Work asking me to see violent patient while pregnant

[Kitely]

Since I got pregnant work haven’t been great. My two managers have never been pregnant as sadly both have infertility. I was warned that they’re not particularly supportive of pregnant colleagues but I hadn’t seen evidence of this.
I won’t be too identifying but my job involves direct work with patients and also holding a ‘caseload’.
I work three days a week and after going down to part time my caseload didn’t reduce. Infact it got bigger. It’s totally unmanageable at the level it is. Suggested safe caseloads are less than half I have.
I was off for a month with horrendous vomiting. When I returned I received no support checking I was okay.
A 5 minute pregnancy risk assessment was done. It’s so basic and doesn’t include anything on travel which is a basic aspect of the job.
It does state I’m not to work with violent patients.

So far this month I’ve been asked to do the following I’m not comfortable with:
Asked to assess someone out of area meaning I’d be on trains from 9am-9pm except for two hours during the assessment. I’d be utterly exhausted.

Asked to assess a patient who is violent. He spits at staff, throws items, punished walls. He has done this as recently as this morning.

Asked to assess a patient who has criminal convictions for beating up his pregnant girlfriend

Given an extra 5 cases all needing urgent reviews.

So: I immediately questioned the guy who beat up his girlfriend and they reluctantly had to remove him from my caseload as it went against my risk assessment.

I asked about the other violent patient but was told he has a learning disability so it’s not deliberate and also he doesn’t do ‘anything more than throw cups or his handheld cd player at people/ spit at people’. So therefore that’s okay!

The 9am-9pm travel I was told I would be able to rest on the train so not too stressful (not mentioning the walk to the bus, getting on a tram to the location, walking back to the train station etc). It’s an arduous day.

The 5 cases needing reviewing I just decided to push myself to do as I hadn’t had a positive response regarding other concerns. It was a long day but I managed it.

I know there’s a range of options available to me (simply refusing, taking the issue to higher management, getting union involved etc).

I have long before pregnancy had concerns regarding unreasonable caseloads and expected work level. I am thinking of not returning to work after maternity as this level of work won’t be feasible with a baby to look after.

I am struggling in pregnancy with exhaustion. Doctors say it’s totally normal which is true but makes working so much more challenging. I just wish they could understand that and give me work accordingly. My Doctor has offered to sign my off sick the entire pregnancy but I’d not do that as if I need to return I’m worried it would make my life harder when returning.

So before I get assertive and refuse some of these tasks. My AIBU is this, and be honest. I won’t be offended.

Am I being a bit unreasonable not wanting to do the above tasks expected of me? I’m talking specifically about the very long day of travelling and working with the violent patient? I’m worried I’m being precious. I don’t want to take this further if I’m being unreasonable. I just feel exhausted and anxious.
I am 26 weeks pregnant.

Assuming you work in the public sector, refer yourself to occupational health and raise this all calmly and clearly. Also contact HR. I work in the public sector. I know this happens, but it’s far more common for colleagues to support pregnant colleagues appropriately.

You should not be asked to do “extra” (eg hours or excessive travel beyond your normal role) or work with known risks (this would include violent patients, many communicable diseases, unnecessary radiation exposure). The risk assessment should outline adjustments to reduce risk to you and the child, it’s a legal requirement not an optional thing.

I agree with those who have said that you just need to sort it out and not worry about anyone else here. Consider going off sick if you have to (they will make your mat leave start from ~36 weeks if you are off sick but then you have your annual leave back to use at the end ).

Agree that no way should you be near any violent patients

however unfortunately feeling exhausted is a part of being pregnant for many people and making a fuss over the travel does make you sound quite precious. Many of us have been through terrible tiredness/vomiting etc and had to carry on working

Bloody hell, their risk assessment and mitigation plans are shite.

I used to work in the community and any client with any history of violence had 2 staff at every visit, and appointments were generally held in a community setting rather than in their homes.

The 12-hour day is ridiculous, even for someone who's not pregnant. You should be allowed to stay overnight. Would it be less time consuming/exhausting to travel by car, and would they pay mileage?

I think you would be entirely reasonable to refuse, and that it's unreasonable to expect you to do such a long journey when pregnant.

Get advice from your union as a priority.

You should not br managing violent patients.

Can't you drive it seems unusual for somebody working in the community to not have a driving licence. Obviously you haven't actually said who you work for but if for eg in mental health they usually have 2 members of staff for 1st assessments and also violent service users. If this is the case and this isn't happening you need to be going higher up on this, pregnant or not nobody should be going to see a violent person alone even police don't do that.

I'm guessing you work in adult social services? In which case I can completely believe the the crappy conditions you're working under. I would go with your gp and get signed off

So it’s an inadequate risk assessment? You need to speak to HR and advise them of your rights to paid leave if they cannot safely accommodate you during your pregnancy. Call Pregnant Then Screwed and Acas for more advice.

Speak for yourself - and perhaps read the OP again…

When you went parting your workload should have gone down in proportion

YANBU at all OP. Are occupational health involved?

I'm guessing you're in probation/social services/housing or that sort of public sector roll, in which case they'll be a well defined grievance procedure to follow. What they are asking you to do regarding clients with a history of violence is unacceptable, learning difficulties or not. I was a police officer when I was pg, and I was literally allowed to do nothing that involved public contact. They even sent me with a chaperone to court appearances in case anything kicked off, and this was 25 years ago.

It sounds like your overall workload/caseload needs re-assessing, irregardless of pregnancy. I would contact the union about that.

No to the violent case. Of course you should not be around that.

A 12-hour day of travelling is also unreasonable if you do not feel up to it. That's always the medical advice in pregnancy - don't overstretch yourself.

Put all this in writing. YANBU.

I was pregnant working with clients who posed risk , children and adults and learning disabilities . Also I had to travel .
I was removed into light duties , admin support / report writing / phone calls / advice line . Office based
Speak to HR then union
And the argument of harm not being intended due to lack of capacity is rubbish . Whether intentional or not the outcome of being attacked is the same . Risk to you and your unborn child .

I agree with this tbh. I worked as a nurse right up until 37 weeks pregnant and whilst I was given patients to see that required no manual handling I still had to do all the other tasks, I remember doing bilateral compression bandages on a mans legs hunched over my bump. Pregnancy is exhausting at the best of times but they do need to minimise the risk from violent / potentially violent clients.

I'd go the route of asking your GP for a fit note stating you are well enough to work but not well enough for excessive travel and would outright refuse the violent patient. Pregnant women are not allowed to clean up bodily fluids in the workplace due to the health risks and being spat at carries the same hazards.

Ask them to state in writing that you are required to assess a patient who is regularly violent and throws things at people and who will likely spit in your face, while you are pregnant. They will either refuse and back down or give you some excellent evidence for a grievance.

You should have had a clear plan in place for your return. However pregnancy on its own isn't a disability. If you take all the easy close to home cases, it makes your coworkers case loads exceptionally heavy as now thye have to do your share of the travel and take on your share of the violent clients.

I think you need to pick your battles. Safety is the priority. How can they create a safer environment for you to work in? If the reality is that many of the clients are violent then how can that risk be mitigated? I am not sure what environments you are going into where people are being violent but many of those already have safer rooms with dividers or barriers or ways to keep yourself safer in the environment.

However you can't just avoid all travel or anything that would be tiring or difficult unless you have a specific pregnancy related need that requires accommodation.

You need to talk to your health care team and occ healthy or HR and create a safe working plan based on your specific needs. I worked inpatient psych at one point and many women worked right up until their due date. Pregnany on its own isn't a disability that is accommodated but it can necessitate changes to make the work environment safer (you move slower, can't do restraints, need more frequent breaks etc).

The onus is on you to get them to complete it correctly.

Stand up for yourself and refuse the client with learning issues and violence.

I think you're completely right to be worried about the violent patients and would push back about that.
However I'm so surprised to hear you and others saying a 12 hour day most of which is travel is unreasonable. Many many women, myself included, continued to work 12 hour physically exhausting shifts in pregnancy with travel time before and after to get to work. To be honest actually working for just a 2 hour assessment sounds cushty, you can read/watch/listen away whilst travelling. I'd drop this part of your complaint tbh, it just sounds like you don't want to do any work and will undermine your chances of being taken seriously for the other issues.

Given what you are describing, you will have a professional body. Consult with them, they are really good.

I think you could probably do the travel one - if as you said you will be sitting on a train most of the day! You could take a nice packed lunch and a book it could even be quite restful. Ask for a taxi to and from the station though.
As to the violent patient throwing things - absolutely not. I don’t know what they are thinking!!

I had to take myself off the ward as soon as the lunch trolley came round!! 🤢

this is what I think too. I would love to be paid to sit on the train for a chunk of the day!

I fully agree with this.
Very sensible advice.

Talk to your union (assuming you’re in one) immediately and then HR. The risk assessment seems inadequate and the manager’s interpretation of it poor.

im not sure about the travel issue, if you work 9-5 the 9-9 would be unusual but unless unwell in pregnancy I’m not sure how getting a train would be a problem.

your casework sound like the whole of the public sector at the moment. But having more than a full time caseload when going part time is poor management. But I imagine staffing levels have been cut due to budgets. The reality is you can only do what you can do in the time available.

if you pay into a union this is absolutely what they are there to help you with.

You would be correct.
Im so shocked to hear of the risk assessments other places have. When not pregnant it is standard practice to enter the homes of violent patients alone with nothing more than a mobile phone.