to say don't go and get signed off with stress

[writingonthewall]

I see this all the time on MN

OP: there's been a death in the family, I'm doing fine but need time off work to organise the funeral/comfort DH. work will only give me 3 days compassionate leave, after that I have to take holiday or unpaid leave

everyone else: go to your GP and get signed off with stress.

before I get flamed, I am a GP and I fully understand that bereavement hits different people in different ways. I sometimes do sign people off work after a bereavement - if you can't stand up for crying, then you can't work. And whilst there is no hierarchy of grief, as a general rule losing a child is very very traumatic whilst losing a parent is something that you do expect to happen at some point. So no problems with signing certificates for genuine mental health problems post bereavement.

What I do object to is this "get signed off with stress" when you aren't ill.

Do people not realise that, firstly, you are asking the GP to commit fraud. Secondly general practice is buckling. We are under resourced (all practices in one area I know are about to lose 20-25% of their funding) and even if we had the money, there are no GPs to recruit. And it's going to get worse if the new juniors contract doesn't get sorted out.

Every appointment taken up with a medicalisation of normal life, is an appointment that someone who is ill can't have and a potential delay in the diagnosis of someone else's cancer or other serious condition.

so please. see your GP if you are ill - physically or mentally. But think before you do and don't involve us in your battles with your employer and your general normal life events. Being sad after a bereavement is normal. The treatment is to talk about the person you have lost, cry a bit, and take care of yourself. It isn't to rush to the doctor for a medical cure.

Jeez! OP! I hope you aren't in our practice I think your soulmate works there already.

3 days would not be enough when my elderly parent dies. My previous employer allowed 2 weeks when my other parent died. This time will be much more complex. I am executor, sole next-of-kin in Europe and I will be grief-stricken although I am a realist about how much time a 90 yo has left

IME funerals take a week and are frenetic. Then there's bank accounts and solicitors to sort. I suppose a maximum of 3 weeks would help. I currently work for human beings so hopefully it won't be an issue.

Agree with OP. Grief is to be dealt with somewhere other than the GP. GPs are surely for those who are unwell. I found working through grief therapeutic. I would have fallen apart if I hadn't worked.
However some employers sound harsh! I also don't understand the issue with taking annual leave. Surely that is what it is there for.

That can't be true Octonought. My friend has had 3 sick notes since September. two for depression and one a possible miscarriage ( MC Friday went to doctor Monday and was off all week.

YANBU Op. I agree you may well have to take more time off for a bereavement but it isn't a medical issue -there is no cure that a doctor can give you that a supportive workplace, friends and family can't provide.If you need AD because of it than that's another matter.

It is true. Some GP's will sign off earlier, but legally, they don't have to, and I think it creates work for ourselves as it becomes the norm.

I very occasionally sign off at less than 7 days if someone is very anxious/depressed and can't cope with questioning from their employer, but technically, I shouldn't.

See first paragraph of page 7: www.gov.uk/government/uploads/system/uploads/attachment_data/file/465918/fit-note-gps-guidance.pdf

Completely completely agree with you.

There are cases of bereavement and mental illness that require sick time off work but there are far to many people that take the mick and doctors who allow it. Having read some of your posts I can now see why what one of my employees told me to be true. He had a small accident meaning he couldn't work for a while. On visiting the gp after a week off he was asked how long he wanted to be signed off for. He explained that he wanted to be off work as little as possible & asked how long he should leave it before going back. Gp said "we'll start you off with 4 weeks and come back if you need another 4". He was a lot better after 8 days and came back on reduced duties for a couple of days before being fully back by 2 weeks. A less committed person would have (and very much has) taken the piss.

Then there's bank accounts and solicitors to sort....

You can't use 'sick' leave for this. Compassionate leave would be ok but surely you can't declare yourself medically sick unless you are sick.

Well, you can't work, can you?

Wtf you're putting the onus on your employer which I agree is where it lies. So I'm not sure what your point on terms of sick notes is. If your emplyer was not reasonable then you'd expect the health service to force them to give you time off?

Not everyone gets annual leave. I worked in a term time job. My job was working one-to-one with children so I couldn't make up time after hours or in the holidays. I literally had no annual leave to use.

I think some of the posts on this thread show why there is such a stigma associated with mental health in many countries. There is not a one-size-fits-all solution to how to deal with somebody who is bereaved. The idea that 'working through it' is a solution for everyone simply because it was beneficial to some people, is preposterous.

The role of healthcare professionals is not solely to 'fix' sick people, but also to help prevent illness. They treat patients, not sicknesses. And in the case of GPs, there needs to be a far greater emphasis on the bigger picture, and the patient's entire life and what they are dealing with, and not just on the one immediate aspect of bereavement.

I think that it would an excellent use of surgeries time and resources to write a very strongly worded letter to all the schools in their area telling them that they will not be providing sick notes for childhood illnesses that require absences from school.

And to publicise the letter on their noticeboard and websites.

There are probably more slightly poorly children than there are grieving adults.

Hmm that's interesting. That's the best argument I've seen so far. I'll need to think about that.

I agree with the hierarchy of grief thing. I have experienced the death of a child and it was unbelievably traumatic and I went back to work 6 weeks later. Grim doesn't cover it. I didn't go and see my GP at any point - did not realise it was an option even though I felt I was going mad with grief. However as bereaved mum I had access to once weekly free sessions with a psychotherapist without whom I wouldn't be here now. Other people who are bereaved prob don't get the same support. I do feel for GPs and I hate what this govt is doing to junior Drs, the NHS and education. And I largely agree that bereavement is a process. But this should be handled in case by case basis - if patient seems stressed under massive pressure then surely ok to sign them off if GP thinks this is right thing to do. Not if not. OP isn't it possible to handle in same way as prescribing drugs - for example I may want to Prozac to get me through my stressful life but will only get it if GP thinks fit.

Lalala I'd argue in that case your employer should need to give you some paid time off. I don't think you should get a sick note when you're not sick because they won't. Does thay make sense?

wtffgs Your post illustrates exactly the point the OP is trying to make. If your grief is such that you are unable to work, then you should absolutely be signed off. However if the reason for requesting a sick note is because you need time off for administrative duties (executing the estate, arranging funeral etc.) then you aren't actually sick and therefore you aren't unfit for work.

As an earlier poster said, the GP service is in crisis and there is a very real risk that our children and their children won't have access to the same GP free-at-point-of-use service that we currently enjoy. If we are to avoid this then it's essential that we protect it. One of the ways that we can do that is to not use the service for unnecessary reasons. Asking for sick notes when you aren't unfit for work is one of them.

Are you my Gp? having a son with suspected autism one whom is incredibley violent and always threatening to kill himself, then losing my mum and my aunty within 3 months, well i am sorry for having to ask for a sick note!!!!

What percentage of your patients would you say were asking for sick notes when they don't need them? Is it a big problem? Or something that winds you up because it's frustrating when you're overloaded?

Good question ricketytickety

I would say that at least 5% of my time is taken up with attempts to medicalise normal life - be it:

-requests for certificates for people who aren't ill,
-hairdressers/massage therapists/reiki healers etc etc etc wanting me to sign a bit of paper and absolve them from responsibility
-people who have had a sore throat for two hours, taken nothing over the counter and want me to make them better instantly
-people who want me to fix their teeth despite the fact that I'm not a dentist and am neither trained nor insured to do this

etc etc etc etc. I'm sure the other GPs on this thread can add to that.

In a big practice with, say 10 full time GPs, that is the equivalent of a 50% time GP completely lost to such requests.

Gees, I feel like I'm reading an alternative thread. I really don't see why the OP is getting such a flaming. It's a real issue in some practices wrt to sick notes.

I got and get most of my support from other bereaved parents, FWIW.

Pitiful, I agree, it's a British thing in many ways. I'm from the US originally, I moved here when I was 31. I have to say, however, as a bereaved parent, I really feel for my fellow bereaved in the US. The attitude towards grief after child loss there is, IME, far, far worse.

Ooh this is a tricky one. It's the employers at fault but the gp's/NHS that suffers.

I'm a teacher and was given 2 weeks off when my mum died (she was only 62 so not the more usual age related dying) and told to take more if I needed to. Some jobs you might be able to get by with soldiering on, but others where you are client facing it's just not a good idea for anyone. I spent the first month of being back crying on the way to work, crying in the loo at break, on the way home etc. but during lessons I put on a show of being fine. I thought it was 'fair' to the school and students for me to return then. I would have been useless had I been made to come back on day 4! But... I would have gone in if I'd been made to as I just don't think it's a GP's job to sign someone like me off. Different of course if it was someone who simply could not function or had lost a child.

I'm not a dog owner animal lover at all so the dog bit did make me chuckle.

I would say sick notes for 'I've fallen out with my co-worker' are more of a problem than 'my child died' (the second would not be a problem!)

I know someone who wished to be signed off because their cat was missing.

Then sent a written complaint when told no. Which the doctor then had to reply to, reflect on, discuss at a meeting, and mention at their appraisal.

But - why bereaved people? I'm still not understanding why they have been singled out.

" It's the employers at fault but the gp's/NHS that suffers."
That's exactly it, that sums it up for me. I suppose it's similar to other services where the burden doesn't fall where the responsibility lies.
I'm sorry you lost your mum. I agree she was very young.

I love animals, I really do. But when you get them you realise their life expectancy isn't going to be as long as a person's. That's an important difference.

Doctors are not supposed to put bereavement on a sick note. In the same way they can't put pregnancy. Because neither are illnesses. There can be illnesses associated with them, but they are normal events in normal lives.

The lack of adequate leave for them does not mean you should force your GP to commit fraud.

The answer to everything these days is "see your GP" or "get a note from your doctor". Doctors want to see and treat ill people. They can't cure all social ills.