Struggling with work (I'm a nurse) at 29 weeks pregnant

[Strugglingat29weeks]

I'm 29 weeks and exhausted. I've got a 20 month old and a lovely supportive DH but I'm struggling so much at work.

I work 12.5 hour days on a really busy unit, which is especially busy at the moment because it's winter and flu season. I've got hypertension that I do have mostly under control but gestational diabetes which is getting harder and harder to manage. I need to take my insulin 30 mins before I eat but my breaks are only 30 mins long and if I can't time my insulin properly my sugars can drop too low, which is dangerous when you're in charge of other people's medications and wellbeing, or too high which is dangerous for the baby.

I've asked if I could do all of my hours across 3 days instead of 2 but my boss has said they can't accommodate it.

AIBU to get a sick note asking for amended hours or even to get signed off completely so I can focus on the end of this pregnancy. My consultant thinks it's a bad idea for me to be working the long shifts but I really don't want to leave the ward shorthanded at the busiest time of year.

This. Your employer must accommodate your medical needs during pregnancy. Get consultant to write a note stating you need shorter hours etc.

They can and must accommodate your needs. If they make you go via OH that's what they will tell them, but tbh they should know that perfectly well and be prepared to do it without OH input. If they don't, then absolutely get signed off, relax and enjoy the end of your pregnancy. Don't feel guilty about leaving the unit short, the important thing is you and your baby. If you dropped dead tomorrow they'd replace you and patient care would continue. I'm an A&E doctor and had my 3rd baby in October, also had GDM which was very hard to control even with insulin- I went on maternity leave at 31 weeks because I was exhausted and miserable and not coping, even though my department were actually amazing - took me off nights from the first trimester because I had HG and lack of sleep made it worse, shortened all my shifts to 8 hours without a murmur. In retrospect I wish I'd got signed off until mat leave kicked in automatically because I've now lost time with my baby at the other end, but I'm so glad I stopped work when I did as I had the chance to rest up for those final few weeks and was much better able to cope when he arrived. Pregnancy affects everyone differently (and even different pregnancies can be different for the same person) and just because some people bounce around in work up until their due date doesn't mean you ought to be able to as well. Put yourself and your baby first- you have years to be a model employee but only a few more weeks to maximise your comfort and health during this pregnancy.

My lovely consultant has written an emphatic letter to my boss about being allowed to drop down to the short day shift, so on Tuesday I'm going to take that to my equally lovely GP and get a fit note for amended hours. I'll see how I get on with that, but I'll have a low threshold for getting signed off completely!

Thanks for all the encouragement ❤️

Manager was off sick so spoke to matron who said a couple of things I wasn't sure about, maybe someone could shed some light?

1. If I was to go off sick she could start my mat leave early. I said "yes, at 36 weeks" but she insisted it's earlier than that.
2. If I get a sick note saying I'm to do reduced hours then I'll only get paid for the hours I do and not be entitled to sick pay for the rest of the hours. So if for example instead of 2 long days I did 2 7.5 hour days I'd only get paid for the 15 hours I worked and get sick pay for the remaining 8 hours in the week.

Really not sure what to do for the best. There's so much flu floating about that we're back to masking in our trust which makes me feel a bit anxious and really ramps up my nausea.

Definitely speak to Occupational Health, do you have your consultants opinion in writing, if so your manager needs to immediately review your pregnancy risk assessment both for you and the safety of the patients you are treating. If this was a verbal conversation, make sure you back it up in an email more so to protect yourself so there is a trail. You can be signed off immediately as you and baby are more important. Take care OP.

Go off sick, now!

The thing is, if I really can be forced onto maternity leave early, then we're a bit scuppered financially. So just wanting to check options. If I can be on sick leave until my mat leave starts (at 36 weeks) then I think that might be my best option.

Absolutely classic NHS trust being an absolute arse and putting staff and patients in danger. The fact you're even stressed about this is telling of the working culture. What total bellends.

Don't wait around. Get signed off sick, insist on an OH referral, also remember OH are on nobody's side particularly and speak to a union rep because the union will be on your side. If it comes to it, any meetings make sure you have representation and take notes. Your manager and matron sound horrible. Sorry. Look after yourself and your baby first.

Your best bet is to contact your union they’ll be able to advise you and make contact with your matron regarding your rights
I know they can make you start mat leave early but I didn’t think it was before 36 weeks
Honestly they sound really unsupportive I would go off sick

If course you can be on sick leave. And they could easily make it possible for you to work with reasonable adjustments. Absolute bellends.

YADNBU. Speak to occupational health. This may also be helpful www.rcn.org.uk/Get-Help/Work-and-family

DOI - matron

From the RCN site "If you are off sick with a pregnancy-related illness in the last four weeks before your expected week of childbirth, your employer can ask you to start your maternity leave."

She can't put you on mat leave before 36 weeks.

There may be helpful advice here too https://www.hse.gov.uk/mothers/

Other alternatives include short term non clinical secondments if you can't work clinically I.e to patient safety/governance etc

Oh OP.

Honestly, get signed off tomorrow and take it easy. I believe 36 weeks is the earliest they can start maternity leave, which you have already chosen anyway.

I work the same shifts and can only imagine how hard they are whilst pregnant and with GDM. You know how dangerous poorly managed blood sugars are so step back and look after yourself and your baby. The relief you’ll feel will be immense, I promise.

Bless you. Your background makes you very aware of the need to manage your health but also makes them think you will just cope, bet they wouldn’t advise a patient the same.

I think tell them you don’t want to let them down but must look after yourself and the baby so it’s either shorter shifts or signed off/start mat leave. No OB or GP will ever disagree with you.

is it your first? I found the shift to prioritising myself as the carrier of the baby really hard first time round. But you’re the only one who will.

When I was pregnant (which admittedly was years ago), if you went off sick for within your last 10 weeks, then it was counted in your Matt Leave (basically you had to start Matt Leave early)… you might just want t check with HR \ Union (caveat .. it’s probably changed since my day)

Don't feel bad, gestational diabetes is really hard to manage. I was also on insulin and went off on maternity leave at 33 weeks pregnant, despite my job being office based where I could time the insulin properly. But I just found it so mentally difficult to focus on my job, on bringing in all I need, managing the right timings, eating the right things and then also being heavily pregnant together. I'm not surprised you're not feeling great when on your feet all day combined with that. The only thing that matters now is doing what is best for you and your baby, you owe them nothing. Hope you're OK.

Presuming you’re NHS, sick pay is full pay for 6 months then half pay for 6 months so this wouldn’t affect your pay.

They can start your maternity leave early if you are off sick with no possibility of coming back before baby is due. My friend ended up going on mat leave at 34w due to being off sick but there was no way she was going to be back before he planned mat leave. You need to check your trust policy.

Have you had an OH referral? Considering you do a physical job this really should have been done for you when you became pregnant. I'm not medical but I am a people manager and you should absolutely be getting at the very minimum OH breaks to accommodate you being able to additional breaks to take your insulin. An OH specialist could also make the recommendation of temporary shifts changes. It's a bit late in the day for this I know but your manager has definitely fallen short of a few things here by the sound of it.

A lil update: they've agreed to shorter shifts, I did my first today and its blissful to be home by 4. I feel so much less exhausted and like I'll be a better mum on my day off tomorrow. I spoke to the union who were really helpful and helped me word an email which did the trick! Thanks for your support!

Well done OP I hope they are paying you fully

Late to the thread but I just wanted to weigh in as a doctor working in the NHS who is currently 20 weeks pregnant. Please don't feel silly OP! I've been experiencing syncopes at work during this pregnancy and feel so useless and embarrassed when they happen, so can sympathise with some of your feelings. Nursing hours are much tougher than doctor hours and I have had adjustments made in the past few weeks to keep all shifts at or below 8.5 hours because I am so exhausted. Classically, my Trust tried to claim that my pay would change also but this is incorrect and I am now continuing on normal pay for my reduced hours.

My lovely Consultant colleague recently said that no one in the NHS will turn around and thank me for exhausting myself and putting mine and my baby's health at risk. She is so correct, and it has really helped me to reframe some of my intrusive guilty thoughts when they crop up. Don't waste your health and your baby's health for a job (particularly not to the uncaring NHS!)