6 Tips for Working with a Chronic Condition

[Melissa Mills, BSN]

I’ve had asthma since I was 18-months old. Through the years, I coughed and wheezed my way through sports, school, and other activities. I struggled my way through nursing school and was even forced to leave clinicals a few times because I was too stubborn to know that a sick nurse (or student nurse) isn’t much good to anyone. It wasn’t until I was in my early 30s and was diagnosed with a second chronic condition that I realized it was time to care for myself or I simply wouldn’t be around to provide care to others.

With maturity and knowledge, I developed strategies that kept me healthy so that I could care for patients and those who reported to me when I was in a leadership role. Without having a plan and sticking to it, I wouldn’t have been able to fulfill all the functions I held at work and at home.

Here are 6 tips I’ve used for many years when working with a chronic condition.

Be Honest With Yourself

Nurses tend to put everyone’s health and wellness before their own. When you have a chronic illness, you have to place yourself in the rightful position of most important. This might mean that you have to acknowledge symptoms at work and confront them with the same care and compassion you give to your patients. You might also need to schedule time off for yourself or ask for a bit more help at home during times of exacerbation.

Being honest with yourself might also mean knowing when it’s time to look for a job that isn’t as mentally and physically taxing as being a bedside nurse. Consider other roles where you change your workspace to fit your needs better and possibly work a Monday-Friday schedule without weekends and holidays.

Control Your Stress

A good case of too much stress is sure to send almost any chronic illness into a tailspin. Find stress management methods that help you cope both on and off the job. If you’re having a particularly stressful day at work, take a mindfulness break.

You can practice mindfulness alone by taking five slow, deep breaths while silently saying “breathing in” with each inspiration and “breathing out” with each expiration. This simple exercise helps to connect your mind and body. Just being in the moment can help reduce stress and restore balance. Or, you can download an app like breethe, calm, or headspace to get guided medications that help with anxiety, stress, and other symptoms.

Find Work-Life Balance

Every nurse needs work-life balance. However, when you struggle with a chronic illness, leading a balanced life is of utmost importance. Be sure to take off time when it’s needed and schedule intentional rest on your days off. Other ways to find work-life balance include:

Stick to your set schedule. Don’t pick up extra shifts or stay over.

Find a hobby. Having something you love to do outside of work can help you relax and connect with who you are other than being a nurse.

Take your vacation days. It’s estimated that 52% of Americans leave unused vacation days each year. Don’t be one of these people. Take your vacation, even if it’s rest.

Find a Trusted Provider

You know the importance of having a trusted provider. Find someone who specializes in your condition and be sure to establish a healthy provider-patient relationship. As hard as it might be, try not to be the nurse when you go to appointments, but collaborate with your provider to create a holistic plan of care.

Be Mindful of Disclosing Your Condition

This one can be a real struggle. As a nurse, you know that everyone gets sick, but as an employee and co-worker, you understand that not everyone empathizes with those who have a chronic illness. This means that if you’re going to disclose to your boss and co-workers that you have a long-term condition, you must have a plan and do it with intention. Here are a few tips that can make disclosing a long-term illness a bit easier:

Never tell others before you tell your boss

Don’t overshare. No one needs to know the details of your test or treatment. Just tell them what they need to know.

Remember to tell Human Resources after you’ve discussed the condition with your direct supervisor.

You’re not obligated to tell anyone. However, being honest with your supervisor is as much about your self-care as it about them.

Know Your Rights

The Americans with Disabilities Act was signed into law in 1991. This act requires your employer to make reasonable accommodations (when possible) so that you can perform your job. Of course, what’s reasonable at a desk job might not be remotely plausible as a floor nurse. Request information about your company’s FMLA policy if you must be off work for appointments or treatments.

Chronic illness takes its toll on your life. When you’re trying to work a fulltime job, participate in home life, and stay healthy - it can be a challenge. Use these tips to help you manage. What other tips do you use to manage your chronic illness while having a job?

[Daisy4RN]

Great article. I have a autoimmune chronic illness and the last couple years of my full time hospital job were very difficult. I attempted to use vacation/PTO days here and there but was consistently denied (because of staffing reasons). I went to the MD and had him sign the FMLA (I believe it is Federal, not company). This enabled me to call in sick when I needed to without fear of going over the dreaded number of allowed sick days used. I obviously let HR know (ie when giving them the papers) but I never told my manager and only a few co-workers but eventually more people knew because you have to mention it is a FMLA day when you call in sick. I always felt a little guilty but my family, friends and few co-workers convinced me that that is what FMLA is for and not to worry about it. It is difficult to manage a chronic illness, especially while working, and I completely agree with all your suggestions and have used many of them. When I was still working full time I always (99.9% of the time), took at least my lunch break and would find somewhere quiet (usually my car), without the work phone so I could just rest a little and do the breathing/de-stress. It really helped me. And it is very important (like you said) to schedule rest time on your days off (without feeling guilt or feeling the need to explain to anyone).

Thanks for the article, and wishing you health and well-being!

[Melissa Mills, BSN]

On 3/7/2019 at 4:48 PM, Daisy4RN said:

Great article. I have a autoimmune chronic illness and the last couple years of my full time hospital job were very difficult. I attempted to use vacation/PTO days here and there but was consistently denied (because of staffing reasons). I went to the MD and had him sign the FMLA (I believe it is Federal, not company). This enabled me to call in sick when I needed to without fear of going over the dreaded number of allowed sick days used. I obviously let HR know (ie when giving them the papers) but I never told my manager and only a few co-workers but eventually more people knew because you have to mention it is a FMLA day when you call in sick. I always felt a little guilty but my family, friends and few co-workers convinced me that that is what FMLA is for and not to worry about it. It is difficult to manage a chronic illness, especially while working, and I completely agree with all your suggestions and have used many of them. When I was still working full time I always (99.9% of the time), took at least my lunch break and would find somewhere quiet (usually my car), without the work phone so I could just rest a little and do the breathing/de-stress. It really helped me. And it is very important (like you said) to schedule rest time on your days off (without feeling guilt or feeling the need to explain to anyone).

Thanks for the article, and wishing you health and well-being!

Thanks for sharing Daisy4RN! It is very challenging some days, and you have to learn to balance. You are right that FMLA is a federally mandated law, however, every employer has some flexibility in how they apply the law for their employees. I've worked for employers who offered paid FMLA and others who didn't cover any FMLA time, but you could pay yourself if you had vacation or sick time. It can be quite different from one employer to the next.

Hope you are staying well, too.

Melissa

[VivaLasViejas, ASN, RN]

I recommend not disclosing one's chronic illness to their employer or co-workers, if at all possible. Doing so paints a huge target on your back. The ADA is a piece of feel-good legislation that has no teeth. An employer may not be able to get rid of you for having a chronic illness, but they will find other ways to do it. Some of the reasons thrown at me over the years: "Not a team player." "Has too many absences." And the ever-popular, "Does not meet our standards of excellence." How do you fight that?? My doctor wrote a letter asking for reasonable accommodations for my condition, and my bosses destroyed it before I even got a chance to explain the need. Never again.

[Daisy4RN]

18 hours ago, VivaLasViejas said:

I recommend not disclosing one's chronic illness to their employer or co-workers, if at all possible. Doing so paints a huge target on your back. The ADA is a piece of feel-good legislation that has no teeth. An employer may not be able to get rid of you for having a chronic illness, but they will find other ways to do it. Some of the reasons thrown at me over the years: "Not a team player." "Has too many absences." And the ever-popular, "Does not meet our standards of excellence." How do you fight that?? My doctor wrote a letter asking for reasonable accommodations for my condition, and my bosses destroyed it before I even got a chance to explain the need. Never again.

I agree with you that in general it is not always a good idea to share your chronic illness with your employer. In my case I was on my way out of hospital nursing anyway so was just trying to make it a few more years. I agree that some people need to be careful when disclosing based on their personal situation, thanks for pointing that out!