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Are work being unreasonable?? And when to start mat leave - working as a doctor

(51 Posts)
jellyspoons Fri 24-May-13 12:46:36

Hi,
This is my first post so hope it goes OK!

I work as a hospital doctor and am pregnant with my first baby, due in September. I work shifts, and so far work have said they have no obligation to reduce my hours at any stage in the pregnancy whatsoever (including nights/13 hour day shifts/carrying the crash bleep), though if I get to the stage where I really can't cope then they would have a rethink and sort something at that time. We're short staffed as it is so I can see why the consultants are reluctant to take me off the oncall rota.

My current job finishes on Sept 3rd (I'd be 37+6), and my last two shifts are night shifts. The week before I have very tiring oncall shifts Mon-Thurs. If I finished the preceding Friday to that, I'd be 36+2.

Work have asked me to swap my night shifts and oncalls from later in the pregnancy to earlier in my pregnancy as a "goodwill gesture", especially the night shifts in early September at 37+ weeks as these will be difficult for them to cover as they encompass the change of job period. There are other night shifts at 33 weeks and 28 weeks I'm also due to do.

Currently I've been remarkably well during my pregnancy (hope it continues!). I wonder if I'll get bored if I go off work too soon, but, I also don't want to push myself more than I can manage. Work implied that if I swap the night shifts in early September at 37+ weeks then they might be more amenable to sorting out cover for other shifts earlier in the pregnancy - though I'm not sure whether to believe them! I'm planning on taking 9 months mat leave but may want to extend it to a year, I'm not sure yet. So I don't want to go off too early and sit around bored pre baby, then be forced to go back before I'm ready to at the end of mat leave. I also reckon I'll be over my due date as my mum was late with all 3 of us by 2 weeks!

So! I think I should probably go on mat leave at 36+2 and leave them the issue of sorting cover for the subsequent shifts, but I also am unsure as how much I should pander to the consultants putting pressure on me to swap shifts, in order to get goodwill from them. I also don't know whether if I just carried on, then saw my GP and got certified as "too tired to do oncalls" then they'd be forced into being reasonable and I could work 9 - 5 or equivalent for the last few weeks before going off at 37+2 - this would be my preferred option if possible, I think, but it seems a bit risky rely on (especially as the oncall shifts, whilst knackering, are 9 hours and so they could probably make me do them I guess).

Thoughts??? Anyone else been in a similar situation?
Thank you!!

ApuskiMcClusky Fri 24-May-13 12:49:56

Hello, welcome!

Have work completed a risk assessment with you?

jellyspoons Fri 24-May-13 12:50:47

Kind of - there was a sit down chat but nothing put down in writing...

jasmine31 Fri 24-May-13 13:01:27

Hello!
I don't know where you stand legally but working 13hr shifts and night shifts doesn't seem like a good idea later in pregnancy. You will know better than me but I thought there was a link between night shifts/long hours and prematurity/low birth weight.

I had my baby in Sept last year and got signed off night shifts (as a vet) at around 6 months. I didn't want to wait until I was physically struggling and getting stressed out. Most of my colleagues who became pregnant did the same, many of them earlier in pregnancy.

What do other hospital doctors do in your situation?

Good luck with getting something sorted.

Fishlegs Fri 24-May-13 13:01:39

I think the consultants are being unreasonable, but you can go via Occupational Health, who will do the risk assessment and make recommendations.

Are you doing gen med? It seems crazy to be giving you the crash bleep cos you ain't gonna be able to run anywhere soon!

I work in EM and although there's the odd person who's happy to work a full rota till 38 weeks, most people stop doing nights by the time they are 27 weeks or so. With my first baby I did my last lot of nights at 27 weeks and it was fine. Everyone was kind and made allowances, giving me plenty of drinks and a seat at every opportunity.

I'd also stop at 36+2, you don't want to be doing that last week of on call. Sure it'll be a bit of a headache for them to cover it, but your priority is the health and well-being of you and your baby and that has to come first. Most reasonable consultants would think like that so don't be put off if this bunch are unsupportive.

BikeRunSki Fri 24-May-13 13:09:10

I am not medical in any way, but I do a professional job with a night duty rota, which I stopped at 28 weeks. I went on mat leave at 36+5 in both pg, quite happily and really quite ready to finish. As for your baby being late - I wouldn't rely on it. My mum had 2, one early, one late: mine have both been early, my sister 's both late.

Kendodd Fri 24-May-13 13:12:19

Congratulations on the baby and good luck with the next bit.

My current job finishes on Sept 3rd does this mean you won't be working with the same people when you come back? Or you'll get a new job entirely or it's just when ML starts?

If you will be leaving I think this gives you a lot more leeway to make demands (even though these 'demands' may be things you're legally entitled to) in the real world, you might have to still work with these people and need to keep them sweet.

I think you need to have a pregnancy risk assessment done, which I believe is a legal requirement. Get that done/redone and take in from there.

As for going on leave early, make the most of it, sleep late, go to the cinema, go shopping, it may be YEARS before you get to do these thing again.

jellyspoons Fri 24-May-13 13:36:34

Fishlegs - Yeh I agree it does seem unreasonable to me. It's funny, when I had the conversation with the consultant she somehow made it seem quite reasonable and sensible to "see how I go", but in retrospect it now seems a bit miserable! Two consultants have suggested there's no need to see occupational health unless I felt unwell, but I think you're right occy health are probably more likely to be sensible about it.

I work in paeds, and the crash bleep covers paeds and neonates. (The neonatal one goes off quite regularly).

Jasmine - yeh I've been looking up the stuff on prematurity from shift work etc but the latest evidence seems to show a small / non existent risk www.ncbi.nlm.nih.gov/pubmed/23343859) so not sure I can use that to help me.

Other doctors - well, I have friends who worked the same job as I'm doing, last year, and work were also very inflexible and said the same things and they were forced to do full shifts until 36 weeks (or take sick leave if they weren't coping) then go off on maternity leave at 36 weeks. However, in other hospitals friends working at my grade have been automatically told nights and shifts longer than 8 hours are banned after 28 weeks, and this has been put into place without them having to do anything at all. So I think it depends on the hospital and my one happens to be short staffed and therefore less flexible...

jellyspoons Fri 24-May-13 14:08:16

kendodd - my current rotation finishes on September 3rd, so if I wasn't pregnant I would then move from this job to a different hospital but still working within the same specialty and training programme. So I'd still have a job, but it would be working with different people. It's a standard part of being a hospital doctor to rotate jobs every 6 months or so.

Yeh I hear what you're all saying and I think it is the right thing to do, go off at 36+2, it does slightly annoy me that it doesn't seem possible to plan to work til 37/38 weeks but on 9 - 5 shifts, as this would be my preferred option. But from what my colleagues tell me who did the same job last year, not even occy health / a proper risk assessment would stop me from doing the 9 hour oncall shifts as these aren't considered excessively long hours.

Have just spoken to another friend and after occy health involvement she stopped doing nights after 30 weeks, and reduced 13 hour shifts to max 9 hours, thought still had to carry the crash bleep for her entire pregnancy.

I really don't like confrontation so I'm just kind of dreading speaking to the consultants and saying I'm not going to do what they've asked me to!

Thanks for the support, guys.

ApuskiMcClusky Fri 24-May-13 14:09:19

With the new 'fit note' system, it's easier for GPs to specify that you can continue to work but with accommodations made, and they can specify what those should be - e.g. no nightshifts or on-calls; if work then feel they can't meet those requirements, then you would be off sick as usual. So it isn't now a choice between being signed off sick or doing what they tell you, your GP can support you, so this is a good back-up position to have (worth talking to your GP about your possible concerns upfront so you can get a sense of their level of support).

But I agree that Occupational Health are the first stop - they will be geared to supporting you so that you can work as long as you can / want to rather than risk overdoing it and having to be signed off.

If the consultants fret about it, just say that you want to plan ahead - that you don't want to drop them in it at the last minute if you're not able to cope, and that having a plan in place will help you feel better able to manage your workload.

jellyspoons Fri 24-May-13 14:10:05

My friend also said that the department made her swap her long days and oncalls to earlier in pregnancy so she ended up with loads of them at 30 - 34 weeks, which made her so knackered she had a miserable time and went off sick for a bit then off on mat leave as soon as she could at 36 weeks. Miserable!

jellyspoons Fri 24-May-13 14:14:24

Apuski - Yeh the "planning ahead being the best thing to do" I totally agree with, but the consultant I did the verbal risk assessment specifically said this that planning ahead was not departmental policy as they preferred to see how it goes. So they aren't very receptive to this argument.

One of the problems is that over 50% of the rota is one kind of on call or another, and even standard day shifts that I do the minority of the time, I carry the neonatal crash bleep during those. So the whole thing is just a bit of a nightmare really.

Ah, neonatology. Of course.

I have some second hand experience of the training and I have to say that I think the consultants ABU. Do I understand correctly that they want you to do more long shifts now to make-up for the fact that you will be physically unable to do them later on in your pregnancy?

I think that is an outrageous idea. I know a lot of consultants used to work longer hours during their training, but that has changed for a reason. The rotas in most places are designed in a way that enables proper rest after intense periods of long shifts or on-calls. Especially in an intense and acute specialty like neonatology. As far as I understand, it is planned this way so that doctors (even those healthy ones who are not pregnant) have a chance to rest. How would it be fair on you to take on an excessive workload during a physically difficult time? I understand they are understaffed, but that is their responsibility to sort out. They should not pressurise you into taking on additional, tiring shifts now because you will be unable to do them later - you are having a baby, not jetting off on a nine-month holiday.

I think it is fine for you to carry on working for as long as you want, but I think it is unreasonable for them to want you to take a heavier workload now. Your shift pattern is actually very demanding as it is, there is little reason for you to have to strain yourself for the benefit of the consultants.

jellyspoons Fri 24-May-13 14:35:29

youngblowfish - Yep that's exactly what the consultants have asked me to do - swap the night shifts, on calls and long days to earlier in the pregnancy so that they are covered. They've specifically said that if I don't do this then my colleagues will be made to do them at the last minute with short notice which will be difficult for everyone. And speaking to my colleague who was in the same position last year she said they "made her" do these swaps which was one reason she had such a tough time from 30 weeks onwards.

Yeh it is ridiculous that working in neonates with prem babies every day the department don't have that in their mind as a reminder to actually be nice to pregnant women!! But it does seem to be the case.

So yes, the more I think about it the more it seems crazy to swap shifts to earlier in the pregnancy, it would be really hard work. (Plus from my reading of the law it doesn't seem they have the legal right to ask me to do this). However, it's easy to say this here on a web post but saying it to the consultants who are my bosses is a bit harder. Eek!

hedwig2001 Fri 24-May-13 14:50:13

I work in Neonates. We have 2 pregnant SHOs at the moment. Both are working reduced hours.
See occupational health. Also maybe discuss with your Obstetrician.

ApuskiMcClusky Fri 24-May-13 15:00:41

Planning ahead is inevitably hard, as people's pregnancy experience at work varies from able to carry on exactly as before to being signed off for the whole pregnancy with severe hyperemesis, for example, and anywhere in between. But their approach seems to assume everyone will fall into the first category, which really, with the job you have and how demanding it is, I would say is not typical. So it seems more sensible to plan for the 'average' pregnancy experience!

Hope Occ Health can give some good advice - and to me it sounds like you are trying to get a good balance between your conscientiousness and your wish to cope with your pregnancy.

Cookiepants Fri 24-May-13 15:10:44

Hi Jellyspoons,

I'm due September, and work shifts as a critical care nurse, so know what you mean. I'm nearly on permanent nights til I leave sad . As I understood it I would not be allowed to work past 36 weeks without a note from my GP / midwife and occy health which they do not like doing. People have advised me to 'see how I go' and not do anything I feel unhappy with i.e moving heavy patients or nursing aggressive ones! They are a little better at making sure I get breaks and leave on time though.

Oh, jelly, but surely that is blackmail? Please make a fuss. What they are proposing is so unfair, I am a little at a loss for what to suggest in terms of making them realise their appalling empathy by-pass.

Points I would make:

1. You are not responsible for organising the rota, they are. Telling you that your colleagues will be made to suffer if you do not increase your workload to dangerous levels is unfair and very possibly illegal. What about the European Working Time Directive? I am sure you can possibly phrase it in a slightly less confrontational manner, I am just angry on your behalf.

2. I do not see how they can make you swap your shifts. Suggesting this as a 'good will gesture' when they threaten to make your colleagues work extra for you is surely a contradiction in terms? I don't think they would have a leg to stand on legally, but hopefully it won't escalate. Certainly, all doctors I have ever come across only swapped shifts if it suited them or if they were getting a favour in return. If the person organising the rota cannot get adequate levels of cover, then they need to find a locum.

3. You can try phrasing it in terms of how you want to work for as long as possible, but working within the current rota as opposed to doing crazy swaps. Do use the example of your friend who has worked there before and had to go off sick due to being overworked - emphasise who you'd like to avoid that.

4. Is there a sensible consultant at work that you could speak to who could possibly back you on this issue?

In all honesty, what they are trying to do is put excessive strain on a pregnant woman for the sake of cost-saving. Do you think that is reasonable under any circumstances? I think they see you as a soft target. It disappoints me so much to read a story like this, when a woman who is clearly very intelligent, capable, and committed to her work is made to feel as if she is putting others out by being pregnant. What a sexist attitude.

jellyspoons Fri 24-May-13 18:01:36

Aw thanks, youngbf. It's really nice to hear what other reasonable people think so I know it's not just me making a fuss for no reason. And the way you phrase it makes a lot of sense.

Having said that, though, I've had my fingers burnt in the past on one occasion for drawing attention to myself (I put in writing my concerns about an incompetent senior colleague, who then made a counter complaint saying I was incompetent, which led to a whole headache) so I've become a little bit cynical as to fighting battles after that. I'm afraid whistleblowing in the NHS / fighting employment rights in my experience seems to become a massively stressful exercise even if you're in the right. Hence why I'm acting a little like a wet blanket currently!

Yeh, the EWTD applies unless you opt out of it, and if you organise your own swaps you automatically are opting out of the protection of it. So that wouldn't apply (though as I said, I do know they can't force me to do these swaps, as long as I stick to my guns and don't stress about the hassle for my colleagues).

The consultant that I had my verbal risk assessment thing with is probably the most approachable female one in the department, she's got kids and is part time herself. And she didn't say these comments in a threatening way, it came across as a very reasonable conversation in the way she said everything, somehow (don't quite know how!!). She's also one of 2 designated consultants in the department for this kind of issue, the other one is far stricter and I think would be far less likely to be sympathetic. Then there's two other male consultants who are my designated supervisors / mentors, one at my hospital and one at a separate site, but I don't really think that getting these people involved would help me politically, I think it would just create bad feeling.

So.... I think what I need to do is firstly, not agree to any swapping of shifts to earlier in the pregnancy. Then, to plan to go off on mat leave at 36+2, but before that see my GP (who is really lovely and sympathetic) at 25 weeks or so and get signed off night shifts / 13 hour shifts from 28 weeks or whatever is reasonable. It seems with the fit note system that they shouldn't really be able to argue with that. And I know enough GPs that if my current GP won't sign me off (which I doubt) that I'd be able to find someone who would. The sticking point will be that I'll still have to have the crash bleep for the whole time I'm working, but I can't do much about that. If I fight that one then (based on my colleague's experience last year) I think it would be a major incident and require my trade union etc to get involved - plus massively annoy the department, so probably not worth it.

I have no idea what any poor member of the public would think with me waddling along at 36 weeks with the crash bleep to a neonatal crash call... madness really.

thanks for the support again, it means a lot!

Sorry, RL got in the way.

Ha, I am sure they have a way of coming across as entirely reasonable, when they are, in fact, anything but.

Yes, I think your plan sounds perfect. Forgive me, I do come across as terribly forthright occasionally, but it was not my intention to suggest that you start a crusade against your unit's unfair practices. While it is true that I believe it would be best for patients and for the unit to decide sensibly how to manage busy, pregnant doctors, I think you are absolutely right in not rocking the boat too much.

I have little advice with regards to the bleep, but hopefully it will not be as big an issue if you do not work excessively long hours.

Anyway, best of luck with the negotiations (believe it or not, I also hate confrontation in RL) and best of luck with the pregnancy.

IJustWoreMyTrenchcoat Sat 25-May-13 10:35:52

Your NHS Trust should have a Pregnancy At Work policy as well as one on Maternity Leave and pay. It would be worth looking up in your HR policies so you know where you stand from a HR point of view.

I was looking at mine on the intranet at work just recently and it definitely had specific sections on night shifts, long hours and excessive standing etc. especially in later pregnancy. Ours also recommended pregnant members of staff should be taken off the Crash Team.

littleducks Sat 25-May-13 10:55:57

Being taken off the crash team seems sensible, i don't see how it could be fair on you or your patients for that to continue. I ran for the bus the other day and really overheated and felt ill afterwards. I don't think you could be expected to run, knowing a life may depend on it, then arrive and be in a fit state to do anything!

mamadoc Sun 26-May-13 09:05:26

Hi jelly spoons, I am a Dr and during my 1st pregnancy I worked until 37 weeks in gen medicine, shifts, nights, crash bleep. I really, really regret it.

My DD was born IUGR and spent 2 weeks in SCBU. I was healthy, non-smoker, normal BP, no RF and I truly believe the stress of my job was the cause. It was at the time of MMC. I was stressed out of my head with that thinking neither DH nor I would have a job. I went to a job interview on my due date! My consultants gave me the 'its not an illness, you can work as normal stuff'. I swopped my week of nights and did it at 30 weeks under pressure from them.

I now look back and think what was I thinking of! I don't know if this is true for you but I had trouble seeing my bump as a baby, a separate person I had to stick up for. I thought they were just doing this stuff to me so I should suck it up. Now I feel really differently. No job is more important than my kids.

DD was just fine in the end but the SCBU stay and subsequent focus on her weight really spoiled my first year with her and knocked my confidence as a mother.

For DC2 I was by now more senior and working in a more family friendly specialty. I did as per your plan above. Finished at 36 weeks, got signed off nights from 3rd trimester, didn't swop any shifts just worked them as rostered. Much, much calmer. DS born twice the size of DD in MLBU, bf easily established, home next day and I was so much happier. Contrast with the horrible hospital stay (in my own hospital with colleagues popping in whilst i was wired up to a double breast pump!) it was so worth it.

I haven't looked at the research lately but did at the time and I think some studies do show adverse effects of shift work, some don't. It did not make me feel reassured.

In summary: stay strong, do this for your baby, no job is worth as much as your child. These people putting pressure on you just want an easy life. They can organise cover they just don't want to bother or pay out. If they put it on your colleagues it is them causing the trouble not you. If you do make the sacrifice they will not remember or give you any credit and you are actually making it harder for others following to challenge this culture. It's going to feel a bit awkward but this is worth a bit of embarrassment. They cannot make you swop shifts or dictate when you take leave or go against a GP note so as long as you remain calm, polite but determined you will win out.

Dilidali Sun 26-May-13 09:27:33

It's an ongoing ' joke 'where I work about giving birth 3 hours after your last shift. It has happened in more than one occasion. Yes, the babies were small, needed a little hand in the first few days and the mums are adamant next time they won't leave it that late, and they don't.
I agree, see occy health, stop at 36 weeks. If you haven't got far to run from the dept to matty, keep the crash bleep, if it is miles, hand it over with a smile and go off sick, safer that waysmile.
Congratulations on your pregnancysmile.

jellyspoons Wed 19-Jun-13 02:29:49

An update on this...

I saw the occupational health nurse yesterday, who discussed with her consultant and emailed me back today. They've said from their point of view I have to go and see them again if I'm finding it too tough and they could make recommendations at that point to reduce hours / nights etc. But they wouldn't give out general recommendations in advance.

Oh I don't think I mentioned before on here, the latest line from the bosses (in addition to asking me if I've swapped my nights yet so I can still do them all), is that any shifts I get reduced in hours I have to "make up elsewhere". So if I go onto 9 hour day shifts instead of long day shifts, I have to come in on my days off to make up the shortfall of 4 hours for every reduced shift. Occupational health were totally useless about this and said that I'd have to discuss it with my line manager and be guided by what they said.

The crash bleep in the third trimester occy health said "could be risky" but they wouldn't specifically advise whether it was acceptable or not. Like I say, I'm a bit ambivalent about fighting carrying the crash bleep as I think if I fight it I'd end up doing paeds A+E shifts instead which although supposedly only 9 hours are completely shattering and tend to finish 1 - 2 hrs late with no chance to sit down or drink or eat all shift.

Oh and I also spoke to the BMA a while ago and they said everything work was saying was completely ridiculous and unreasonable and that if needed they could get involved. But I don't know that I want all that extra hassle!!

My GP said he'd write me a fit note saying whatever I liked on it, whenever (well he was a little reticent at first but then said he'd be happy to do whatever I wanted).

Hmm pretty frustrating and stressful all round really.
Mamadoc - thanks for your thoughtprovoking post. I had a bit of a panic the other day when I didn't feel movements for a long time (though pleased to report now getting kicked lots and lots!) and that made me think I should try harder to look after myself. Easier said than done. Got annoyed at myself yesterday for being persuaded to stay late by the consultant, I'm way too much of a push over and staying 2 hours late every day to sort stuff is not a good plan! And I won't be able to do it once I have a baby and nursery etc etc!!!

So yes, current plan (agreed with HR) is to finish for mat leave at 36+2. In terms of nights and long days, nothing is decided but I think I'm mainly tempted just to do all the rota'ed hours as it'll actually be less tiring than coming in on my days off (1 hr commute time also) to pay back the hours. And I'm too big a wuss to get the bma involved.

Right, best go to bed!
Argh have to sort whole of eportfolio by end of tomorrow to get year signed off! Not going to happen!!!!!! Especially when not allowed proper amounts of caffeine!
xx

TheDetective Wed 19-Jun-13 12:41:05

Good luck jellyspoons. I had my baby last November. I'm a midwife working on the wards. I worked til 37+2 doing nights for the last 3 weeks. That last week nearly killed me off, I felt awful. Tired, massive, awkward, not sleeping, the start of pelvic discomfort and vaginal pain (wtf?!) and a sore toe but that's by the by!.

As I was on the PNW, it wasn't uncommon for me to pick up the phone to hear a screech down the other end 'get to LW now, scrub'. And off would I run, bump and all, down 2 corridors and up a flight of stairs, legging it the length of LW to the theatre. It was awful. So, I would not be happy having the crash bleep. I started to struggle with this around 29-30 weeks.

I too had an IUGR baby, born on the 2nd centile, where as my previous baby had been born on the 75th, 8lb 5oz. I also went 20 days past my EDD, as I didn't want to be induced. I think the stress of working and the stress of being told the day before my EDD I had to provide a statement for an incident with in the next 3 weeks actually stopped me being able to relax and let go enough to labour!

Do what you need to - get your GP on board. How does the doctors AL work out? Can you go on A/L from 36 weeks? Perhaps taking ML from 38 weeks or whatever? Or even AL from 34 weeks, and ML from 36 weeks.

Next time round, I won't be putting myself through the stress - no way.

I hope the Consultants see sense. I would advise you to tread carefully for the sake of your career, BUT, don't let yourself be walked all over. Let the union get involved if you need to. I rang mine for advice loads during the pregnancy, and it was really helpful.

Good luck again. smile

mamadoc Thu 20-Jun-13 01:20:15

Glad to hear you plan to finish at 36 weeks.
You are under no obligation at all to swop those nights so DO NOT be pressured into doing it. They can sort out their own problems.
Long shifts and crash bleep seems less clear but I am sure if you had a fit note saying no nights and no shifts longer than x hours they would have to honour it. Not at all sure they can force you to make up the hours that sounds crazy and just like blackmail.
Remember your baby needs you much more than your job. No-one is indispensable. If you did run around swopping it all and martyred yourself to the bitter end I guarantee no-one is going to appreciate it anywhere near enough for it to be worth it.
And, as you say, this is just good practice for re-orienting your priorities when your baby is here. I still work bloody hard but I leave on time as pick up is not negotiable (unless genuine life/death situation). I take whatever paperwork stuff I can home for after bedtime eg dictating letters, CPD and somehow it gets done.
Good luck

Isatdownandwept Thu 20-Jun-13 07:09:18

The conversation goes "I am really sorry, but whilst I am happy to continue my normal shifts and normal scheduled rota for as long as I am able, I really cannot take on extra at any point in my pregnancy, which is what you would be asking me to do if you want me to bank up extra nights and on calls now. But I am of course happy to do my fair bit until my GP tells me to cut back. Am sure you don't have an issue with that?"

Really. It's that easy. If they come back and say its unfair on them to have them cover for you later in your pg you need to say that you are very sorry but the job is demanding enough as it is and you are really quite shocked that they seem to expect you to even think of doing extra at any stage in the pregnancy, and surely they don't think it right to deliberately plan to overload you at any stage? And so on. Just be very polite, but keep repeating. If they keep pushing then I would simply say that the level of stress that they are putting you under with all of this is making you feel very upset and that if they want to pursue this then it would have to be with the involvement of HR, given that you have already pointed out again and again that you are perfectly willing to continue your shifts and rotas as contracted for as long as you are able.

Your bosses are being primal. You have all the legal rights in your hands but I appreciate it is easier said than done to use them. Better to just keep politely telling them they are arses until they get the message. If they don't then if it were me I'd get signed fit and if they blow up at that I'd go to BMA.

MorganLeFey Thu 20-Jun-13 15:57:01

There is a handy NHS/RCP/OccHealth document giving general advice to employers & employees in pregnancy - like reducing 'long hours' (definition was >40 p/w I think)... although amusingly my NHS OccHealth didn't seem to be aware of it! The MWF have a campaign that nights in general should be stoppable in the third trimester.

I stopped nights at 28 weeks (specific risk assessments things were also lone working & violence in my post) & consecutive long days. So obviously did my normal days in place of zeros for out of hours that I had not done.

Thankfully my Supervisor (recently returned from Maternity Leave) was really helpful with my risk assessment/her recommendations - although the clinical director had suggested in our intro rota meeting with all the doctors on it that I swap the on-calls I was due to do in the early part of my mat leave - effectively doing more on calls in the same period & partially covering my own leave - I was too stunned to respond eloquently at the time (!)

Anyhow - jumped through the OccHealth hoops, though they were really vague about the strength of their 'recommendations' to my line managers. My plan B was seeing my GP & presented specific concerns/risk assessment & the NHS guidance (!) so got a handy fit note with the 'fit to work' and adaptations of no nights, shorter hours etc. Then had enough confidence to present to the rota side of things that options were I did my job with adaptations - so kept doing the day part, or I would be signed off not fit to work until Mat Leave could be forcibly started at 36/40. They opted for former & didn't need to whip out the note.

I momentarily felt selfish & demanding but then thought it wasn't really just about me but the bump too & latter stages of pregnancy start being higher risk again & I would blame myself/work if anything went wrong.
Although perhaps easier for me to do this as my report-writing supervisor was on board & it was a short post with this specific trust & not in my overall specialty - so less concerned about grudges!

I started at 37/40 & finished at 35/40 using some annual leave. I did not want to be stressed out in latter stages & wanted to properly - practically/physically/emotionally etc. prepare. As it happened she came at 37+4 (Caucasian primip - I was expecting to go beyond EDD) - so pleased I did! Unforunately, I planned to get portfolio perfect in 38-40/40, whoops... Also would have had plenty of other sedentary things to do if overdue - like revision etc.

Good luck. smile

stickortwist Thu 20-Jun-13 16:21:32

I tried to name change but failed.... I just wanted to let you know that im not in the slightest bit suprised that asked you to to extra nights now. Whilst pregnant with ds2 i worked a v busy gen med sho rota in a dgh. At 32 weeks ish i walked into hr halfway through a 13 hour day and sat and cried that i couldnt carry on. I sent myself crazy trying to plug gaps in the rota as they couldnt get locums and working extra long days and nights it was hellish. it took a long time to get over.
However with ds3 i managed to work till 36w as i had more supportive colleagues and a fluke of the rota meaning no nights after 28 w.

Ive always been able to find someone who would hold the crash bleep for me. If you want tl do it officially i would see oh at about 20-30 w when ypu start to show more and say you dont think you can safely perform bls ( or use defib although showing my age they are probably hands free now)
Sorry for spelling . On my phone!

Good luck and dont let them make you the scapegoat gor any rota gaps

MildredH Fri 21-Jun-13 17:12:56

I agree with the earlier poster. There is no way that they can ask you to work extra hours to compensate for not doing long days. It sounds as though they are chancing their luck- hoping to pressure you into agreeing. Earlier advice entirely correct- be polite but firm. (I realise this is much, much easier said than done with the situation you describe). Is it possible to liaise more with medical staffing rather than with your seniors?

This thread makes me slightly nervous. I'm 17/40, working as an SHO in gen med at a hectic DGH. I struggled through trimester one only having two sick days for vomiting. Feeling lovely now in second trimester but apprehensive about later on. Our rota is 50% medical take, always 12 hour day or night shifts and our medical staffing dept are not known for being reasonable!

I wish you well. Really hope you get it sorted.

Itaintmebabeitaintmeyourlookin Fri 28-Jun-13 21:43:38

First reaction..... Bastards .. Lol

More measured reaction.... I bloody hate HR

Sensible comment..... Do they want all shifts covered so you don't have to repeat part of your training? If you are employed via the Deanery can you ask fr LTFT training? If you are Trust Dr just be a LOT more firm.

Simply say you can't do it and exhaustion/ nausea etc are impacting on your stamina to do the full time hours.

Under no circs do your nights early, that s outrageous

Twirlbitesruinedmylife Sat 29-Jun-13 18:17:35

Just wondering if you have considered talking to your HR department. It may be your department is not following your hospital's policy.
I'm concerned that you may be under so much strain there is a risk to patient safety and if you agree then you really need to look at your trust's whistle-blowing policy.
In addition, if your trust is an FT (and possibly even if it isn't) you should have a non-executive director on the board who has a special responsibility for staff safety.
I have only dealt with unions for non-medical staff but maybe the BMA can help you.

Itaintmebabeitaintmeyourlookin Sat 29-Jun-13 22:27:27

Medical staffing don't care, they really don't. We are simply a commodity they need ... The number of times I have heard Oh we bleeped you for urgent on call cover for tonight! Can you do it? No? Are you sure, can you think about it... And many variations thereof usually finishing off with, Can you ring us back before 4 , I go home then....GGRR

Zoomania Sat 29-Jun-13 22:46:52

Of my hospital medic friends most stopped nights at 28w I think. Med reg friend stopped work at 31 w with three weeks a/l then maternity leave starting 34w. She already had SPD starting which has resolved now she has stopped running around doing 12 h days. I know plenty of medics who worked til late only t have baby early and wished they had had a longer break first. I know a med SHO who worked late but 9-5.

You have given them enough notice..there should be no need to say they will suddenly have to get your colleagues to cover.

Itaintmebabeitaintmeyourlookin Sun 30-Jun-13 00:28:28

Any problems go on sick leave without any worry. They will not be there in the middle of the night if you feel exhausted and unwell.

jellyspoons Sun 07-Jul-13 19:43:38

Hey all,

Well, hanging in there and executing plan A of smiling and nodding when asked to do unreasonable things, but actually not organising any shift swaps etc seems to have worked.

I did my 4 nights at 28 weeks and 3 long days last weekend, which were exhausting (I stupidly did a swap to get a friend's wedding off - I organised this when I was about 6 week's pregnant and didn't really think about it! - so ended up working crazy numbers of hours within 8 days). BUT, one of the consultants in charge of the registrar rota came in on one of my night shifts for a sick patient and ended up asking me what was happening with my nights, how much longer was I going to do them for.

I said the truth which was that I'd be asked to continue as long as possible and not to organise anything in advance to get out of nights, and that I had one more set of nights to go at 34 weeks. And that I wasn't looking forward to them and thought they'd probably be really hard. And the consultant (who has previously been really militant over email etc) then asked why I hadn't swapped them with someone. I kept my ground and said I didn't want to tire myself and swap nights to earlier in the pregnancy, plus it's pretty tricky to do swaps on our rota anyhow. She then started saying about how maybe I needed to swap into doing long days or shorter A+E shifts instead of nights, and I had to remember that if I did any less hours than I was rota'ed to do then it wouldn't count as training. I said that wasn't really bothered about 6 weeks of this job not counting as training, I'm going to be a trainee forever anyhow. Therefore if I did reduced hours and it didn't count as training I was happy with that. Then the consultant said that was what Registrar A said last year, and she totally screwed over her colleagues and the department and it wasn't fair on anybody, and "everyone" thought she was really unreasonable. I managed to bite my tongue and not stick up for my friend (Registrar A) who I know worked bloody hard despite SPD etc etc trying to cover an understaffed rota. Hmmm... didn't feel too good about things after that coversation!

BUT! Amazingly enough 2 days later this same consultant emails all the registrars to say - Registrar X has agreed to do jellyspoon's nights (at 34weeks) at locum pay rates, Registrar Y has agreed to do the long days that registrar X should have done, and jellyspoons are you happy to do the 9 hour A+E shifts that Registrar X should have done? Of course I said yes so no more nights for me, yay!!!!!

There's been no mention of me making up the hours due to going from nights to 9 hour day (A+E) shifts for those 3 days, so I'm hoping that if I keep a low profile it won't get mentioned again. Anyhow, I've been doing lots of unpaid overtime recently (had to write a report for a case going to court, and I went on a compulsory course on my day off...).

So yes, feel a bit better about it now, it seems by holding firm the consultants got cold feet about making me do nights at 34 weeks and have caved, yay!

The crash bleep is a battle I'm not even going to try and win, I'll just resolve to not run down the stairs - it doesn't actually make you much faster running I reckon so not worth it over a quick walk. Long days I'll see what happens, if I need to start doing reduced hours and coming in at lunchtime I'm sure the other registrars will be supportive (even if not consultants). And actually I only have a total of 3 long days and 6 evening A+E shifts left before mat leave starts (including the ones to make up for nights)... so I reckon I can manage those!

Main worry at the minute is my bump's been measuring small (as done by my hubby after people at work made me paranoid telling me I look tiny for 29 weeks) so I'm going to see the midwife on Tuesday and see what she thinks, if I need a growth scan etc. Feeling pretty guilty about working too hard and not letting Blob grow enough... oh well not much I can do about it now. Also felt AWFUL last week when I missed my midwife appointment as I failed to get away from work in time.... idiot. Oh well.

Next 3 weeks I don't have any on calls, which is going to be amazing, then have a lot of annual leave in August interspersed with some on calls. Fingers crossed will be OK.

Thanks for all your support, sorry for the mammoth posting. On the plus side I passed the year (ARCP) whoo! Even despite not being allowed proper amounts of caffeine for eportfolio purposes!!

Would love to hear how other people have got on, hope everyone out there is doing ok.
Jelly

Twirlbitesruinedmylife Sun 07-Jul-13 20:32:47

Glad things are looking generally up

Take care of yourself and bump

I'm short and have a small body even in proportion to my height so even though my bump measured right for dates people at work kept asking if I was having twins. Don't worry about what peole say you look like but do get yourself measured.

Best wishes

Abra1d Sun 07-Jul-13 20:42:44

I would have been appalled if a doctor treating me in hospital when I was pregnant or otherwise in need of care was compromising her health or her baby's because of some macho requirement by her superiors. I mean, what is the actual point?

I looked very small right up to birth but my son was nearly 7lb 5oz--just very curled up and breech. The midwives kept asking me if i was a fitness instructor (snort--only time in my life that's ever happened but I did have very strong abdominal muscles back then). I kept being measured and told to keep movement charts. I got so stressed by the concern I developed blood pressure problems, then picked up a UTI and then they decided I might have pre-eclampsia.

Xenia Sun 07-Jul-13 20:49:52

I don't think working will have made the baby small, don't worry about that. Babies are very robust even if mothers are working in the fields all day. Also most of mine looked fairly small (except twins born at 40 weeks!) but they were fine.

I worked until I went into labour in a similar professional job and that worked out fine, back full time after 2 weeks. I think it just depends on the person as to what works best for them.

DerbyNottsLeicsNightNanny Sun 07-Jul-13 21:35:56

Haven't read the whole thread so apologies if I repeat anything. I'm 29wks pg and am a teacher, usually work 3 days pw. From very early on in my pg I got a reduced hours GP note saying I should work 3 mornings pw only - its been a godsend! I do think some people at work are a bit p*ssed off about it & I do feel a bit guilty but have decided to put myself 1st.

First pg I worked full time until 40wks with no probs. 2nd time around has been a different story with more 'issues' and generally feeling not as well.

My advice would be work as long as YOU want to & to get a docs note if needed to help you work the hours that suit you best smile

chickieno1 Sun 07-Jul-13 22:09:33

Good luck with rest of your pregnancy jelly.

I'm a doc but luckily was doing research and no on calls when pregnant with ds. I was working v long hrs though and on my feet and also scanning pts lots which didn't help my back and pelvis. Worked until end of 37th week and then moved countries which was stressful. Ds was 2 weeks late and I was exhausted. He was good size emcs and healthy thank God. Looking back I would say try and get as much rest as possible and try and finish work as early as you possibly can.
If you're worried about size of bump I would try to get a growth scan. Surely they would see a colleague at your hospital if she was worried?
Congrats on passing the year!

My GP signed me off at 29 weeks (from a professional job, quite stressful but not shift based or as physical as medicine). My GP said that women in stressful professional jobs have smaller babies. I googled it and couldn't find any evidence to support this. I think she had probably suffered during her pregnancies and was sympathetic as a result. GPs can be fantastically supportive and it is well worth discussing your work with your GP if you haven't done so.

Xenia Mon 08-Jul-13 21:21:22

As I say it depends on the person but I do not agree that doing less work is always putting yourself first. What is so often morphs into is career destruction, putting yourself last, becoming an unpaid servant at home whilst a higher paid man who has not made the same choices swans in thinking he is a God as he now earns more and his career has become the important one. Avoid that as much as you possibly can.

No one has suggested that the OP throws in the towel on her career and becomes a SAHM. All that is being suggested is that she looks after herself and her baby and takes the support that is available to her. My GP said "you're only going to have this baby once, so you might as well look after it and yourself as well as you can" and in many ways having someone 'external' saying that made it easier to make the decision to do so.

Your personal experiences Xenia are fairly unusual and whilst they clearly were what you wanted to do or felt you needed to do, it is perfectly possible to achieve a middle ground of taking care of yourself while pregnant, taking the whole of your maternity leave entitlement and having a fulfilling and rewarding career.

Take care of yourself and your baby Jelly.

Daughteroughter Mon 08-Jul-13 23:05:13

Jelly spoons have you discussed with your clinical tutor I am a senior manager in an nhs trust and have had a discussion with ours last week about a number of fy1 and fy2 who are pregnant to sort maternity leave, not least because I found one sitting in a corner crying with exhaustion and she was only 30 weeks

MildredH Mon 08-Jul-13 23:12:48

Great news Jelly.. Glad you've had some kind of resolution although it sounds as though you've had to do a fair bit of compromising!

I'm 20 weeks, working as a med SHO in a frantic DGH. Struggled with last set of nights and got more in 2 weeks. Seeing occ health in the morning to discuss whether they could be shortened. An A&E SHO friend just got signed off nights entirely at 22 weeks by the same dept so I'm hoping for a favourable response!

Half of the problem is that no shift in the last 3 months has been fully staffed meaning loads of pressure to keep clerking new patients without breaks or even time to pee often!

Xenia Tue 09-Jul-13 09:22:02

I agree and it also depends on how you feel and the nature of your work. I was certainly lucky not to be ill. However I do think women need to know that plenty of us take very short leaves and that that can be the best solution including longer term so you do not because the main child carer at home and the balance of equality and power in a relationship with a man are changed forever to the disadvantage of a woman who leans out, not leans in. It is at the time of first babies that most of the damage is done to women in career terms because many "choose" (or their social conditioning makes them think they choose) to put their career second to their husband's.

mamadoc Wed 10-Jul-13 00:40:18

Glad to hear that you are getting some concessions.
I am sure that 'it won't count for training' stuff is blackmailing bollocks too and anyway you just passed your ARCP for this post so presumably all signed off anyway.

Small bump could be something or nothing.
DC1 bump was small, baby was small IUGR
DC2 bump small again, baby twice the size of his sister!
I had growth scans for both but apparently the 1st one was done too early and was falsely reassuring/ should have been followed up.
So do get a growth scan but get a consultant opinion on it don't just sidle up to someone in a corridor (tempting when you know people and can bypass systems)

jellyspoons Fri 06-Sep-13 17:53:49

Hey everyone and thanks for the responses! Xenia I think I'm in a bit of a different situation from what you're describing. In my case my husband is a Dr too (GP registrar) and he's actually desperate to do the main childcare when I go back to work at 9 months - he's planning to do this for 3 months whilst I go back full time until I can get a part time position. He's very into kids, I think eventually we'd both love to be part time.

Anyway! I'm now 38 weeks and have been off on mat leave since 36+2. It's generally worked out OK, I was very grateful not to have to do the nights at 34 weeks - at that stage I was starting not to sleep well and feeling pretty tired being on my feet for long periods. Instead of the nights I did 10 hour A+E day shifts, which were pretty hard work but not as bad as nights.

Annoyingly, the consultant / registrar in charge of the rota did try and make me do EXTRA hours to make up for not doing those nights (i.e. they put me down for 43 hours of day shifts, instead of 36 hours of night shifts...). I managed to persuade the reg in charge of the rota that this was unreasonable though, so got out of the extra shift!

I also rang up HR and discovered I was owed 33 days annual leave this year (I had previously been told it was 30) so with that extra leave I managed to get out of working nearly all my day shifts in August, so I just had to do the on calls. Carrying the crash bleep was a bit ridiculous at 36 weeks, I did a fast walk rather than a run!

Am now enjoying maternity leave, going out for coffee with NCT people and nesting! Bump is on the small size still but growing and my midwife isn't worried - says it's in proportion to me and not to worry. So I'm not!

Thanks for all the support out there,
Jelly

Lonecatwithkitten Fri 06-Sep-13 19:19:49

Jelly I am a vet a worked till 36 weeks. My bump was always small and my midwife like yours said your fine, baby is growing no need to worry. Her point was because I had kept fairly fit and standing a lot had maintained strength in my abdominal muscles that everything was always going to be tight and neat. She was very right neat 7lb 10oz baby was what I got.

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