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…)

They really shouldn't be putting you in the situation where you're dealing with potentially violent patients. I was a police officer though all 3 of my pregnancies and it was light duties right from the start, and this was 25 years ago. Because of the unpredictable nature of my job (probably on a par with yours) light duties ment virtually no public contact. Could they move you to a different ward or department where the patients are more settled? As for the badge, I suppose it could help in certain situations, but if someone is at the point of kicking off at an A&E doctor they're probably not going to take much notice of a badge, and at 23 weeks it's going to be pretty obvious soon anyway.

I’d think “THAT’S the protection she’s afforded?! Really!”

Your boss is a shit

It's not enough, but I DO think it's a good idea and a start. It makes people more aware. It won't change everyone's behaviour, but if it reduces even one aspect of risk, surely a good idea?

Request light duties, change of department for a while. It's only temporary.

FWIW this is the start of a great many changes to your career. Feel free to be amazed as you,

• are passed by for promotions ('mummy track')
• talked down to
• assumed not to be available ('who will look after the children!?')
• assumed to either be bulletproof (no sleep with a newborn, no problem, here's a 14 hour shift...) or too-vulnerable to cope with anything (we won't contact you at all for 12 months, assuming you'll not be interested in returning)
• get torn between expectations at home and expectations at work
• realise your DH is completely immune to ALL of this.

Like magic, having a baby.

The only way around all of that ^ is to get a BULLETPROOF nanny.

This

I worked in A&E during my second pregnancy. Similar experience and a boss (female) who suggested I was slacking when I had to go off nights. Appreciate that running the department probably strips you of all empathy but it felt awful.

I've never really thought of what A&E staff do when pregnant, what do others do where you work? I think the badge might be useful for your colleagues if you work with different people on shifts that they can be mindful and switch with you when needed. In a few weeks it'll be obvious anyway.

A&E is so unpredictable, I think if it was possible I'd ask to be moved to a more sedate area or perhaps to paediatrics where you won't get the big blokes and drunk or high people more likely to lash out.

Hi, I'm a doctor in a diagnostic setting so patient contact wasn't so much of an issue during my pregnancy, but I did take a big step back from already limited patient contact, and came off the oncall rota quite early on as working long antisocial hours made my symptoms unbearable.

You should know you absolutely have the right not to work antisocial hours and not to have patient contact. Is there another sensible member of more senior lead staff you can speak to? I know all too well the frustration of a male colleague who just doesn't get it (though actually the person who helped me most was a male consultant).

To answer your question, obviously the badge idea is just ridiculous and if anything makes you more vulnerable.

Also if you're a doctor in training, have you spoken to your TPD?

If you were a police officer you would be put on desk duties to avoid any type of confrontation risking harm to you or your unborn baby.
If you're employer can't manage the risk, manage upwards and highlight their obligations under the Health and Safety Act - see the Health and Safety Executive maternity guidelines- very useful. Get an OH referral and see your GP.

I wore one as a pregnant nurse. Things like xray, gas induction, not pushing trolleys etc I was much more able to avoid without a fuss as staff members I didn't personally know could see why I was removing myself or not helping with certain tasks.

watchthesunrise has it neatly summarised.

Motherhood.

If you weren't a feminist before you bloody will be now.

Wow you sound charming don’t you. Do you also have an issue with people with disability badges?

Nope, entirely different

The situations you face are unacceptable for anyone. No one should have to deal with violence. Wearing a badge won’t stop the violence you face at work.

Thanks everyone for your messages of support, I just really needed a vent!

It is definitely eye-opening to see that some of you think the badge may not be a bad adjunct to more stringent measures of protection. I think I would feel like a pillock wearing one at work, but maybe that’s a reflection of my own insecurities? Actually if one of my colleagues or someone I saw working in some other public-facing role were wearing one I would definitely feel some sympathy and modify my behaviour to be more helpful - so maybe my boss was not just being entirely obtuse!

That being said I agree that a badge is not ‘enough’. I tried self-referral to occy health from 8 weeks, when the conversation went like:
Me: ‘I’m calling to inform you that I’m pregnant-‘
OH: ‘Err, you need your manager’s approval for that.’
Me (in my head): ‘What, to let my husband knock me up?…’
😂

Anyway, after much cajoling, it took the strongly worded ‘contractual obligation’ email to go above the head of my consultant supervisor and get the referral from one of the service managers. I went into that appointment with a pre-prepared Fit Note from my GP and told them what hours I would be able to work and that they should take me off my patient facing role from 28 weeks. This appears to have done the trick…

As for the FFP3 suggestion - at that particular time the Trust policy had just changed which meant that my respirator mask had been confiscated (!) and I was yet to be fit tested on the new masks. Just usual NHS political shenanigans.

I wish I’d thought of being asked to be moved to somewhere less high risk. Maybe something to consider next pregnancy. I’m actually very glad to hear that pregnant police get taken away from the frontline though because I’d been thinking if I’m this worried about potential abuse it must be a million times worse for you guys.

@flowersfortea thanks for the steer RE PMGUK!