For not wearing a ‘Baby on Board’ badge to work in A&E…

[Moonlighting]

Slightly facetious question but then the suggestion was so silly it was hard not to start with that!

I’m 23 weeks pregnant with my first and have had a bit of a rough pregnancy so far with sickness and the whole constellation of pregnancy related symptoms. I am an A&E doctor and have had to ask for some accommodations at work because I am simply not able to do the hours I normally would.

It has been a long struggle getting any help with this as everyone seems to think this is someone else’s problem. Finally my boss (a male consultant) sat down to do a written risk assessment with me. As part of this he had to ask me about occupational risks.

Now in recent weeks I’ve had several hairy moments at work which have fortunately not resulted in any harm, but could have:

• A physically strong man with advanced dementia smacking me as I examined him.
• An aggressive drunk taking a lunge at me (which I fortunately sidestepped).
• Having effectively just given someone a general anaesthetic, a radiographer came in to do an x-ray on the patient in the next bed. Thankfully and unusually there was someone in the room adequately trained to take over from me whilst I popped outside.
• Someone with confirmed covid whose lungs were failing needed a prolonged aerosol generating procedure. Had the colleague I asked to help taken any longer in coming I’d have been forced to start myself.

I mentioned these, as well as the fact that on a daily basis I cannot avoid being involved in some manual handling of patients and equipment, and inevitably spend some time on my knees on the floor either doing procedures or for lack of chairs in front of the computers.

His response? ‘You should wear one of those badges they wear on the Tube so everyone knows you’re pregnant and will be more considerate.’ I actually laughed because I was sure he was joking but he was being dead serious…

So, what would you think if you turned up to A&E and your doctor was wearing a ‘Baby on Board’ badge?

I guess the real underlying question is AIBU to expect my employer to safeguard my wellbeing whilst I’m more vulnerable? I love my job and I feel awful that I can’t be as effective as usual in such a time of genuine crisis in the NHS, but right now I feel my stronger obligation is to protect my baby.

(Funnily enough, eventually me sending written communication to the tune of ‘I will take you to tribunal if you don’t refer me to Occupational Health’ seemed to do the trick where all else failed…)

The same as I think about the ones on the Tube.
Ridiculous.
Your colleague is also an idiot and it sounds as if your hospital/trust weren't really helping you until you insisted.
Good luck for the rest of your pregnancy

Bloody ridiculous that you have to spell this shit out to them. They should be grateful you are even still working away given the risks. Don’t do anything else you shouldn’t, no matter what the consequences, your life and your baby’s life is as important as anyone else’s, do not put it at risk for your employer.

A really good idea. The reason for it is to protect your baby from colleagues who have their mind elsewhere. It's not for "congratulations" attention.

I don't think a 'baby on board' badge would have prevented any of those situations... even if the guy wasn't a complete tool

I actually think he has a point op. Yes he should be putting things in place but I guess you’re not always going to know if each patient is going to be difficult until you see them?

If you have a whole range of colleagues, some who won’t know you or forget, then surely seeing the badge will remind them to swap with you or not ask you for things? I also think it would genuinely stop the drunks swiping at you…

it’s a good idea to be fair. even drunk assholes are usually automatically considerate of pregnant women

Well that's not really good enough is it? If I were you I would self refer to Occ health, failing that do you have someone responsible for your hours/annual leave etc? They might be able to help. As an NHS sister I know our training doctors have an admin person, who looks out for them, including their welfare.

The thing is, you are at real risk of harm particularly in A&E, not just the manual handling side, but drugs/chemicals and assault. I hope you get this sorted. It's hard enough being pregnant. Look after yourself.

Sorry to answer your question I think I would find a baby on board type badge a bit odd!! No member of staff should need to spell out the need not be assaulted.

Can you request a secondment to elsewhere? ICU maybe? Or obs & gynae? A&E is a complete mosh pit and I think a badge will do fuck all to change that.

I worked as a nurse until 9months pregnant, so massively obvious without a badge. I can confirm that obnoxious people are still obnoxious, aggressive people are still aggressive and lazy or busy colleagues are still lazy or busy even when they can clearly see you are pregnant.
The risk assessment should exempt you from dealing with/ being exposed to aggressive or unpredictable patients, cytotoxic drugs, X-rays and pathogens such as covid/ chickenpox/ rubella. If that means a temporary move to a different area, so be it.

Without wanting to derail the thread, @PAFMO, what’s your objection to them on the tube?

OP, if I saw you wearing such a badge I would feel nothing but sympathy for you, but obviously it’s a ridiculous suggestion. For what it’s worth, I work in a school and have had several risk assessments, each updated I think twice in my pregnancy, and amended duties/changes to my role without me needing to ask - particularly helpful when I wasn’t ready to tell colleagues and could just shrug and say “the head has changed my duty rota.” At what point can you ask for/insist on amended duties?

I had to ‘go off sick’ at 23 weeks pregnant due to being kicked by a patient while I worked on a surgical unit. That was the only way I could protect my self and my high risk pregnancy( 3 previous miscarriages) as even occ health were useless, ‘don’t do this don’t do that’ are useless when you are on your own in an acute setting, with an acutely Ill, confused patient. What do you do, let a patient fall on the floor and say ‘ I’m pregnant’ . As NHS staff you are treated appallingly, imagine being in the fire or police service and being put in these situation.. it just wouldn’t happen. Maybe because the NHS has a high ratio of women this is seen as the norm, my pregnancy was 24 years ago and it’s shocking this is still happening now. Good luck!

Talk to your union / HR, the man sounds like a muppet.

Ultimately do you feel safe to work in A and E with accommodations or do you want them to move you somewhere else? It would be good to know that before you talk to them.

The Baby on Board badge is a good idea on the tube as kind people will often notice you and offer their seat without any risk of offending you if you're not PG. It's not a warning to others that you are PG and they should treated you differently. Anyone who is minded to assault you is not likely to stop just because he notices you're PG. His suggestion is laughable.

Speak to BMA for advice and/or come join us on PMGUK where there are many who have had the same issues as medic mums!

Without wanting to derail the thread, @PAFMO, what’s your objection to them on the tube?
I always just found them really twee. And passive-aggressive. When I wanted a seat and wasn't offered one I used my voice ans asked for one. I just think the badges make it look like the wearer is asking either to be congratulated or assumes everyone else should notice what they are wearing to jump up and offer them a seat because they are too scared to just ask for one.

If I saw a doctor wearing one on a ward I would find it eyeroll-inducing.

Could you not have self referred to occupational health before now? Seems like there’s been a few bear misses that a badge will not solve.
A&E is a massive risk to a pregnant women, could you be temporarily moved to a ward/clinic that would be safer for you?

Would have made no difference in the first two examples. May have helped with the others.

I would wear the badge. You work in a risky environment.

On the Tube only kind people act on them. Bastards just ignore them. In A&E they would have impact on the bastards behaviour.

No impact on bastards behaviour I mean.

You should have been wearing an appropriate FP3 mask for the AGP. Which would reduce the covid risk.

Can you ask to be seconded to a different department for the duration of your pregnancy? I'm not sure if that's a thing, I'm a student nurse so I've heard of nurses being seconded but not doctors.

Good luck Op, I work in A&E and know how challenging it is at the best of times

I don't think a badge would help tbh. No one is looking at badges when things are so crazy. I work in medical receiving and it's also fairly crazy and potentially very dangerous but the good thing is that we have lots of great staff close to hand and I did ask them to take over for me and swap for a more appropriate task they would in a second. Plus if I know a colleague is pregnant I'll often say to them to swap out so they don't feel awkward and like they are being lazy. I've had colleagues run the whole length of the unit to an arrest at 8 months pregnant and go to jump in with compressions.

You really do have to advocate for yourself, management have very rarely got your back. I was pregnant was assigned to a young very strong built man in the DTs who had bent an inch thick IV pole at a 90degree angle just an hour earlier. I actually lost that pregnancy at 11 weeks so if it did happen again I would be very quick to ask for help/get extra hands for heavy moves.

One of my friends is a community SALT and she's getting to be office based from 28 weeks as its deemed too risky...so don't feel guilty for a second asking for support in a potentially risky situation.

I don’t think it’s an either or situation. A baby on board badge isn’t enough to safeguard you (and your employer absolutely does need to put more in place), but I can see how it could be helpful in limited circumstances.