior Doctor)

Anika Rahim:  Apparently I always talked about it growing up! As a young child, I was really inspired by my (late) father who did a lot of philanthropic work in Bangladesh building schools for children in his village so that they could go onto university like he did. I guess the idea of serving others was therefore built into my conscience from a young age. At school, I enjoyed both the arts and sciences and I realized that medicine was the perfect combination of the two for me to serve others.

Amina Hersi: I decided I wanted to be a doctor when I was 4 years old. I’m not sure where the idea came from. But I remember drawing my dream job and being asked if that was a nurse, before I curtly responded with no way! As I got older it became more determined to fulfill my dream. I decided I wanted to be a GP in my final year of medical school. I noticed I seemed to like knowing a little about all the specialties, GP seemed like a good fit for me. Funnily enough, I started medical school wanting to be a surgeon but dissecting cadavers told me that it wasn’t a good fit for me.

8. Have you ever thought about leaving?

Taslima Rashid: Sometimes I wish I had more free time to pursue other passions; learn languages, get the chef diploma at Le Cordon Bleu, hang out more in Bangladesh with my family, do more relief work. I’ve been really lucky to secure a career break over the next six months and will hopefully try and get at least a few of those things done! But despite that, I can’t actually imagine being anything else. This is the only thing I’ve ever known and it is who I am as a person.

Anika Rahim: I don’t think I’ve met a single doctor who hasn’t thought about leaving during tough times, even the best of medics!  It’s important to keep options open but right now, I’m pretty content with my plan Alhamdulillah.

Amina Hersi: I’d be lying if I said I didn’t. There have been times when I’ve burnt out, where I’ve been so exhausted that I stopped seeing the point. I would think of things I wish I could’ve done instead. Burn out is a serious thing, we spend so much time at work, it consumes us. It’s times like that where you need a holiday/a breather from work and to take time to look after oneself.

9. What does a day at work look like? What does a day off look like?

Taslima Rashid: I get to work for 8:30 (tube permitting). I do a mix of sexual health clinics, HIV clinics and specialist clinics in contraception. I may be on call, or on a late clinic which means I’ll be at work until at least 9 pm that evening. If not, then I technically finish at 5 pm, but I rarely get to leave at that time as there’s a lot of extra admin, research and side projects that come with being in my field of work! It’s a long, punishing work day, and I couldn’t do it if I didn’t really love the work. One thing that does annoy me a lot is that I rarely find time to eat lunch. However, a lot of our wonderful patients will bring sweet treats for the staff which usually keep me going!
Currently, a day off is either studying for my last exam, admin for my upcoming wedding or meal prepping for the week – I love to plan dinners ahead as it takes some of the stress out what is always a busy work week. Very boring, unfortunately.

Anika RahimDay at Work – It depends on the specialty but for Respiratory medicine which was my last job as an FY2 doctor, the day starts off with a ward round prioritizing sick patients first, making a jobs list (very important!) and doing any urgent tasks before lunch (e.g. booking scans, important blood tests etc). I worked with an incredible team so we always met up for lunch even if it was brief – time off from the ward is so important for headspace! The afternoon comprises chasing blood tests and scans, making referrals to other specialties, family discussions, reviewing unwell patients and handing over to on-call teams. During on calls, you might be seeing new patients in A&E or looking after unwell patients on the wards. If you’re on a night shift then, of course, you’re sleeping during the day and working throughout the night!

Day Off – I enjoy catching up on reading (just finished The Underground Railroad which is brilliant), going for a run, relaxing with a swimming session with my sister, checking out exhibitions in London, meeting up with friends and family for a meal. If I have a few days off, I like to go away either abroad with family or on a countryside break with friends. I aim to use the time off as an opportunity for spiritual reflection and increase my ibadah than I’m usually am able to during the week/ whilst on call so that might include going to an extra class or reading more Quran.  

Amina Hersi: A day at work involves waking up a disgusting o clock, snoozing the alarm multiple times before peeling myself off my bed. Skipped breakfast due to snoozing. Grabbing a coffee and a piece of fruit instead. Ward round – writing plans, doing jobs (chasing scans, blood test results, writing letters) for the rest of the day. Sometimes no time for lunch, find the time to speak to 16 sets of relatives in the afternoon. Sometimes you might have a few unwell patients who need stabilization, urgent scans and blood tests. Over time, again but you have to because the patient comes first and you’re happy to stay to ensure their safety. Lather, rinse and repeat.

A day off consists of a lovely lie in! Spending the day catching up on the things I should’ve done all week, laundry, cleaning, and self-care. I might read a book with a relaxing face mask. Find time to see my family and friends who I’ve neglected all week.  I’ll use my expensive gym membership for the first time that week.

10. What’s the nicest thing someone has said?

Taslima Rashid: Patients that say I’ve made them feel at ease after a consultation is always nice to hear. It can be really nerve-racking coming to sexual health clinic if you’ve never been before, so it’s great to think I’m helping
take some of the stress out of that for someone.

Amina Hersi: I’ve had nice flattering compliments about being pretty etc. But the best compliments are the ones where they say thank you for being kind, compassionate and for working so hard. These are the compliments which have me welling up. These are the ones that build up morale, so please if you see a hard-working doctor please let them know.

Anika RahimI worked with a really inspiring and experienced palliative care doctor. During a really tough week at work, she told me that one of my best qualities is that I’m a natural with patients and my clinical judgment is spot on – because I admire her work ethic and honesty so much, I felt really privileged to receive that compliment from her.

11. Have you had any unpleasant interactions with a patient?

Taslima Rashid: Yes, anyone who tells you otherwise is lying! Everyone in the UK needs a check or treatment at some point in their lives, so your patient could be anyone. That includes mean people, rapists, paedophiles, racists, etc. You have to treat them regardless of who they are. The key is to speak up when a difficult patient has crossed the line. Now that I am older, I feel much easier calling people out for unacceptable behavior. I deserve to be treated with respect. I just wish I knew how to do that when I was younger.

Amina Hersi: Of course, I have had many an unpleasant interaction. I remember an elderly gentleman who needs IV fluids. I was asked to cannulate him for his fluids. I was then bitten, scratched and spat at. All whilst he called me a black B***h and a dirty towel head. Days later I comforted him as he died. That’s the thing, you see people at their most vulnerable but also their most unfiltered state. They are sick, in pain and sometimes confused. It can be really disheartening when you work yourself flat out, but to some people who don’t appreciate the NHS, it is never enough. That’s why it’s important not to seek validation from the patients. They don’t always understand the sacrifices we’ve made, the behind the scenes battles, the dinner reservations we’ve cancelled, the trips we’ve cut short, the weddings/christenings/funerals we’ve missed.

Anika RahimThere are always occasional challenging situations to face, but that is part and parcel of the job because we’re dealing with people’s health and in some cases, it is life and death. Understandably patients and their relatives are sometimes frightened/anxious/upset as I would be too! I think so far (Alhamdulillah), I’ve always been able to negotiate to achieve the best outcome with the help of nursing staff, seniors and my colleagues.

12. Is your name well received?

Taslima Rashida: I’ve heard examples of people abbreviating or changing) I abbreviate my name. I suppose it would be nice to use my full name with my patients, but if I’m honest, abbreviating makes things easier given my consultations are often rapid, with a high turnover. Although I know I shouldn’t make excuses for people – everyone I meet should make the effort to use my full name!

Anika Rahim: Yes it is; everyone knows me as either Anika or Ani and I’m comfortable with both as the latter is my nickname anyway. I think since the late Dr Kate Granger designed the ‘Hello my name is…’ badges (https://www.hellomynameis.org.uk), people make an extra effort to remember names. I know that by seeing other people’s badges it definitely helps me remember their names. Her badges are a great initiative.

Amina Hersi: Thankfully my name is short and relatively easy to spell, so no changes but I do get the odd anglicization of my name to Hirst, Hersch, Hershey and Anna, Nina or Amelia.

13. If you were PM for the day what 3 changes would you make to the
NHS?

Taslima Rashid:

1. Stop cutting sexual health funding!
2. Allow PrEP to be prescribed in the UK
3. Increase spending on health care generally, and invest in tackling mental
health issues – we fall woefully short compared to other countries.

Amina Hersi: 

  1. I would remove all private contractors and centralize all the companies who supply and run the hospitals so the profit could be reinvested into the NHS.
  2. Better support and pay for our staff – including the cleaners who work extremely hard, the nurses and the junior doctors. I would improve the way rotas work and ensure that staff are not overworked and underpaid.
  3. More NHS funding – I would move money away from weapons development or other things that don’t really offer the taxpayer value.

14. What can we do to help the NHS?

Taslima Rashid: Patients will often complain about us not being able to offer certain tests or treatments. I completely agree with them. But when I tell them ‘the most important thing you can do is complain to the government, write letters
to your MP, demand increases in funding for a sexual health’, they sort of zone out. But it’s an essential way of getting heard!!

Anika RahimTwo things – Firstly, I think all of us can learn to appreciate our NHS more. It is a wonderful institution, albeit not perfect, but important to remember that access to healthcare is precious. Secondly, we can all look after our own physical and mental health much better. We need to think about preventing disease as much as we do treating it especially in the Muslim community. Pick up a sport!  

Amina Hersi: FOR THE LOVE OF GOD please don’t rock up to A+E with problems that have been bothering you for months. If you’re not dying/possibly dying, or you’ve not had an accident then please go and see your GP (you can call 111 for more advice). I’ve heard of people attending A+E with hangnails! The NHS is crumbling we need to help reduce the burden by taking on certain costs. I am often asked to prescribe paracetamol for GP patients. It costs a whopping £8 on a prescription when we can go and buy a pack for 16p! The same goes for cough syrups, gaviscon, thrush treatment – all of these are available over the counter.

15. What do you love about the NHS?

Taslima Rashid: Everything. But mainly the people within it and the patients.

Anika RahimI love the principle of what the NHS stands for (free healthcare at the point of delivery) which I think really unifies the diverse range of healthcare professionals from doctors to nurses to physiotherapists etc who work for the NHS. People truly care about patients and I’ve seen such great examples of patient care that I’m inspired by.

Amina HersiI adore the NHS, it’s free at the point of access. The NHS supports people through treatments that our neighbours across the pond would fork out thousands for. Chemotherapy, new proton beam cancer treatment, expensive monoclonal antibodies, the latest cutting-edge technology to help us live longer better lives. I love serving the general public, meeting and working with people of all backgrounds Is beautiful. The NHS offers workplace equality, equal pay and I have nothing but praise for this institution. 17. What advice would you give to someone thinking about doing
medicine?

16. Advice for those looking to get into medicine?

Taslima Rashid: It’s a challenging time to go into medicine. When I started it was pretty simple, but we are in a period of drastic change for trainees. Read around the changes and make sure you know what you are getting into before applying. If you are unsure, there are lots of people you can talk to, including me.

Anika Rahim:

  1. Always start off with the right intentions and incorporate your goals into your supplications.
  2. Get work experience in different settings to get a feel for what the NHS is like e.g. hospital, GP practices, nursing homes
  3. Keep up to date with scientific developments whether that’s through BBC/TEDTalks/books etc. (I’d recommend When Breath Becomes Air and Being Mortal)
  4. Develop your interests outside of medicine whether that’s playing sports, art, photography etc.
  5. Remember that medicine is a marathon and not a race. Take each day as it comes and when the going gets tough – go back to renewing 1), making more dua and surrounding yourself with the right people!

Amina HersiMedicine is a long arduous road, there are moments when you will feel inadequate, inexperienced and you’ll wonder if it’s for you. Resilience is a trait you’re going to hone. BUT with all this hard work comes a really rewarding job. You will laugh, cry and feel a lot of things but you’ll also experience raw humanity and its incredibly humbling to be there for the beautiful moments of life. A lot of people go into medicine because they’re smart and they think its a challenge. you can tell who these people are because they hate their job. Evaluate your reasons, because you can only cope with all the hardships if you understand why you want to do it. P.S you will do a lot of unpaid overtime, so you have to think it’s worthwhile.

17. If you had to start again would you still be a doctor?

Taslima Rashid: YES

Anika RahimAbsolutely!

Amina Hersi: Honestly? I often fantasize of alternate careers. Ones where I don’t have to worry about making mistakes that cost lives. I’ve dreamt of being a writer, an architect, a physicist. I have friends with lots of exciting careers in the city, sometimes I feel like I missed out. I wonder what else I’d be good at. There are doctors who branch out into their passions and set up side businesses, it’s definitely something I’d consider. But I was a strong headed little girl and I don’t think anyone could have changed my mind, so yes if I started again I’d still be a doctor.

18. How does Islam impact your career? Does it?

Taslima Rashid: Not really, no. But as previously stated, I feel that the people in my specialty champion inclusion. I don’t know the exact figures, but there is certainly a fairer divide in terms of men and women in leadership roles and refreshingly, more women of colour than I’ve seen in other fields like surgery or medicine.

Anika RahimYes definitely, my faith reminds me that what I do is also an act of worship if I do it for the right reasons. The constant reminders about life and death are often a point of reflection and really motivate me to do better spiritually.

Amina Hersi: Every morning before work, I try to purify my intentions. I remember why I’m there, to help the sick. There has been times when I’m tired and I don’t feel very energetic. Islam teaches me that I need to do everything I do well, it stops me from slacking, it makes me want to be better.  It also makes me remember the little things. I always go round giving patients water on my ward rounds, because I remember there are blessings in alleviating any suffering even thirst.

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