Many specialists and medical leaders we are speaking to are talking about the high levels of stress and exhaustion they are working under. Many describe desperately needing a break or simply hanging on until their next period of planned leave.

Ironically, and frustratingly, many also talk about how their own stress and exhaustion is made worse when colleagues take leave. It is an awful situation to be in. Knowing leave is important and desperately needing it yourself, while at the same time being pushed to breaking point because colleagues are away and there is inadequate cover.

There is clearly a broader problem where leave is not always adequately covered or back-filled, leaving teams to absorb huge workloads and patient numbers that were already too high and are then pushed into the impossible through workforce shortages.

While these larger system issues are beyond the scope of this article, we do want to talk about how leaders can take leave seriously. Treat it as part of their work and find ways to build it into everyday business planning.

As we approach winter, the mid-year school holidays, exam season and flu season, we are reminded that time away from work is not a luxury but a normal and necessary part of life. People get sick. Families have periods of increased pressure and responsibility. School and university exams, seasonal illness and holidays occur every year and should not come as a surprise.

Good workforce planning recognises these realities. Leave is not an inconvenience to be managed around but an essential part of sustaining a healthy workforce. Leaders should be planning for it, not reacting to it.

This article is about the leadership work involved in taking breaks and supporting others to do so to and treating this as part of work.

So, we ask the question: If we took leave seriously, what would it look like?

Below is a list of items that could be on a to do list or meeting agenda of clinical leaders, that could help surface the issue of leave in a safe, contained and practical way. The objective is to find ways to talking about and planning for leave across a workforce in as practical way as possible – both for doctors and for their colleagues and patients.

For example, we could have the following agenda items on our to do list:

To do: Organising and planning leave across the team/department

1. Check the leave requirements for my workforce

In Australia, our main leave entitlements include annual leave, personal/carer's leave (sick leave), parental leave, family and domestic violence leave, compassionate and bereavement leave, long service leave and public holidays. Many workplaces also need to consider cultural and religious holidays.

Planning for, accommodating and supporting leave across the workforce is part of the job. It is not just the responsibility of HR and medical workforce departments but also of team leaders, managers and senior leaders.

Complex workforces require thoughtful planning throughout the year, not just around Christmas, New Year, Easter and other major holiday periods. Good leaders understand the leave patterns and pressures within their teams and plan ahead to ensure leave can be taken without placing unreasonable strain on colleagues or compromising patient care.

2. Check the policies and practices we have for how leave is requested and granted.

How and when should leave requests be submitted? What flexibility exists? How are unexpected situations, such as illness, family emergencies or funerals, accommodated? How are decisions made and communicated?

Many workplaces have an unwritten understanding of "how things are done" but these informal arrangements can quickly become problematic when competing needs arise. There may not always be a perfect answer but having clear, transparent and consistently applied processes helps everyone understand how decisions are made.

It is also important to consider how individual requests are balanced with the needs of the wider team and the delivery of a safe and viable service. For example, planning ahead for periods when multiple senior staff may be taking sabbatical or long service leave can help avoid unnecessary workforce pressures.

The aim is not to create barriers to taking leave but to support fair, open and practical decision-making that recognises both individual needs and service requirements.

 

3. Set the vision, and clarify expectations, around leave – what, when and how we take it.

This is a conversation about why leave is important and how we can work together to support everyone taking the breaks they need while maintaining a safe and high-quality service for patients.

The goal is not to encourage people to maximise entitlements. It is to recognise that rest, recovery and having a life outside work are essential to remaining healthy, safe and sustainable in our roles. Planning and taking adequate leave should be seen as a normal and healthy part of professional practice, not something to feel guilty about or avoid.

4. Talk about it. Is it safe to talk about leave?

It is no secret that there is significant stigma around taking leave, particularly in healthcare. Leaders have an important role in changing that culture by making leave an open and practical conversation rather than something people feel guilty about.

As you and your colleagues approach your next break or holiday, talk openly about planning for leave, being away and returning to work. The aim is to ensure everyone can take a genuine break while providing clarity about who is available, who is covering key responsibilities and who can be contacted if needed.

Other important factors to consider when planning and taking leave

  • Handover: Planning your exit


    Let people know you will be away. Many doctors tell us they arrive at work only to discover that a colleague is on planned leave for a significant period. This should rarely come as a surprise and is something that can usually be communicated and planned for in advance.


    Make the cover arrangements clear. Who is acting in? Who is responsible for key decisions? Who should issues be escalated to? Are there changes to patient load or other responsibilities that the team needs to be aware of?

  • Re-entry: Taking up the reins again


    Let people know when you are back. Reconnect with colleagues, identify any key updates and ask where to find relevant information or documentation. Returning from leave is not just about catching up on work. It is also about reconnecting with your team and rebuilding the day-to-day professional relationships that support good patient care.


    Talking openly about leave and breaks with others

  • Replacing guilt with care and curiosity?


    Without sounding trite, it would be helpful if it were easier to talk about leave, without the predominant emotion being either guilt at having left and added to work to colleagues or frustration and burnout at the extra work you were left with. These are organisational and system issues that are misplaced onto individuals and costly to their social and professional connection.

  • Finally…Try not to stay in phone/email contact:


    But if you do, have some clear and shared guidelines for what, when and how you will receive and respond to urgent and non-urgent messages.

For now, take a real time out when you are on leave from work, and find space to rest. For those left to hold the reins at work – try to wish your colleagues well as they depart and make sure you have some leave planned across the year to look forward to. 

Resources

Dr Anna Clark (PhD) delivers AMA Victoria’s Leadership education and Leadership coaching programs.  

If you have been thinking about taking some time to reflect on your leadership work, clarify your direction or invest in your ongoing professional development, we encourage you to explore our leadership education and coaching programs here, or schedule a free 15 minute Leader Check In with our team.