To refuse to keep being deployed?

[Fififelix]

I've worked in a MH setting for 2 years. The services are entirely different I mostly work with dementia or ASD on the male wards as is my preference. Because I'm female I keep getting moved to the female wards primarily for personality disorder. These ladies severely self harm and I spend much of the shift cutting off ligatures , attempting to de-escalate headbanging. I just can't do it anymore my DM has a diagnosis of EUPD and has spent much of my life in and out of hospital right now she's having a relapse and it feels so close to home. I understand these ladies have trauma and I feel empathy for them but I feel like I emotionally can't provide this care anymore.

I'm wondering how I will tell my employers this they will probably say I'm breaking my contract as I need to agree to redeploy for business needs. Is there anything I can do to mitigate this? I don't want to get fired.

Well, if you don’t want to do the job you’re hired to do, then look for another one

What a kind and helpful response 🤔 doesn't sound like this is the job op was hired for?
I would look for something else op, as doubt this will change.

Do you have occupational health? Can you go to them and explain the effect being on that particular ward has on your own mental health? Surely they’d prefer to have a member of staff working somewhere rather than no member of staff at all?

I think I would start by saying it's impacting your own health and that you need to stay on your originally agreed wards. If they are in any way awake they'll see that as the shot across the bows that it is which is that you will end up off sick if they keep forcing the redeployment.

I work in NHS and I know of colleagues who have gone through Occupational Health and cannot be moved to certain areas due to personal circumstances. You might need to get a letter from your GP regarding your mental health, I'm not sure.

If it's NHS you can self refer to Occupational Health.

Have you ever considered counselling? It might help you understand why you are so unkind.

Seems like a reasonable response though. OP works in MH setting, she calls it being redeployed but she isn’t being, she works in that area. I expect none of the staff can just pick their favourite bits or favourite patients.

It does sound very demanding though and I have every sympathy with OP, I couldn’t do it, but then I wouldn’t take a job there. So back to the previous poster, OP needs to find a role that suits her better, not expect to stay where she is and pick her favourite (type of) patients and only work with them.

@Fififelix The first thing to do is explain to your work why you find those wards very difficult.

However, it may be that they continue to want to deploy.

Given the shortage of nurses/care staff and the fact you've only been there two years, I'd start looking for alternatives whilst also trying to start the conversation with your current manager.

also nhs. I would start by having a conversation with your own manager and requesting they refer you to oh. This way manager sees the report and has to consider the recommendations.

i would also ask for a stress risk assessment. If you like the job you do it seems a shame to leave if it can be avoided. However…like pp said it may be unavoidable and you’ll end up looking for a new job where you are less likely to be moved sadly.

I’m going to assume that the female patients want/need a female carer, so it’s going to keep happening unless you can get a job in a male only area. But that’s probably unlikely because they need to safeguard their female employees. It’s a difficult one.

Hi OP, I just wanted to let you know how utterly amazing I think you are. I work in A&E and we regularly (daily) see MH patients who have caused physical harm from the behaviour you describe. I look in awe at people like you. I have no idea how you do your job, at all, never mind with compassion and care. You are truly amazing.
back to your question…as PP have said, if you have Occ Health start there. Otherwise do tell you manager you are struggling and why. There is a national shortage of people in your role, so they should try to make adjustments to enable you to stay in a position that works better.

Are you in a trade union to seek advice from?

You should absolutely explain to your employer the effect that your work is having on your own MH. Do you have regular supervision meeting with your manager at which you can discuss how your doing?

I think they'll want to retain you and do what they can to support you. They will prefer supporting you to watching you leave.

It also makes sense to play to peoples strengths - if you don't have the capacity to support these women in the way they deserve, then it is certainly not ideal to move you there regularly.

However, I doubt they will be able to guarantee that you will never have to support female patients, as it will form part of your role and care may be compromised. Do you think there are other people they could move instead? Maybe a conversation could result in further training and support for you, and the possibility of you being 'last choice' for that ward.

I work in a school and teachers and TAs often have preferences for year groups and stages - you can take their preferences into account, try very hard to accommodate, but sometimes it is still unavoidable.

@Fififelix I agree with those saying discuss with your manager if you haven't already and get referred to OH.
Adjustments like this are made all the time in this sort of work and it's not an unreasonable request.

Please ignore those telling you to change your job or not work in MH, they clearly don't have a clue so don't let them make you feel worse!

I think I am going to have to change my base to male only/no female acute specialist PD. I don't have problems with working with all females it's just a particular presentation I worked in a mix rehab and it was fine as they had different behaviour/needs.. Nursing is mostly a female profession even MH. Even if they said male only staff on a male site they wouldn't have the required numbers to staff it.

The Trust will argue it’s not redeployment but I don’t agree. I have worked in acute working age mental health and moved to older persons some years ago. We do support other wards occasionally but I know my staff do not like it and vice versa. The needs of the patient groups are very different. I struggle with working with different patient groups now, I had some difficult experiences that still affect me many years from my time on working age wards and I have opted not to do that anymore for my own well-being. It sounds like OP has incredibly valid reasons not to want to do this which is not unreasonable. Trusts should be supporting staff mental health as well.

I would self refer to occupational health and reach out to your GP for support. I wish you well op and hope occ health are supportive💐

Have you ever worked on an inpatient ward full of self harming people?

My DH does.

Last week he had someone who stabbed them selves in the eye with a biro and has lost her eye. He also has a woman who is lovely much of the time but in a rage pushed and assaulted another patient who hit their head and died as a result.

Not to mention the more usual self harming (cutting, ligatures etc).

It is not easy work and all staff have times when the level of destructiveness is too much.

Speak to the managers first. Its not quite the same thing but when a close relative of mine was seriously sexually assaulted, my manager immediately stopped me having to work with sex offenders, because she understood that it was affecting me badly at that point.

I would speak to your manager, explain the backstory with your mum and ask that you keep away from the womens PD ward as far as possible. If they fob you off, then that's the time to think about looking for a new role.

Yes the patients need female carers but it isn't the job of op to be the default carer just because she is a woman.

Agree with going to occupational health, your have a reason why it isn't suitable for you. Ultimately if you go off sick due to the issues they won't have you at all. There is a massive shortage of MH nurses, I do not think they will want to lose you.

Really?? Have you ever worked in such an environment? I have.

I'm an LD nurse and previously worked in secure services on the LD dual diagnosis pathway. This was what I was trained for and enjoyed it, I knew how to talk to and deescalate my patients. When I had been there a little while I started to be sent over to the PD wards to cover, and I hated this. It wasn't what I signed up for.

I'd imagine that there are staff from the PD units that feel totally out of their element with ASD patients. Unfortunately this is what makes some staff leave as ot gets to a point when they dread going in to work. I found that I was moved when I picked up bank shifts so ended up working bank elsewhere to stop it happening.

Yes so I've seen someone sever their own tendons, put pens in wounds even food ! , sever their arteries with a broken cd they had managed to smuggle in . Refuse antibiotics, rub dirt in the wounds. Stab themselves out on leave requiring a hysterectomy. Bang their head so much they fractured their skull and needed an operation.

Working with Older Adults and ASD is very different to this.

Also LD trained 🤣🤣 i wouldn't say I'm very fussy I love ASD, Low and medium secure male,Older Adults, organic, rehabs assessment and treatment just not the PD/Female acute. It's making me hate the job I start to dread going in.

its a difficult job you’ve got, demanding physically and emotionally. Be honest with your management, vaguely outline your personal situation and explain the self harm unit is triggering for you and you and it’s not manageable for you to work there. Any manager with an ounce of compassion would play to staff strengths and aim to retain staff through looking after their welfare.

Reading your post I wonder if you are suffering from Compassion Fatigue. It must be incredibly stressful working in that environment especially when you haven't actually chosen to do so. I think you need to see you GP and Occ Health. Your mental health needs to come to first. How can you give care effectively if you are yourself unwell.

That has to be the rudest response to a comment that I've read on MN in ages. The tyranny of 'be kind' and the PA suggestion of counselling is a form of insult I'd read about, but never seen quite so blatantly in action.

Especially as voting with her feet, when there's a permanent staffing shortage, is the single most effective thing she could do. And she could make it cleat that she was only interested in working in roles with no redeployments.

Right now, she's stuck on a contract that obliges her to be redeployed. She needs to end that contract.