Calling In Sick: Dealing With Mental Illness At Work, Part 4
The series concludes with a discussion about what often happens when an episode of mental illness manifests itself at work, as well as ways that nurses can fight discrimination and seek recourse when their jobs are threatened.
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If you are a nurse diagnosed with depression, anxiety, or any other psychiatric illness, you are probably doing all you can to maintain your mental health: you're taking your medications as ordered, keeping your therapy appointments, seeing your psychiatrist and/or PCP on a regular basis, plus taking appropriate self-care measures to keep your body as healthy as possible.
Unfortunately, almost everyone with these conditions will experience a relapse at one point or another; it's the nature of the beast. Even more unfortunate is the fact that stigma is very much alive and well in the workplace, both due to the sensitive nature of the healthcare business and to the relationships between nurses and the public, which trusts us to hold lives in our hands. So when stress and strain exacerbate an underlying mental disorder, it can become very difficult to keep it under wraps.....and sometimes, we wind up paying a terrible price, as I did earlier this year when a severe mixed-manic episode cost me a well-paying executive level position.
"But what about the Americans with Disabilities Act?" you may be asking. "Doesn't it protect us from being fired for getting sick?"
Short answer: Yes, and No. It didn't do a thing for me when I was relieved of my responsibilities because my employer deemed my request for "reasonable accommodations" to be unreasonable, and it was clear that I could not perform my job without them. But to be fair to the company, they had tried on a previous occasion to accommodate me by changing my schedule to a four-day week to help reduce stress, which unfortunately didn't provide enough relief to prevent the catastrophic mood episode that sent me out on a three-week medical leave of absence in lieu of hospitalization.
I could have fought the termination. But since the best I could have hoped for was being given my job back with retroactive pay---and because I had neither the desire to return to the job nor the intestinal fortitude for a bruising battle at that time---I decided against it. The Equal Employment Opportunity Commission allows 180 days for the filing of a formal discrimination complaint, or charge, against an employer; however, they will not always file a lawsuit on your behalf even if they find the employer in violation of anti-discrimination laws. You have the right to sue the employer after the EEOC makes that determination, and of course you can choose not to involve the EEOC at all and file suit on your own.
We have discussed elsewhere in this series the pros and cons of "coming out" with your illness at work. But what if you have a public breakdown, or worse, are admitted to the same hospital where you work? These defining moments change the game, as the illness can no longer be kept secret and you're not in control anymore. Or are you?
The answer is a guarded "Yes". No matter what happened or who was present when it happened, you always have the right not to discuss it with your supervisors or co-workers. Both HIPAA and your employer's policies protect you from unwanted intrusions into your files and provides for discipline, up to and including termination, for anyone who accesses your medical records without authorization.
But there are also situations in which experience can be an excellent teacher, and depending on the circumstances (and your own feelings about sharing it with others), you can do much to educate your fellow nurses about mental illness. You need not be ashamed of it; it's not a character defect and it does NOT define you. But it is a part of you, just like brown eyes or freckles. The fact that you are a nurse who holds down a responsible job proves that you don't have three heads and you're not an ax murderer; no one should fear you because you have something that makes you act oddly at times.
As a nurse living with a mental health diagnosis, you may also be the right person to instill compassion and empathy into those who are lacking. You can gently persuade co-workers not to use words such as "loony" or "psycho" to describe patients. You can offer insight into what makes some tick by talking about the time you had an episode because you couldn't keep your meds down for several days due to an intestinal virus. You can even place yourself in the patient's shoes and encourage others to do the same, even though they will never truly know what goes on in his brain.....or yours.
My thanks to all nurses, students, and others who have been following this series. I hope that it has proved useful in helping readers to understand not only their co-workers and patients, but also family members and friends who struggle daily with bipolar disorder, schizophrenia, ADHD and other mental health challenges.
