Sick with stress

[MeLikeDoughnutsTooMuch]

Hi everyone, not sure if this is the best place to post this but I'm a mature student so here goes. Currently I work as a support worker with the learning disabilities service. I work in what is widely accepted to be the worst house in our trust. Three incompatible clients living in what is only slightly better than a shack in a "supported living setting". I work a stupid rota system which only amounts to about 35hrs a week but sees you working nights, days and evenings in the same week, often with no days off anywhere in between to give you time to adjust. One of the clients self harms constantly (head banging) and another has a high pitched and incredibly loud scream (quite often directly aimed into your ear), and personal hygeine is non-existent. Their behavioural problems are arguably the result of their living conditions, but management assure us there is no quick fix to any of them. I find myself having to take a time-out from work. There isn't really any way to avoid the issue - it's stress. Not work-related, but work-INDUCED stress. I know several of my colleagues are very close to the edge at the moment, but I've come to the point where I can recognise I'm at the limit of my endurance in this particular situation.

My question is how big a deal is it to have "work stress" appear in your medical records? Yes I know nobody wants it there; I've had to accept it's not a weakness on my part. Working in a stressful environment is fine, when that environment becomes inhumane to staff and clients it's not. I'm going to need a sick note. Is it ok to have stress appear on it? I'm concerned because I've just got a place on a GEP course and am worried about any potential implications on my future employement prospects. Any advice welcome.

[Renal]

Originally Posted by MeLikeDoughnutsTooMuch

I'm going to need a sick note. Is it ok to have stress appear on it? I'm concerned because I've just got a place on a GEP course and am worried about any potential implications on my future employement prospects. Any advice welcome.

I would not promise you anything but;

First of all, that sounds a bit shit mate, not something you should be dealing with on your own. Have you thought about getting back-up, support or a rota switch from work?

Medical students seem to have a tendancy towards mental health issues, I know a number of students who have suffered or are suffering with depression, manic depression and schizophrenia. Our medical school is very well organised to deal with and help these students and it is never held against them unless there is a true fitness to practice issue - which there won't be in your case.

You will have to disclose this to the university but the details will be held confidentially by the occy health department - this is mainly for your benefit, however, you would be well advised to let a senior tutor or mentor (whatever you have) know in advance if you anticipate there being problems in the future.

What's more, it is illegal to discriminate against anyone because of mental health issues, both on university entry and on applying for jobs.

Hope this helps.

[the_slob]

Hi here

The conditions you are describing are a million miles away from the experience I have had of working in learning disabilities. It sounds more like you need the police or the care comission than a change in rotas.

Firstly let me say that I work for the Richmond Fellowship right now although I am going to St Andrews to study medicine in September. I work in 3 houses where there are 3 individuals living together and although there are certainly issues with them living together we are always able to resolve them eventually.

Personal hygeine is one of the main reasons we are there to look after these people. If there are any issues of personal hygeine there should be risk assesments done and their psychiatrist should be brought in to the service to oversee their behavioural difficulties. At no point should anything be "left" as it is a matter of behaviour. Behaviour like this always must be challenged and the service is failing completely in its remit if it doesnt. Your managers are entirely responsible for implementing support plans to overcome these behaviours and if they are not tying they are failing in their jobs and more importantly the people you are supporting.

The behaviour problems otherwise are harder to deal with and one thing I would say is that exposure to these types of behaviour can be extremely waring and can very quickly lead to the sort of stress you are describing. It is unfortunately one of the major difficulties of this type of work and a lot of my colleagues work between different houses so that they are not over-exposed to certain individuals. Even the best behaved supported person gets waring eventually.

What you are feeling is perfectly natural for what you are describing and I would suggest maybe even considering a change of jobs. It is not your problem that these processes are occuriong as they are and TBH you dont need to be part of a collective guilt process when you are trying to set yourself up for a new life. Also you only have 3 months left at the most before you go to uni and hard as it seems soon it will all be over. If nothing else keep that in mind as much as possible. It may also give you a lot of leeway to make a fuss about trying to implement changes as you maybe have less to lose than others you work with.

I hope this helps.

[Fizzwizz]

What's at issue here isn't the stress of your job, it's whether you are presently coping. I imagine your GP sees that your usual stress management mechanisms are not working and he has to intervene. Firstly let me say that this is nothing to feel weird about. Depression/Anxiety affects many people, Doctors included, however this problem is current.

Occupational health does have the power to deem you 'unfit to practice' based on medical and mental health grounds. There was one case posted here where a student in similar position was not allowed to commence their course because they had suffered from depression recently. The reason they gave was because they considered it unfair to the student to subject him/her to the high pressure of medical school if there was any chance the depression was not fully healed. The student was offered a deferred place.

One point you should consider very carefully is this. GEP is extremely stressful. You really should not underestimate the mental strength you will require to withstand this course of study. GEP has a significant number of stress related problems with students. Part of selection is trying to find students who can cope with the pressures of GEP (and ultimately medicine).

I'm not trying to put you off here, I just feel it's fair to point out that if you can't cope with a poor employer you might do yourself a disservice with a 4 year GEP course. The 5 yr option may be better.

It may be helpful to discuss this with your GP to get his views on the effect a GEP course may have on your health. If he thinks it's not going to be a problem the occupational health will happily tick you fit to practice. Obtaining a sick note is not going to cause you a problem, but a current mental health issue could. Speak to your GP!

Hope this helps ... Fizz

[the_slob]

In response to the last person who wrote a message I dont want to cause an argument but it doesnt sound like you work in learning disabilities. It can often be very, very tough work and in some ways is tougher than working as a GP because of the intensity of contact you have with only a very samll number of very difficult behaviour. I can fully empathise with what the person is describing who started the thread but I can honestly say that if he can cope with what he is coping with to a large extent then he will definitely be able to cope with studying medicine GEP or not.

Studying and working in mental health are totally different pressures and often it is the behaviour of the very people you care for that is the issue.

What I would ask is whether you have been vulnerable to stress-related psychological conditions before or if this is the first time? I know from working in mental health that most people feel like they are living on the edge a lot of the time just due to the nature of the job. This is definitely not a good indicator in any way of whether you will cope with being a doctor as they are very different sorts of pressures. The world of medicine is one now where mental health is taken very seriously and instead of being seen as a weakness in any way is tackled as one of the main issues affecting doctors today. You must not be scared aobut asking for help because this is actually the only way you will be able to get on with your course and become a succesful doctor. If you really feel you might not cope then unis often accept a gap year but there is a strong possibility that when you get out of this job you will probably start feeling a lot more human again!

Good luck and remember you are just one of many confronting these issues every day.

[Fizzwizz]

Originally Posted by the_slob

it doesnt sound like you work in learning disabilities. It can often be very, very tough work and in some ways is tougher than working as a GP because of the intensity of contact you have with only a very samll number of very difficult behaviour.

I don't deny that some jobs are incredibly tough. But tough jobs are not exclusive to to working with learning disabilities. There are many stressful occupations. GEP medicine is also very stressful and is easy to underestimate from the outside. You also underestimate the stress GPs suffer.

The issue here is not whether my job is more stressful than your job, it is that the OP is no longer coping with the stress of his/her job and is receiving medical intervention. This should be taken seriously, depression/anxiety is a pathological condition with a death rate. I would consider it negligent for anyone to subject someone suffering from depression/anxiety to further stress. The OP asked if this would affect his/her application. The answer is it depends on his/her actual mental condition at the present moment. I don't want to pry into this which is why I say speak to the one person who does know, your GP! I say this not out of elitism, nor because I think the OP won't make a great Doc, but because I'd be concerned that the OP would not pass/complete the exams and could become more ill. If the GP is not worried then neither am I.

And at no stage have I suggested that the OP is not fit to practice. I merely suggest that if he/she is worried how this issue will affect his/her application then he/she should speak to his/her GP!

Best wishes ... Fizz

[the_slob]

I agree with a lot of what you have said and of course depression is a very serious condition. I actually said on another thread that the person should consider taking a year out who stated he was suffering from clinical depression.

However what I also know from experience is that working in mental health is actually different to other jobs. The type of stress involved is actually exclusive to this type of work because it involves the possibility of a high degree of negligence towards helpless people which creates its own state of mind and their behaviour eventually starts to be something that occupies your mind a lot. The people on the frontline bear the brunt of all the problems whilst the managers tend to stay away from services as they themselves cant really deal with it.

In life whatever role you fulfill there is always going to be stress but some are actually greater than others and I know from having worked in mental health for 2 years as well as having worked in many other types of employment that this type of stress is very exclusive to working in mental health because you are being confronted daily with people who really can disturb you with their behaviour.

The rates of depression and mental illness within the area of mental health work is, as has already been stated by someone else, far higher than in other types of medicine and in other types of care. This is why I say that the OP is not going to know whether it is the job or other factors that are causing the depression. I think a lot of people go into mental health very positive about life and come out worn, bruised and battered! I understand your insight into depression being a very disturbing and potentially pathological condition BUT I do not automatically think it has to be clinical depression out and out and the person has already stated it is work-related and not a general condition. So the advice would be to be honest with yourself. If it really is clinical depression then as the previous person on the thread says consider the stress of studying intensely and how it will affect you. However job-related stress can often be alleviated by a change in job, or in your case going to university as it gives a boost and a real feeling of optimism about positive change instead of being negatively tied into a very depressing situation.

[Fizzwizz]

If the OP has depression, it doesn't matter what caused it. The issue is that this is 'current'.

If the OP had suffered from depression 6 months ago and was now fit and well I'd be saying don't worry at all!

[the_slob]

I understand what you are saying but there are many different scales and types of depression. There is not a catch-all process of dealing with it and each individual is different.

Again I say that you must work in mental health before you can comment on it as it really is very different even than from other types of medicine. I am not meaning to pick an argument but it really does matter what caused it because it may very well be the case that if the cause is alleviated recovery may be very swift. Despite depression being a clinical condition it is not the case to say it only has biological causes. The causes are often very much external. An example might be a woman who is being physically abused. Outwardly she may display signs of depression that could be treated clinically. However the underlying cause is the abuse and only when that is dealt with can the journey back to a better state of mind be accomplished.

Also I would say that given the low efficacy of many anti-depressants often the best course is giving the brain new stimuli that help it recover from external factors that may be causing the depression. In this case a change of preoccupation may be all that is required..

[Chulalongkorn]

Hi,

Having a period off work for stress-related issues is no disgrace and will not in any way affect the offer you already have. You must certainly declare it on your occupational health records but in no way will it be held against you or get you labelled. This information will not be passed on to your uni tutors either- it is confidential medical information. As Renal has said, many medical students experience far more serious mental health issues so in answer to your question, no, being off for work-induced stress is not a big deal at all.

The GEP course can be stressful (I have just finished one) but after working for many years in healthcare before I studied Medicine, I can honestly say that the stresses I experienced being a student on a GEP paled into insignificance compared to the stresses one experiences in caring for others in a health or social care environment. Do not assume that because you have needed to take time off for stress in this job that you will therefore be unable to cope with the stresses of studying GEP medicine.

If studying does get on top of you at uni, as it can to anyone regardless of whether they have a history of a stress-induced illness or not, there will be excellent pastoral support mechanisms in place to help you through. Sounds like at the moment you do not have any, which may be a contributory factor to you having to have time-out.

So take some down time from work and look forward to starting your course in September. All the best with it. I thoroughly enjoyed my course and I am sure you will too.