It’s my appraisal tomorrow. As usual I’ve left everything until the last minute. And as usual one of the items on my “I must do better next year” list is “filling in my training and reflections throughout the year”.

This year has been… a challenge… and there’s more and worse to come.

I often get quite emotional during my appraisal, but I’ve sat here reflecting on the year, baring my soul, and for the first time I’ve cried whilst writing it. Goodness knows what I’ll be like tomorrow.

But do you know what? It’s actually been quite cathartic. I’ve talked about how I find it hard to switch off when I leave the practice. How I wake in the night remembering all the things I forgot to do that day and must remember to do tomorrow. How I not only work through my lunchbreak, but I also do emails at home, stay after my working day is finished, and am constantly thinking about what to prioritise.

I’ve highlighted how we’re short-staffed in reception, which means I’m often spending a couple of hours a day answering the phones. How I worry that my deputy will tell me she’s had enough. Or that we’ll get that CQC notification when we’re barely keeping our heads above water with the pandemic. Or that the plates I’m spinning will start to lose momentum, and I’ll drop an important one.

I’ve admitted that I don’t think the partners understand how absolutely awful the workload is at the moment, and I’ve challenged them to walk a day in my shoes.

But I’ve also written down how I’ve accessed the NHS coaching programme* which has given me a chance to vent, and strategies for keeping sane. And I’ve reminded the partners that I’m an employee; I know I’d be missed if I wasn’t in post, but I’m ultimately replaceable.

Appraisal is often seen as a tick-box exercise – something that can be put off until tomorrow because, let’s face it, it ain’t going to get the queue down at reception, or the flu vaccines ordered for next year. But this experience has shown me that it’s important to value myself, to take time to remember I do this because it’s a job I love (even if, like a recalcitrant child, I don’t like it much at the moment!). That practice management is my chosen career, and saying that I’m a practice manager and I work in the NHS makes me proud.

I’m more than a tightly stretched elastic band holding the practice together.

So please, practice managers, make time to stop and reflect. Write down how you’re feeling, show it to the partners and get them to understand. And if they’re unwilling or unable to listen (even if they don’t have all the answers), then give some serious thought as to whether they’re the right partners for you.

*https://people.nhs.uk/lookingafteryoutoo/