Legal and ethical dilemma

[sunshine080]

My job requires a professional registration in order to perform. My current registration expires shortly and I have been contacted to renew it. In order to renew I have to confirm that I am still fit to practice, and declare that there have been no changes to my health that would impact this. So I have two choices; lie and keep my job (because without a registration, I have no job), or declare my health issues, be unable to renew and lose my job - which subsequently means losing my house, being unable to support my family and child, etc. I am already in a high state of anxiety about this predicament and the closer it gets to the expiration date, the worse it's getting.

WWYD?

So you have symptoms, no diagnosis, and work in healthcare. You feel that your job is affected by the symptoms. With all due respect- if it's healthcare, there are multiple roles you could look to apply to. I wouldn't say that an undiagnosed set I'd symptoms is something I'd put down on my registration, but I would look at another role if I was an independent practitioner and felt that people may be at risk from my actions.

I have found myself driving on the wrong side of the road on a couple of occasions, having no recollection of things I've done immediately prior, etc.

when you kill someone telling your boss about your health condition will be the least of your worries.

I don’t see the dilemma? You report your health issues no question.
You knew the limits when you took the job. You cannot lie and put others at risk. I know this may mean going on disability benefits and losing your home, but it is also an opportunity to retrain into something else.

Can you take some time off sick to focus on your health and getting some effective treatment.

Haven't read the whole thread but have seen your most recent post, OP. Amitriptyline made me feel really drowsy and thick headed. I was also prescribed it as a way of avoiding hrt (I wanted hrt, gp reluctant for mysterious reasons). Eventually they agreed and hrt has definitely helped my migraines and energy levels.

I think you need to argue for hrt and go elsewhere if your doctor won't listen.

First things first for the brain fog you get Lamberts Multi-Guard ADR Tablets. Take 2 every morning. These are the things that have made the single biggest difference to me.

While they are taking effect you pay to go privately to a menopause specialist. The following was written by a friend.

HRT: not for everybody. But can be life changing. And is not just about hot flushes and insomnia.
Falls broadly into 3 hormones. Oestrogen which continues to decline post menopause, apart from its reproductive function it also affects the heart, skin, hair, pelvic muscles and brain, including mood. Almost all HRT oestrogen is now administered topically, patches or gel, and is made from Yams. My own experience with lack of Oestrogen was really terrifying depression so I use Evorel patches and Oestrogel and I do find that if I try to cut back too much the black chasm is there within a couple of days. Also noticeable increase in achy joints.
Progesterone if you take oestrogen you need progesterone to stop too much lining of the uterus building up. Pre-menopausally it regulates periods and supports pregnancy. Also it regulates mood, sleep cycles and low progesterone can induce sleeplessness and anxiety. I take one Utrogestan a day. For some reason I can’t absorb it topically!
Testosterone ovaries produce 3 x as much testosterone as oestrogen so why this has been ignored hitherto is a mystery. Gives us strength, energy, improves self image and sex-drive. For me the correct dose has definitely given me more energy, feel better in myself and take a bit more interest in life. A topical cream - Androfemme. Until this year this was unavailable on the NHS, but while writing this I see that the new NICE guidelines recognise its benefits.

Even if you think HRT is inappropriate for you I would recommend a telephone (zoom) consultation with The Newson Health Clinic. Not cheap but I think £250 well spent (based in Stratford). Mostly you should be able to have what they recommend on the NHS. But like most time that you pay for, they give you as much advice as you want. And Menopause is their world. Not done side course at medical school that nobody took!
Newson Healthh_

Dr Naomi Potterr_. Another clinic where you can have a zoom consultation.

There are loads of other helpful bits and bobs. All can be discussed with them.

Yes, yes, yess_: advice and products. Especially helpful if you cannot take Oestrogen based products. Very conscious of people living with cancer and post cancer treatments.

We live in a world/country where roughly 10% of women actually receive the appropriate help with post menopausal life! Lots of inappropriate prescribing of antidepressants, which do not help as it’s not Seratonin that we’re lacking!

I hope some of this is helpful. There is lots of help out there and hopefully something for everyone. I think that it’s worth accessing some indépendant advice, even if only for the chat and to impart greater knowledge to our daughters. There is a strong correlation between PMT, post-natal depression and a difficult menopause. Hormones are neurotransmitters (similarly to seratonin: makes you happy, dopamine: well-being , movement, sends messages to cells, etc) and need regulating in the same way.

Social media: there is quite a bit of good stuff on Instagram. You don’t have to interact, just follow. @davinamcall is a menopause champion. Lots of good links here. @menopause_doctor (Dr Louise Newson), @drmenopausecare (Dr Naomi Potter), @carolinehirons - skincare. @nadinebaggot - Times skincare & make up. She’s 60 so particularly interested in what looks good on older skin. Useful tips from all these.

Could you not go into teaching or mentoring for those starting out in the profession? Maybe become a tutor?

As someone who has received a life changing medical diagnosis as opposed to going through the menopause (at 52 I will also have this to contend with in the near future) you need to be responsible for your own decisions and do the right thing. It reads like you have been symptomatic for a while. Stop stalling and do the right thing. Get advice from your union if unsure.

Speak to your professional advocate or whatever we are calling supervisors these days.

You do not need to go bankrupt. Tale some sick leave and get it sorted. Luckily there has been quite a drive towards supporting staff members through the menopause so occy health should be sympathetic. Fitness to practice pertains to long term, irreversible problems.

Honestly it does depend on your job and health condition for me but my gut would be to declare it hon. I know it's hard but you need to start getting a plan in place because you'd be unlikely to be able to keep it hidden and will eventually have to leave. Start planning now, can you give more information, am sure someone can help 💐

If you could kill someone, think very carefully about what you do here hon. Can you scrape enough together to go private?

I'm struggling to understand this. You work in a medical environment and are being fobbed off.
Go back to GP and ask them to explain why you are being prescribed anti depressants when this is not in line with NICE.

Surely you have read them ?

Why would you not stand up for yourself and risk your whole career.

Failing that go private.

Another one for- Go private and get sorted. Good luck op.

Yes you need advice on this asap. Your employer (if you have an employer) may need to make some adjustments for you, it may well not be a case of you'll automatically lose your licence and be dismissed if you disclose this. Most public sector pension schemes have an ill-health retirement benefit, do you work in the public sector? You need to face this and deal with it properly, lying is not an option.

I would see a menopause specialist privately if every GP in the practice isn’t helping you. I took HRT for over a decade, but the male GPs I saw initially were dismissive. Only when I saw a female GP who had done gynnae did I get the medication I needed.

You are going to have to throw short term money at it in order to keep an income long term. It might mean a debt you can’t really afford but better than losing your job.

Good luck op, what a horrible position to be in.

Re-register. Take immediate sick leave if you are unsafe to practice. Speak to your manager and occ health. Ask around for a competent GP - mine is happy for me to have a lot of choice and involvement with my HRT. Occ health may be able to recommend someone. Last resort - get a private appointment and stick it on a 0% credit card. If it makes the difference between being registered and not you'll be recouping the money through maintaing your earning power.

Go to a different GP of go private. This is outrageous. Plenty of women have been in your position due to peri menopause. You are a classic case study. There is every likelihood all your symptoms will disappear once you start HRT.

Please pay for a privage menopause docotor! GPS are notoriously patchy!
anxiety, brain fog, fatigue are classic peri menopause.
gel is transformatory. Patches work wonders.

You aren't going to lose your registration over some undiagnosed peri symptoms.

And if you are getting no joy from your GP, spend some money on seeing a private menopause specialist. The British Menopause Society has a list of accredited specialists on their website, just pick one that does on line clinics and sort it out.

Ok, HCPC registration goes retrospectively that's what your audited on. So I've the last X years have you practised the competencies. My guess is yes, so re register.
Then.... Go off sick. Complaints in with the practice manager. It is outrageous that you could loose your job because of in all likelihood quite treatable peri menopaise symptoms. They are not following nice guidance. If you can pay for a private Meno specialist near you (urgently). Assume you might need to go down the fulll HRT journey including testogel so budget for that.
Use Mumsnet Meno pages for further support and advice.

Going through a completely natural process such as menopause is not a health condition FFS!

@sunshine080 I understand that you're being fobbed off by your useless GP, but have you said the following (or something similar)?

"I've spent time researching this and I now know that all the problems I'm experiencing match up with the list of symptoms for peri-menopause. I appreciate you trying to help me with other medications, but I want to try HRT and believe it could really help me. I don't want counselling. I don't want anti-depressants. I am XX years old and it would be entirely normal for me to be experiencing symptoms based on the natural waning of female hormones in my body. I feel awful. I'm not functioning properly and if I don't sort this out, I am at risk of losing my job. Please will you write me a prescription for HRT, so I can at least try it? It could well save the NHS money and it will certainly save my time and yours so I don't have to keep coming back and begging you for it".

It's all very well paying £300 for a private appointment, but you really shouldn't have to. Many of us, through being firm and informed, have got HRT from our GPs (or their colleagues) that is free (apart from taxes and prescription charge).

In case you're not aware, amitriptyline can have short term memory issues as a side effect and as previously mentioned, can make people feel quite zombie-like, so if you actually are taking that, it might be making things worse for you. Best of luck to you.

Get a consultation for HRT and address the issue!

You don't need to throw away your career for a temporary, treatable issue.

I am not functioning adequately enough to be responsible for people's health.

That's your answer then, surely.

Sorry but this is absolutely black and white.

If you are responsible for people's lives in your job and you are not well, you can't do it. It's that simple.