Calling In Sick: Dealing With Mental Illness At Work, Part 1

Inspired by discussions with allnurses members and others, this is the first in a brief series of articles about how anxiety, depression and other mental health conditions affect nurses in the workplace. These illnesses are among the most common reasons we miss work, and they contribute to billions of dollars in lost productivity each year. They also carry a high cost to sufferers in terms of stigma, loss of job security, and self-esteem issues. Nurses Disabilities Article

The alarm clock jolts you awake as it does every morning at 0500, alerting you to the fact that today is yet another work day. You groan and pull the covers over your head momentarily, wishing for nothing more than to crawl into a warm cave like a hibernating bear until you feel human again......if you ever do, that is. And you're beginning to doubt that more with each passing day.

The prospect of another shift filled with unceasing demands and busy-work tasks threatens to overwhelm you as you force yourself into the shower, and once again you suspect that there really are worse things than death.....namely, going on like this. Certainly no one appreciates the fact that you have to throw yourself against a metaphorical wall every day: not your family, who counts on you to put food on the table; not management, who calls you on the carpet for every minor infraction of their million-and-one rules; and definitely not the patients who run you ragged with endless requests for warm blankets and Coke, and then complain when you're not fast enough.

You're depressed and very much aware of it, but other than taking the medication the doctor gave you at your last visit, there doesn't seem to be many options. You can't be in your therapist's office every afternoon; you don't want to burden your friends with your troubles; and you certainly can't talk to your co-workers. They're all dealing with their own stresses (both on and off the job), and besides, you don't want to end up in the unemployment office, like one fellow nurse did after suffering a 'nervous breakdown' at work.

So what can you do? You heard what people said about her.....that she was crazy. Looney-tunes. Psycho. What if they were to say the same things about YOU?

The truth is, if you need medication and/or therapy to cope with your condition, you are among the one in five Americans said to have what authorities call a diagnosable mental illness. Depression and anxiety are the most common of these, and while they are treatable, they are two of the major reasons why workers call in "sick".

It doesn't stop there, of course. Nurses are human, and as such we're subject to the same psychiatric issues as anyone else: schizophrenia, manic-depressive illness, personality disorders, even dissociative identity disorder (formerly known as multiple-personality disorder). The fact that the general public has no idea of this speaks well of the thousands of nurses who battle mental health problems and still manage to take good care of their patients.

For the most part, we struggle in silence, fearing the stigma that surrounds those who carry such a diagnosis. Everyone has seen news stories about people with whispered rumors of mental illness being accused of all sorts of horrible crimes; who wants to be associated---even remotely---with the likes of the Sandy Hook school shooter or the Aurora, CO theater killer?

But sometimes, our 'nonconformity' is discovered despite our best efforts to hide it. A nurse with depression may stop coming to work and fail to notify her supervisor; one with bipolar disorder may have a manic episode that increases her productivity at the same time it creates inappropriate levels of hostility which she cannot control. And if we are unlucky, we may find ourselves being eased out of our jobs, or even terminated outright when our employers deem it "unreasonable" to make accommodations for our disabilities.

This short series of articles on dealing with mental illness in the workplace is inspired not only by events in my own life over the past couple of years, but by conversations with others here at AN and with former co-workers who have shared their stories with me. It is my sincere hope that one day, healthcare professionals with brain disorders will be viewed with the same compassion as those who suffer from other medical conditions.

To be continued......

Specializes in adult psych, LTC/SNF, child psych.

I hardly got any sleep during the day yesterday and after whining to DH, he said "why don't you just call out of work?" I stayed up until 2ish, got up this morning and am at PT for my back. I'll be up until 2ish, reset my schedule by sleeping until 8p and then I'll go to work and hopefully resume my sleep-wake schedule for Friday.

I'm going to the Renaissance Festival with my bestie on Sunday and I'm looking forward to that. I can get through the rest of the work week and take more time to focus on myself this weekend!

dolcebellaluna said:
I hardly got any sleep during the day yesterday and after whining to DH, he said "why don't you just call out of work?"

While we don't want to make a habit out of it, like I said earlier, sometimes you've just gotta do it ;)

Specializes in LTC, assisted living, med-surg, psych.
AZ_LPN_8_26_13 said:
While we don't want to make a habit out of it, like I said earlier, sometimes you've just gotta do it ;)

Hence the term "mental health day" :yes:

I've never been able to call out of work due to my depression or anxiety. I always feel like its a cop-out and my boss won't see it as a legitimate reason. That's not to say I haven't called out when I've had an anxiety attack, I just tell my boss it's for a different reason, like the flu. It's sad. I'm not a nurse yet, and my boss knows about my MI but I still do not feel comfortable opening up or being honest about it. Maybe one day...

I've worked primarily in Long-term care, and have no hospital experience. This whole ordeal has shaken my confidence in so many areas of my life.

Specializes in Pediatrics, Emergency, Trauma.
\ said:
I've worked primarily in Long-term care and have no hospital experience. This whole ordeal has shaken my confidence in so many areas of my life.

I can understand your last sentence. :yes:

I have PTSD, and bipolar II trait. I have attempted to return to work many times during my "recovery", and I have dusted myself back and tried again.

I have excelled in areas of nursing; mainly Stepdown and complex care; I loved working hard, the nursing process in action with complex patients, families, and maximizing and seeing results with the population that I worked with.

When I developed PTSD; I always had in my mind that I will "return to the person that I used to be", well, when the reality set in that I was not "who I was", I started to learn how I could manage in the NOW, and it would work itself out with hard work. I worked as an independent contractor, I returned to school to provide more flexibility in my future.

When I reentered, I did reveal my chronic illness, and I guess they weren't paying attention to it until I was halfway through my orientation; near the end, we did the "not a good fit at this time" dance, and I found out I am still in good standing fortunately; one of my reasons of doing this was because with having PTSD, the reality of reliving trauma is very REAL; and I accepted the position during that time; a big NO NO; I thought being five years removed and being in productive counseling would help; well, it didn't.

Looking back, if there was a way for me to delay my start date, I would've did it...I would've started in the summer, where my mood was much better; I survived probation this time! Small victories, lol; but seriously, I have "exacerbations" that are about to occur; and I've decided to return to a p-doc AND have a counselor...after a long talk with my primary doctor. And bless her; she states that I can excel with my PTSD; just with a little more help-and a plan. ?

As much as it was very successful to have this two prong treatment when I was out of work, It's hard when you work five days a week; I have not disclosed to my current job my chronic illness, and unfortunately, have decided to look for a more flexible job; I fear what I need to be healthy will have me looking for a job sooner or later. :down:

I have started to work myself back up to achieve my goals within REASON; not the manic super positive, adrenaline-pumping reasoning that I had before; but with calculated thought in terms of my health; I want to balance my niche; I still think it's possible.

I think there is a place to meet our nursing niche with our chronic illness; I think learning what can work and what work environment we excel at makes a difference, along with having a great support system-whether it's therapy (or therapists) and a good cocktail of meds, and finding ways to enjoy our life, even outside of work. ? Our "chronic brain ailment" makes us better nurses, IMHO. :yes:

Specializes in LTC, assisted living, med-surg, psych.
sarahd333 said:
I've never been able to call out of work due to my depression or anxiety. I always feel like its a cop-out and my boss won't see it as a legitimate reason. That's not to say I haven't called out when I've had an anxiety attack, I just tell my boss it's for a different reason, like the flu. It's sad. I'm not a nurse yet, and my boss knows about my MI but I still do not feel comfortable opening up or being honest about it. Maybe one day...

You don't have to tell them the exact reason you're calling in sick. Most of the time when I've done it for mental-health reasons, I've told my supervisor that a family emergency came up that I had to deal with RIGHT THEN and let it go at that. It wasn't until my illness got out of control a couple of years ago that I couldn't hide it any longer, and by that time I wasn't calling in anymore---I was getting sent home. I can't remember the last time I called in for anything, except for the Norovirus I got right after New Year's.

This is yet another good reason to work PRN (although I am scheduled for most weekends) and to stay away from as much stress as possible. The stress threshold is different for everyone; I just happen to no longer be able to endure very much, although it's better since I've been adequately medicated. YMMV.

What state to you live in? We might be able to help each other.

sarahd333 said:
I've never been able to call out of work due to my depression or anxiety. I always feel like its a cop-out and my boss won't see it as a legitimate reason. That's not to say I haven't called out when I've had an anxiety attack, I just tell my boss it's for a different reason, like the flu. It's sad. I'm not a nurse yet, and my boss knows about my MI but I still do not feel comfortable opening up or being honest about it. Maybe one day...

Where I work, you don't have to tell them why you are calling off, and I usually don't. They don't ask any questions, but you aren't allowed to do it very often, in our case no more than three days in six months. Sometimes I have been actually physically sick with something like the flu or bronchitis or a fever. But even then they don't ask and I don't volunteer info.