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Practice comment

Employers need to recognise the benefits of supporting their staff


Returning to work after being diagnosed with bipolar disorder has shown Vincent Tremayne the importance of employers paying attention to staff wellbeing

The Boorman report, which investigated the benefits of improving the health and welfare of NHS staff, suggested that some of us still do not believe that our employers take this issue seriously (Department of Health, 2009). It might seem unsurprising, but those employers who take an interest seem to perform better. From my own experiences, I can see why.

Some time ago I was admitted to hospital after trying to end my life. A few months on and in a new town, I took an acute staff nurse position at an NHS trust. It was soon clear that I was not staying “well” and while on sick leave I was diagnosed with bipolar disorder.

Once I had been prescribed effective medication I was keen to return to work, but needed a job I could do safely. I started work in an outpatient department with daytime hours, which enabled me to avoid the pressure of an acute ward. After working in outpatients for more than a year I wanted to restart my career in acute care, but was not convinced that an acute trust would give a nurse with mental illness a senior nursing position.

‘Stories from today’s nurses show they do not always receive enough support for their illness or disability’

I applied for a nurse adviser position with NHS Direct. I was honest about my condition during the application process, and was offered the job. My mental illness was taken into account to ensure the job was suitable, but ultimately I was appointed because of my skills and experience. NHS Direct was confident it could provide the support I might need, as it does with all its staff.

In 1948 the NHS was tasked with providing a comprehensive service to improve people’s physical and mental health. Of all the UK’s employers, it should be well placed to remember these principles to ensure it looks after its own staff.

While the NHS on the whole provides a pension scheme, annual leave linked to length of service and part or full time hours, some trusts can offer more. NHS Direct offers its nurses a fixed pattern of shifts that are known months in advance and a physically easier role in a modern working environment. Staff are provided with height adjustable desks, chairs and monitors so they can sit or stand during a call and breaks are timetabled and not missed.

Add in a confidential helpline and a friendly occupational health service and this support has enabled me to resume my career without detrimental effects on my health. With regular shift patterns to choose from, I can plan my life, enabling me to organise psychiatrist appointments or just a day out. Just as importantly, I can concentrate on individual callers’ needs, ensuring they get the most appropriate advice and care, rather than trying to make sense of an entire ward. All these factors contribute to reducing stress.

Employers are required to make “reasonable adjustments” for disabled people, but with the right approach towards staff and the right environment they can provide much more. Years before the Boorman report looked at improving staff health and welfare, NHS Direct have worked to do this.

Since the inception of the NHS much has changed in medical technology and the intricacies of nursing care. Unfortunately, stories from today’s nurses show they do not always receive enough support for their illness or disability so they can nurse better.

Let us hope that other NHS employers recognise the wisdom of looking after their staff so they can care for others. This not only protects employees’ health and wellbeing, but also benefits organisations in improving staff morale and therefore helping them to recruit and retain skilled and committed staff.

VINCENT TREMAYNE is nurse adviser, NHS Direct



Readers' comments (8)

  • This is something that the NHS managers, and Nursing managers in particular are extremely poor at. Not just for those returning to work after illness which is bad enough, but also those who simply need flexible hours, those who need time off for whatever reason, or even those who just want a healthy work/life balance, basically everyone; none are supported in our profession and this is extremely short sighted.

    The level of stress, burnout and a low retention rate in Nursing is proof of this.

    It is basic common sense for ANY profession, look after your staff and they will work well. Not rocket science is it?

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  • Have to agree with Mike, I've been through atress and support was not at it's best.. saying 'we want to look after you' (I was a senior nurse) is not enough! Real alternatives to help support staff aren't always available and most just struggle through illness or leave their post as I did.

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  • It's fantastic to hear of a nurse having a positive experience in this area, & shows how 'reasonable adjustments', which in Victor's case don't seem to involve offering anything not available to all staff, just open-mindedness to employing someone with history of mental health problems. We need to highlight examples like this to less enlightened employers.

    I also suffer from a mental health problem which had cause no attendance issues or adjustments for c.10yrs. It has now been worsened by a prolonged bullying campaign after a registered professional decided it was 'in patients interest' to pass on that I'd ticked the 'chronic mental health problems' on a confidential equal opps form. (This is despite Occ Health being well aware of it already and having no concerns). Occ Health's 'adjustments' consisted of requesting a PDP & regular feedback & highlighting these were extra important for my health, esp whilst bullying continued, even though part of normal line management. 2yrs later, & after 7yrs with my current employer they still haven't happened.

    It has cost me in terms of health/career/financially, and my NHS employer in terms of sick pay etc. for what were effectively non-adjustments. Ironically of course, it also costs the same organisation to provide the care I now need that previously I didn't - double whammy.

    I only hope the financial arguments in the Boorman report hold enough sway in the current financial climate to finally get the message through to NHS employers, where DDA/Public Equality Duty haven't. Maybe money will speak louder than ethics and common sense. Then we can have more nurses, like Victor, contributing their valuable experience to the profession and patients.

    (I have no choice but to post this anonymously due to my current employment circumstances).

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  • I was diagnosed bipolar over 30 years ago , when it was still manic depression. I have received excellent support throughout my career, and , like Vince I have always been honest at interview. I have had senior posts in clinical practice and currently work in education.
    My advice is always be honest and allow yourself to be helped when ill.

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  • Its great to hear how Vincent was able to continue with his career and move forward because of the right support he recieved.
    Sadly, I think this does not happen often enough.
    I myself had immense problems getting a phased return to work after a work related back injury which was caused by a very obese patient grabbing me to try and sit up. I had to remind my employer that my injury was work related and they had a duty of care to support me back to work but it was a daily fight.

    I experience the same problems trying to return to work after surgery for a long term dissability. My Consultan and OH dept informed by boss that it would take a year for me to resume "normal" duties but that I could undertake other useful tasks in the dept. Every suggestion was met by my boss with "I can't accommodate that". They refused to second me to an other area where I had expertise and could have worked "normally" as it was mainly office based, and insisted I remain in the clinical area because of "budgetry issues", ie they did not want to pay me to work for someone else!

    The whole process was very demoralising and its just aswell I had some fight in me other wise I would have been forced to either go off sick again or work when not fit to be in a clinical area.

    My husband could not believe this is "the caring" profession at work.

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  • Unfortunately Lorraine I think your experiences are the norm. Yes it is great to hear of exceptions to the rule, but unfortunately this 'caring' profession is nothing of the sort.

    I understand that on occassion a hard line must be taken because yes there are people out there who unfortunately abuse the system. However when there is genuine need or when just basic courtesy would suffice, the majority of Nursing managers wouldn't piss on you if you were on fire. I don't know wether it is the profession that has made the majority of these people so bitter, or whether the management roles attract a lot of the wrong type of people (power hungry bullies for example).

    But for those managers out there who do get it right, please don't change, and we need more like you.

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  • I to work for NHS Direct, and although some times I could pack it all in especially in the present climate, give them their due... they are REALLY good at supporting those returning to nursing due to ill health.

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  • I find in my trust is all talk, at the end of the day your just a number, that is easily replaced (an ld half the time don't replace)

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