Ethics and toxic high-workload work environments

Hewett discusses ethics and toxic high-workload work environments. Work environments might be considered toxic because of lack of support or because of undermining or intimidating behaviors of work colleagues. Workload is the most important factor contributing to stress. Other factors include bullying and harassment, discrimination, lack of resources, conflict, and dealing with pain and suffering. Much of the focus in the NHS currently is on the need for doctors to be trained in 'resilience' - which may imply to doctors that the problem is not with the system but rather with their lack of coping mechanisms. Social, professional, and cultural expectations - this relates to the organizational culture of the department or practice and to the social, professional, and cultural norms that are accepted and shared by the health professionals. Doctors do have a responsibility to do their work to a safe level and quality, and should have regard for the wider effects. There should be a balance between timely care and good-quality care.