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'If I can’t practice clinically how can I progress in my career?'


Nursing Times blogger Elena Kinchington explains how a surprise diagnosis forced her to look at her own professional identity and make changes to her career.

Over the last year I’ve had the opportunity of working intermittently in a non-clinical position. Having only ever worked clinically this was not an obvious career aspiration; rather the choice was made for me when I was diagnosed with multiple sclerosis.

This was not the path I planned. In this time I’ve had to change the way I viewed my professional identity as a nurse, and my ideas about career development. I found myself repeatedly anxious about my future within nursing and asking ‘If I can’t practice clinically how can I progress in my career?’

I cannot image I am alone in this worry, others must have felt the uncertainty, not just someone like me with a chronic condition, but also for anyone who has had to take a career break for whatever reason. The terms of the Disability Discrimination Act presses upon the employer the need to make a ‘reasonable adjustment’, which is how I found my self building up my confidence and self-esteem in the office.

I’m lucky that this flexibility in the system has worked well for me, and has allowed me to pursue the research and audit aspect that underpins our practice. This new understanding of the job we do has diverged in to new and interesting areas that I never once gave myself the opportunity to consider this early on in my career, so narrowed was my focus. I have a greater understanding of the complexity of practice and people involved that contribute to the nursing of a child.

The way we care for our patients is dependent on individuals who have spent time over the years researching best practice. I for one now have a renewed desire to work amongst these people at the forefront of this type of medicine. It goes without saying that a main part of this is directly related to the support I’ve received both from my colleagues and the system they represent. It has without a doubt strengthened my resolve in continuing my professional practice at whatever level I can achieve, and help me reflect on the skill and knowledge I already have in place. This is a continuing journey that, although difficult and has often made me feel resentful at times, has never been one where I felt isolated. I think that this is something very special about the place we work and its support structure. I hope others feel as I do that we have a culture of collegiality within our workplace that enables colleagues with chronic conditions or personal problems to contribute positively in their job and to feel that they can speak openly about themselves and their experiences without being pitied or victimised.

About the author

Elena Kinchington is a Staff Nurse working in a Paediatric Intensive Care Unit in London


Readers' comments (9)

  • Management? There are tons of dark blues and reds (dependent on your trust) who haven't done anything clinical in years!!

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  • mike thats true then when any thing go's wrong blame it on the under dogs? all they do is walk walk around the hospital all day and moan?

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  • yangqing

    over the years I've found that it's much harder working at all women environment than working at mixed gendered place. must be some kind of group psychology involved ?

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  • Elena I really feel for you having to alter your career plans because of your diagnosis. I too was diagnosed with MS in 2004 and have changed my job as a consequence. Although my boss has been very supportive of my needs and is keen to adapt my work to help me, it is becoming harder to see myself carry on in my current role and even harder to see what else I could still do. I'm glad you have found something else even if it is wasn't waht you had in mind for your future when you qualified.

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  • yangqing I totally agree. A balance of testosterone is needed in an all female workplace to calm down all the screeching bitchiness, backstabbing, nastiness and just plain, pure evil! And this is the supposed CARING profession! Ha!

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  • I was ill 3 years ago and was amazed at the lack of care and support from colleagues. I finally was able to practice again through no help from the management.
    It was my ability to adapt and show I was safe to practice. (NMC rules)
    It is sad to think we have predominately female staff that does always have a caring understanding ethos for each other. I found out the hard way you are only a name and number on the off duty.
    I love my job and have lots to give within my profession and wish we had more support to provide care to our patients.

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  • I worked as a paramedic until 3 years ago when a back injury finished my clinical career; we are not as advanced as the nursing profession with regard to advanced practitioners (they are available but you have to still be clinically working to progress) although I have been very lucky to get a position within healthcare governance in my Trust; it is not an easy thing to accept that you cannot practice clinically only 9 years into what should have been a long clinical career. I have been very lucky in that I have had the support and been redeployed twice, but adapting to how office politics work and learning my new job as I go along whilst managing chronic pain is not easy!

    Good luck to all of you who are going through something similar, there is light at the end of the tunnel, it can just take a while to find it.

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  • I am in the process of being diagnosed with ms. I have only been qualified for three months.
    not sure where this would leave me if I have it.

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  • I had an enforced career break and was unfortunate enough not be able to return to clinical practice later on and had no support at all from any colleagues, in fact their total lack of understanding and sympathy were my demise. During the time I had to spend off work looking after a family member I did a part time MSc degree in Healthcare Management which has greatly enhance my cognitive skills. Later on I enjoyed using my time to read about issues which interested me in nursing which I never even had time to think about whilst working. I engaged in my own private research and decided I would like to write a book on my experiences and a little understood condition on which little had been written. However, since my beginning this project at the turn of the Millennium the body of knowledge has grown at a startling rate and I now have difficulties in managing the huge database I downloaded to my computer and which is very time consuming to sort through. Now domestic and administrative duties have taken over and I am now trying to organize my life so that I can settle into retirement.

    Although I am very bitter about my employment situation when I felt I had reached the peak of my career and especially the valuable insight my MSc has given me of excellent and very poor management and how (deserving and undeserving) individuals rise to these positions, I am grateful for the time out that I had to deepen my knowledge, understanding of my profession and the world about me (and have learnt, sometimes, to be more tolerant of my fellow human beings!). My main interest was, and still is, organisational psychology.

    My thwarted career ambitions were to continue in clinical bedside medical nursing and help to lead from the bottom up to help, leading by example, to iron out some of the many serious problems in our interdisciplinary ward team and those we had with our manager, before working my way further up the career ladder. (I thought that with a management degree I would be better able to understand her (quirky) role and learn to become more supportive of it!). However, life does not always turn out so neatly as planned. In my life where some doors have been slammed in my face, some new ones are fortunately opening ajar!

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