‘Newly qualified’ healthcare professional - I don’t know if I can do this anymore

[idontthinkimcutoutforthis]

I qualified last year as an AHP.

I work Monday-Friday 8-4.30pm.

I’m past the point of exhausted. I’m coming home and just sitting on the sofa numb. Weekends I just cry. I haven’t got the energy anymore. I go over and over and over every small decision I make and panic they’re the wrong ones.

I work independently, have a supervisor about 40 minutes away. Two on site managers and a team of other AHPs (other disciplines).

I’ve never been so tired. My workplace have support options but they’re all just telephone based listening.

I don’t know what to do. My thoughts are starting to frighten me. I haven’t told anyone in real life how tired I am. I cried in supervision this week and my managers have said they want to support me. My clinical lead sent me a lovely email and her deputy did the same. My supervisor gave me a huge hug. The girls in my office told me they want to help if they can.

but that makes me feel inadequate, incapable and useless. I almost want to walk away at times. I love my job, and I don’t understand why I’m so anxious about it right now.

Are you an SLT?
Your set up sounds ljke you may be

I am yes. I honestly don’t know where to turn for help or advice that isn’t my work.

You shouldn't be this exhausted on normal hours. It sounds more like anxiety around being able to do the job properly but it sounds like you are doing well. Are you doing a preceptorship for additional support? If not ask for one. It might make you feel better.

What do you mean your thought are starting to frighten you?

I’ve got a preceptorship yes, I don’t know when that stops, is that a year in post, I’m not sure. I don’t work on a very assessment heavy site so I’m not getting the chance to practice a lot of the normal SLT stuff. My supervisor has me over at her site every fortnight to do a lot of work.

There is a huge amount of anxiety at the moment. I have had problems with anxiety in the past. A lot of it is worrying people are annoyed with me, or that I’m making mistakes, or that I’m making the wrong decisions.

Just very low in mood; especially at weekends - stuff like housework is being missed, I’m overspending and not sleeping. I get a lot of intrusive thoughts and they are far, far worse at the moment.

OP have you had b12 levels checked as this can lead yo exhaustion and low mood.

Otherwise are you on any medication for your anxiety?

What is SLT? Speech and Language therapist? If so, you sound really disproportionately anxious about a role which isn't life or death. Please see your GP

Are you in a rehab environment?
You sound absolutely burnt out by your responsibilities. Have you done your NQPs? Are you dysphagia trained?

I really feel for you you need a break from work I think, what you are describing os sheer overwhelm and possible burn out with it and this is not good in your first year

It sounds like an appointment with your GP could be a good idea, and maybe you need a little time off from work to rest, feel better, and have the brain space to make a plan, with the help of your manager/supervisor.

You're not inadequate, incompetent or useless. You're exhausted and anxious. Take people up on any support they're offering - they want to help you and won't think less of you for needing it. Many of us have been there at one time or another. At some point in the (hopefully near) future you'll be feeling strong, optimistic and capable, and you'll be able to pay it forward by helping someone else who is struggling.

Yes.

@Jabtastic - you clearly don’t know what an SLT does (it’s a lot more than the narrow meaning of those words) and yes it can be high risk and complex.

@idontthinkimcutoutforthis - talk to your GP. Well done you for realising that you are not yourself - that’s half the battle. It will get better but it sounds like you need a little help along the way.

To be fair I spend a huge proportion of time talking about death; swallowing problems can kill. That’s the side I am struggling most with, because that has a huge and scary impact.

thank you xx I’ll ring the GP on Monday definitely. It is a rehab setting yes. I’ve done my NQPs but not dysphagia trained yet.

A preceptorship is usually one year but I think you can extend it if you need to

I'm an SLT and life and death is everything I do. If you can't swallow, you can't live, that's my bread and butter.

Not the point of the thread though.

OP - being an NQP SLT is really hard these days. Being in independent practice is even harder. There's a lot to be said for working in the NHS being surrounded by a team a speechies who have walked the path and being in a team with other NQPs for support. Maybe something to think about but you really sound like you need mental health support too x

Oh I'm sorry I really didn't know that I stand corrected! Well now I understand your role more I can definitely see why you are finding it stressful. Please do get help and support OP and take time off if you need it x

Oh I’m sad to read this. I’m an SLT also so I do understand how you could end up feeling like this. The workload is completely unsustainable and in many trusts/ teams NQPs are just expected to start running from zero and it’s totally unfair.

Please take some time out to recuperate and then accept help from your supervisor. They will be able to take some clinical hours off you so you can recalibrate and build a work life that manageable.

It's tough, I'm an AHP (15 years qualified) and I remember crying in the toilet and not having the energy to make dinner on some rotations early in my career. It does get better, but getting use to the responsibility takes time. Once your clinical reasoning becomes more second nature and you build your experience and confidence it will feel different. I have had some really difficult times in my career in the NHS, it has helped build me as a person and made me stronger than I ever thought possible. But it can be so very tough. You are not alone.

@idontthinkimcutoutforthis I just saw your update. You're in the throws of dysphagia training in independent practice? That is extremely difficult and unheard of really, I'm not surprised you're struggling. I train all our B5s and it's an all day every day thing with constant support from me and the team.

Can I just say thank you to all the SLTs. I really didn't know what you all do. I have MS and I know it can bring issues with swallowing down the line. Some day one of you or your colleagues may help someone like me so thank you, sincerely

@Jabtastic It's really common for people to be unaware of what we do. Thanks for acknowledging the misunderstanding so graciously. Wishing you well with your health

@idontthinkimcutoutforthis when you say you're working independently do you mean in the sense you're away from the rest of your team but in the NHS? Or are you independent as in private practice? Only asking as your routes for support could be different. SLT can be such a stressful job, and like others in caring professions we probably tend to put too much pressure on ourselves.

Hiya, I'm an NQP SLT also and have been in the same position. I work in paediatrics so it is different in some ways, but I've experienced the same relentless exhaustion and anxiety and dread about whether you've made the right decisions, whether there's an unnoticed mistake coming back to haunt you, worries that you're incapable etc, and just struggling to cope under the pressure. It sounds like your team are really lovely and that's brilliant, it's really vital to have good support as NQPs as we are still finding our feet in many ways.

That being said, don't lose sight of all the ways in which you are already capable and the brilliant, life changing work you're doing every day. I know it's hard to recognise when you're in the thick of it but you are doing well.

It sounds like it's worth speaking to your GP. Your low mood sounds quite severe and in my case it was very extreme too, I had thoughts of self harm because going to work was causing me such distress and panic, I stopped being able to eat and was losing hair from the stress. The GP really helped, I was offered therapy, employment advice, and mood stabilisers, and it's made a huge, huge difference. I still have a normal level of NQP jitters the same as anyone else in our position, but I'm doing my hobbies again and sleeping properly, and actually enjoying my job.

It's nothing to be ashamed about, it's a huge adjustment and a lot of pressure to suddenly find yourself in. I hope you feel better soon.

SLT here too OP, and while I'm 25 years in I still remember the absolute dread of the early days. It's completely natural to feel overwhelmed but there are supports there so please make use of them. It sounds like you have a lovely, supportive team around you and if it's anything like teams I've worked in it can be a 'blitz' spirit with colleagues only to willing to help and support.

I am management and clinical and happy to chat more over PM if you want to chat with someone connected, but also impartial.

I trained as a healthcare professional but I would have to stop and decompress by doing factory work and stuff that had little actual responsibility to it, every couple of years for the reasons you describe.

Partly it was because I was having to take far more responsibility than I should have been and general issues of having no backup and asshole bosses.

Eventually I had to leave or I would have opened a vein. I enjoyed the mindless stuff more. I worked with great people, had a laugh, got paid well and didn't give the place a second thought the whole time I wasn't there. The opposite of the role I had trained for.

You might be like me. If you can't do it, you can't do it. Find something else that suits your psyche. Life is too short to live an utterly miserable existence.

Private healthcare company but we take funded patients, I still haven’t got my head round that side of it yet. Most sites that the company run have one SLT based there - so e.g. I am responsible for my case load and day to day running (plus audits, training, targets, reporting, statistics etc), we do check in regularly with wider team regularly and occasionally have colleagues come and visit. Plus I do get that regular day off site to practice stuff I can’t really do at my site (language assessments and shadowing dysphagia work).

Dysphagia side of it I can’t make any decisions but I do have to (I think) ensure guidelines are followed and explained - but this is so difficult when colleagues then ask me to explain things, change things, complain or vent frustrations when there’s very little I can do. There’s a massive lack of training - but I can’t deliver that training yet.

My bosses are good, and my office are beyond lovely (most of the time, it’s a very female heavy team so there’s small gripes and a bit of bitchiness at times).

@Juscou thank you - self harm is exactly where my mind has been going, I used to struggle with that a long time ago and don’t want to go back down that road. Will definitely nip to the GP, I’m on a lower dose of sertraline so perhaps they can increase that for a bit and see if that helps, I don’t know.

Yep I’ve done the crying in the toilet - and standing outside the building at 8am wondering if I really want to go in! I’ve worked for the NHS before this (at band 2
level) and that unit was horrendous for bullying - I was often treated like shit - and very, very wary of ever getting into a situation like that again.