Work and stigma

Tonight’s first post – take 2…. Accidentally deleted my first attempt at writing this post.

Before writing my daily post, I tend to ruminate all day about what I want to say. Sadly all the brilliant words that come to me during the day are usually gone by the time I sit down to write my blog.

Today I got the news today about where I was going to move onto next after I finish the six months in the current ward I’m working in.  We were allowed to pick up to five preferences, and it was heavily implied that if we didn’t get any of our preferences in the first rotation, that we’d definitely get one in our second rotation.  Because I was a late addition to the program, I didn’t get to put in preferences in my first rotation beyond saying I’d prefer a surgical ward over a medical ward – and then literally the day before I started, the ward I was assigned to was changed anyway.

My preferences this time focused heavily on specialist areas (eg A&E, CCU etc). This coming year (starting from August just gone) was supposed to be a 12-18 month break from mental health to focus on my own mental health but as I’ve got better, I changed my mind and decided I didn’t want to wait that long to return to working in mental health.   It was equally agreed to by both me and my boss, but when I was sure I was top of my depression fully, I spoke to my boss about having changed my mind about waiting 12 months to go back to working in mental health and asked if it was okay to put one of the mental health wards in my preferences.  She said yes so I was really disappointed to be told today basically “sorry your other preferences were full and we decided not to have you do mental health for your next rotation”.

I realise they are just trying to protect me.  I know it’s not a question of my ability to do the work.  If they questioned my ability, they wouldn’t have me working at all (especially after I told them general nursing is actually more stressful than mental health nursing).  And I worked while severely for months with no question about my job performance, in fact, if I hadn’t asked for time off to go into hospital earlier this year, my employer would never have known I was depressed.

I just find it frustratingly patronising the situation I’m in now.  With mental health week having just passed, the topic of stigma of mental illness is very big in the public eye right now.  What is frustrating is both the view that my employer knows better than I do what is best for me, and that they know better than my treating team what is best for me.  My psychiatrist, Dr A, knows I’m a nurse and that I was working in mental health.  She is a very responsible doctor and would not have approved me going back to work if she doubted I was ready for it.  Even my previous psychiatrist, Dr C, who I saw today (and plan to write a post about) didn’t appear to have any doubts about me returning to work in mental health – actually he didn’t seem to have any doubts even when I was still working in mental health earlier this year, commenting at the time about how functional I appeared at work. (I think that was part of the reason he didn’t realise how depressed I was at the time).

Different people in the management structure said to me several months ago that they were doing it for my benefit, that they don’t want work to make me depressed but surely it’s up to my treating team to decide if I’m up to the task.  The biggest part of the problem has always been management’s assumption that my work contributed to my depressive episode when in reality working in mental health myself had the opposite effect.  I loved my job, and helping others was the one thing I felt good and confident about at the time.  There was one part of my job that really badly effected me, but it could have happened on any ward – and that was dealing with a registrar who thought it was okay to make fun of mentally ill people and an incident he caused with a patient.

Part of me is tempted to think “what if they aren’t just trying to protect me, what if they are just being polite and are worried I’ll stuff up if I return to mental health” but the reality is, I actually have a lot more responsibility where I am now.  I’m actually amazed at how much responsibility ward nurses have – it’s been 9 years since I first began my journey into the hospital nursing environment with my first prac as a student, it’s been over four since my first paid nursing job and over two years since I became a registered nurse but it’s only becoming a registered nurse in a hospital ward that the size of the responsibility has hit me.  So, I do know my boss and the rest of management trust my mental state because they wouldn’t let me loose with seriously ill patients, some whose lives literally hang in the balance, if they questioned my mental state.

And I’ve been very open with them about where things are at.  I’ve made it clear (or hope it’s clear) that they are more than welcome to contact my treating to confirm I am up to working.  Someone at work has the medical letter saying I was okay to return to work.

So it just brings me back to the paternalistic view of them feeling like they have to protect me.

Don’t get me wrong… it’s nice to have bosses who care, but I am not a child who needs protecting.  I am not weak or helpless.

Maybe they are just being polite and think that someone with a mental illness shouldn’t be working in mental health?  I hope that’s not it because you’d think in healthcare they’d be the most understanding that having a mental illness doesn’t mean someone can’t work in mental health.  It’s hard not to worry though.  I know my previous boss made it sound like if there was a position available in August next year or February the year after, she’d happily have me back. But after today, I wonder if she was just being polite.

I guess I won’t know until I apply.  It’s just hard for me to stay hopeful at times with things that are really important because I’ve been let down so badly by people in the past, and it seems like the more something matters to me, the more likely it is that something that will go wrong.  But I am not giving up hope.  I loved my job and I was good at it, and the patients really appreciated that I genuinely cared about them. My only weaknesses were nervousness in general and social awkwardness with other staff, but I’ve made huge progress with both of those in the last few months and as everyone I’ve worked with has said, the longer I work, the better those will get.

Maybe I’m reading too much into the situation, maybe I’m worrying too much.  Maybe part of me is just mad at myself for quitting working in mental health in the first place.  I was pushed to by well meaning people to give myself “a break from the stress of it” but I didn’t have to go along with it.  Plus, I really did want to spend a year doing general nursing so I stayed qualified to work in general nursing.  But now I wonder if quitting mental health nursing was the right thing to do.

I guess I won’t know until 6 months from now when I start applying for where I go to after my next rotation.  I guess the only thing in life that is certain is that life is never certain.

All I know right now is I feel really disappointed and feel the stigma of having a mental illness is to blame.

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