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A stretched staff cannot do everything

Child protection work must be one of the most harrowing and stressful areas to toil in, yet it remains vital to the safeguarding of possibly the most precious commodity - a happy and secure childhood. Yet the vocation is so stressful that turnover rates are high among staff, with surveys across the world settling on an average of one-third of workers fleeing their jobs annually - which in turn multiplies the strain on those who remain.

These are issues that might seem remarkably similar to many nurses who face analogous difficulties in terms of job strain and the consequent effects on turnover. Any solution from the child protection arena might therefore be useful to consider.

The statistics are quite staggering - a recent survey from Sweden found that one in five children was the subject of a child protection investigation, and one in 10 had received social work input at some time in their life. There is something about childhood in the modern age that looks like the demand for surveillance is going to be ever increasing - a dam is bursting in terms of need and a few isolated staff are struggling with their fingers in the dyke to stem the flood.

What to do when there is a Tsunami, metaphorically speaking, on the horizon? With one-third of staff leaving every year it would appear that most people's reaction is to turn and run the other way, and this certainly feels rational at the time.

Two-thirds of those working in child protection services are found by surveys to be suffering from "emotional exhaustion", and one key symptom of burnout is a related psychological phenomenon emotional disengagement: you turn up for the job, but you are just going through the motions, and there is no longer any genuine caring for the people you are meant to be looking after. Worse still, further along the spectrum of burnout is cynicism - you come to hate the clients because you are really having a kind of breakdown.

Yet another problem is that the government notices there is a crisis and imposes guidelines from above to try to resolve things. In terms of child protection, following several high-profile cases, such as Victoria Climbié, the authorities decided to emphasise prevention, and child protection staff were given the additional charge of looking out for those families who were merely vulnerable as well as those where devastating abuse was being committed.

However, stretched staff cannot be expected to do everything - spot and act on terrible abuse as well as nurturing those families further down the spectrum where nothing criminal has actually happened yet.

One solution within a stretched organisation is to be clear and specific about goals. Goals help us know what is expected of us, and limiting goals to realistic ones is vital in preventing staff burnout and reducing turnover rates. Yet NHS staff frequently appear to have real difficulty having a "goal-oriented" conversation - in stark contrast to the private sector. Perhaps in the commercial world goals are easier to agree on because serving the customer and increasing profitability are not options over which there can be much quibbling.

Another difficulty is that it is the best people in the field - those who are most passionate and perfectionist about their work - who are most likely to end up finding the job overwhelming. The art of survival involves taking responsibility for those problems that we can do something about and understanding our limitations in other areas. Worrying about work in the middle of the weekend is a key symptom that you are overinvolved with work and need to learn when to let go.

Another problem is that the most hardworking among us feel guilty about having a life outside of their jobs or even, dare I say it, taking pleasure or finding fun in their work, because they regard this as not being "professional". Yet the only way turning up to the job everyday is going to be a viable project in a high-stress environment is if we take some delight in what we do.

A hierarchy of goals is a perfectly acceptable concept in any high-stress situation - what goals are you willing to sacrifice to attain higher priority ones? Perhaps the reluctance to discuss goals in the NHS or child protection is because the elephant in the living room might then become apparent - the key goal is really to stay out of trouble. But what with dams bursting all around you, maybe that is not such a bad goal after all - just make sure everyone is pulling in the same direction on that one.