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.

Burnout has been re-classified by the WHO (Jan'22) as an "occupational syndrome" and I wonder from your post, if you might be at risk?
Would it be worthwhile completing a burnout scale and bringing that with you to OH? to illustrate that, it is not a lack of willingness nor ability to work (🙄at the first posted response) but that you are at risk, due to the nature of the caseload?

You're doing a very difficult job and sound willing to do a huge variety of work. I think putting the information in writing for your management is fair. If they want you too "prove" it through occupational health them so be it. They may simply accept not scheduling it on those wards though, or at least accept it subject to emergency support.

I think you have misread - the comment you are referring to was a response a post telling the OP to get a new job because she didn't "want" to do the "job she was hired" to do - i.e. a comment that was pretty unhelpful given the original post.

I actually agree with this.
I don’t blame you for not wanting to work with these patients, it sounds very difficult BUT if your contract allows you to be deployed to this ward/area and you are unable to get an adjustment to say you don’t have to then unfortunately you may need to leave.
I don’t imagine anyone actually WANTS to work in that ward

They do actually. I was on my normal ward yesterday I have to monitor blood sugars , give meds , physical observations, skin assessments , peg feeds , suction and manage incontinence. Many people hate personal care and refuse to do it so they don't like it.

I'm guessing that given the acute shortage of nurses the NHS would rather keep you than lose you, because you are miserable and stressed doing the work they keep assigning you to. If you like the work that others find dull, all the better. I would definitely ask for a referral to OH and see if they can help.

I think I've decided I will talk to managers and occupational health. I absolutely love my usual wards so hopefully they will be willing to make adjustments. If not I will look for a new job without PD/ female acute on site.

I have to disagree with this. There are people that have preferences for these types of areas, horses for courses. The biggest issue is that all of these settings are so short staffed that any preferences go out of the window.

I have dealt with horrific self harm from LD and ASD patients but have always been able to deal with this with compassion and patience. The same level I've always found difficult in PD and some other MH settings (obviously I always give them my best care but inside i feel totally different about the situation). I've spoken to MH colleagues and they can't cope with the ASD/LD presentations. They don't feel able to communicate with them.

Definitely go to manager and occ health. You are being retraumatised at work and not able to perform in those specific wards. I would say it's a reasonable adjustment to not allocate you to those wards, given the many others you can work effectively in. I am an NHS mh professional and in the past have occasionally asked my colleagues to take cases which would have too much resonance and therefore reduce my mental health and ability to work effectively with the person.

This sounds sensible. I think all NHS contracts have a clause saying you may be required to move areas due to service need - you’re employed by the trust, not the ward. But I know a few people who couldn’t be moved to particular areas for various reasons and you definitely have valid reasons. We also kept a record on our ward of who was moved and where so we could ensure it wasn’t the same people all the time. Hope your managers are understanding. Good luck!

Go to your work HR and Occupational health and discuss with them your concerns and how working in the female environment is close to home concerning you DM needs.
If you can suggest that working in the male environment where possible would be a more preferable solution.
If you don't ask you won't achieve change, your employers response, support and actions regarding the request will assist you in making a longer term decision about whether you continue in your present position.

I think you have justification for wanting to avoid one specific type of ward. Hopefully your managers can accommodate.

My goodness- That sounds literally sickening.
Fair play to your partner for being able to work in such an horrendous environment.
It sounds a seriously tough job, and the pay is probably not that great for that level of stress, either.

Good decision both for yourself and the NHS. They really can’t afford to lose good nurses like you. I hope they support you and you can start to not feel dread going into work. No one should feel like that.

You are wise and completely reasonable not to be put in a situation that is triggering for you and where you inevitably won’t be able to provide the same level of care as you would for patients who have a different presentation. It’s best for you and the patients.
mid necessary get a fit note from your GP which can specify reasonable adjustments.

You don't need to 'tell' them. Just ask for a conversation about it and explain.

I can’t give actual advice but wanted to thank you for what you do. My sisters partner is a nurse in a specialist setting, it’s not Broadmoor but it is one of the others that has patients who are on that level I know there are very few in the country. He obviously can’t discuss things as such as it’s all confidential but she has seen what it does to her partner. I do know he has met though never named a few infamous murderers.

He was attacked quite badly a few years ago and still went back. When covid hit he avoided public transport and walked miles to work because he knew an outbreak on his ward would be dreadful. My sister was crying down the phone she was so scared for him plus the walking for almost four hours a day, neither of them drive.

The OP wasn't hired to work on the ward she's being deployed to and her expertise lies elsewhere. Your response is unhelpful and unnecessary.

OP has been redeployed though - just like many staff were redeployed to ITU during the pandemic - she is outside the area she usually works in, and probably doesn't have the training or expertise to deal with these situations.

OP - I am sorry - I would start by asking for an occupational health referral and requesting them to advise that a reasonable adjustment is made based on your personal situation with your DM and the fact it is having an impact on your wellbeing.

Talk to your GP too. Sometimes OH and the management can get caught in a loop. A letter from your GP might help to cut through it.

OP talk to manager and ask for occupational health referral. Explain how your own mothers mental health illnesses makes you find the situation with acute female patients very triggering and ruining your mental health. Get it on record and in writing. Then if you need to take sick leave to deal with your own mental health their is a record that you took the appropriate steps

If your employer won't listen to your concerns and restrict movement, move to a job you prefer. I worked in one area in hospital and kept getting moved, so i just changed jobs. their loss.

I think your best bet is to see your Union rep. They will be able to advise you whether or not it's an option for you to refuse to work in certain areas. It doesnt sound like redeployment to me or else your contract would need to be changed.

I wonder if they have a ward for gobshites?

YANBU. I don't know the answer but didn't want to read and run. You do an amazing job.