Changes. Work advice?

Hi guys.

I’ve been thinking. Generally I hate it when that happens.

For the sake of my health I need to make some changes. Specifically I terms of work. I work 37.5 hours a week as a staff nurse on an acute mental health unit. I love it, but it’s too much. I recently went to a fatigue management course (that I was only allowed to attend outside work hours I might add) and it spoke about boom or bust. The suggestion was that rest periods should be taken in order to avoid hitting that wall we all know so well. In my job it seems impossible. I’m hitting that wall every single day and I’m pretty much an empty shell when I’m not at work.

I used to take what I called ‘restorative sickies’. The odd couple of days every couple of month when I felt the tell tale signs of a relapse. The works sickness monitoring policy has made that impossible. I spread out my annual leave as sensibly as possible and tend to go for little and often in order to try to maintain my health.

After a 18 month long fight of appeals and interviews I finally got the lowest rate of PIP but that is nowhere near enough to let me drop hours at work. I have a mortgage to pay. (Please don’t suggest I give up my home. People mean well, but the thought is too distressing to comprehend. No offence)

I guess what I’m really after is advice on what sort of thing I could practically ask for in terms of reasonable adjustments? Could I suggest 30 mins is added to my daily shift so I can take 3x 20 minute breaks? Could I ask for a working fan in the office to help me during summer months?

I have no clue in terms of my rights. You would imagine that the NHS would be supportive employers but I haven’t found that to be the case. You get the odd meeting where they say they want to support you but it’s all lip service and box ticking on their part. I sound bitter. I am. Despite the fact I have not long since had a 6 week period of sick due to a relapse I have just come off a 10 day stretch of shifts without a day off. I’m exhausted, disillusioned and accepting that something has to give.

Hi Seren,it’s brutal when you hit the wall eh? I had to stop working as I wasn’t fit for work so now I get SSP which is rubbish. I had a insurance policy through my partner’s work which turned out to be a real help. You could check and see if you have one and if it is going to be any good to you…just a suggestion as mine was a bit of a surprise but turned out ok and eased the financial burden a bit. Terry


I work in a reactive intense emotional labour type role as well in the public sector and I similarly have struggled to get work to recognise reasonable adjustments. I have found Access to Work advisers to be very helpful along with the disability law service to get legal advice when things aren’t going well.

We hope the public sector would be the best at recognising their duties under the Equality Act but sadly it’s not due to pressures to do more for less so we MSers can be a bit of an inconvenience to management. I have had relapses due to trying to do my job the same way I always did at 90 miles an hour with the highest case load (due to the ridiculous monitoring system but let’s not get started on performance indicators :). If I could turn back time to when I was first diagnosed then I would say that I should have worked on getting my employee and managers to accept that I was different but still able to do the job and it was their responsibility to ensure that I could. This is where a good Access to Work adviser comes in as they help us to accept it is not us but the employer who has to respond.

It is not reasonable for you to have no other life than work and you can have adjustments to ensure that you can provide the service that you always have done. Get your Union on the them.

I have gone part time just losing one day a week and although financially it has squeezed it was the best thing. I also keep looking for ways of keeping me at the forefront of developments so they can’t say I’m slacking.

I hope you find a way to get through. Changing jobs is also a good solution - the new employer will accept you in your now state so will be more sympathetic (after all they took you on). You are fortunate that the focus for health has at last come more on mental health so there might be roles that are a better fit.

Wishing you all the best

I can only ratify the brilliant advice given by Blessed. Access to Work Get support in work if you have a disability or health condition (Access to Work) - GOV.UK Disabled Law SOCIETY Reasonable Adjustments is a fan; more breaks are great; get your Union involved no way should you extend your day to make it up. Let them discuss it with management.

Contact the EHRC by phone tomorrow who will advise


Cheers for the advice guys. Everything that I’ve mentioned so far has resulted in the suggestion that I can’t do my job. I can. I’ve been on the same unit for a very long time and, from that point of view, I have an awful lot of valuable experience. I just want support. Protected time for admin work. A limit to the number of patients I have to key work at one time. That kind of thing.

The trouble is that the unit is very short staffed so more work is being piled on everybody. The way I’m beginning to see it is that it’s not my fault the place is so poorly staffed.

I’m definitely going to speak to all the agencies that you guys have suggested.

@ggood, would I really not have to make up the time? How does that work?

Hi just wanted to say that I agree with what’s been said above. Your employer has a duty of care towards u under disability law, your experience is valuable and they need to understand tha. I had a similar work situation earlier inthe year when I was overloaded and needing help. I found a session with someone from CAB to b of enormous help. Pm me if u feel that would b helpful… And don’t b hesitant about insisting on the help u r entitled to. Remember it’s not your fault that u have MS!

H x

Hi Seren. I’m a probation officer so similar-ish in terms of caseloads, chaotic work etc

i went from a 5 to a 3 day week, which financially is difficult, but I just seemed to live to work. Re: caseload, my manager asked for a supporting letter from my MS nurse. Basically outlining the basics of fatigue, mental fog and cognitive skills. This has helped me to be put on ‘more’ of a protected workload but similar to you re: staffing cuts etc.

A fan would be an easy ‘reasonable adjustment’. Have you got scope to be referred to Occy Health??



I’ve self referred to Occ health in the past but was told I couldn’t ask to not work night shifts as it meant I was “unable to do the job”. I’ve had just about zero support. As I say, it’s mainly lip service and box ticking.

Having MS means you’re classified as disabled at work. Unfortunately, because it is largely invisible, employers can conveniently forget about it. It is like expecting someone using a wheelchair to suddenly stand up and dash across the room when it suits them! I think the breaks idea would be a reasonable adjustment - have you got a place when you can rest quietly? Maybe you could suggest a month long pilot, to let them see that the job still gets done? The understaffing is their problem to solve, not yours.

Good luck - I really hope you can work something out xxx

Seren the reaction sounds very familiar to me. In the end I had to get really hard core with my employer and get a solicitors letter which suddenly focused them in that they realised I was prepared to sue their arse. However it was stressful. I kept trying to be collaborative for a year and a half. Sorry to be doom. Your situation is different and it can be worked out - many people have very good experiences.

My other suggestion is everything in writing from now on and each time you write you note that the lack of adjustment and responses of performance management/sick procedure rather than adjustment is stressful and this is a factor in relapses for many MSers

It is so very disappointing from the NHS though.

Ps be careful about suggesting a trial it can back fire. If the solution does not work they have to consider other further adjustments again keep batting it back it is their responsibility.

pps occupational health for the employers is just an arm of HR. I insist mine use my independent national health one to make recommendations or access to work. If the employer forces you to go to theirs (which they can) then you have something else as well as a back up.


I used to work for an acute Mental Health Unit so I truly get what you mean.

I took ill health retirement in 2012 but before that decision was made I was referred to Occ Health and they were really really helpful. ie air cond machine in my office, time out when things got hectic, change in hours, lots of changes.

Have you been referred to Occ Health?

Shazzie xx

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I’ve been referred after periods of sick and I’ve also self referred when I’ve been struggling. I see a counsellor through the trust (in my own time) and I find that really helpful. More because it gives me a chance to talk through the lack of flexibility in other areas. It’s brilliant to have somebody to discuss the problems on the unit with. As far as the rest of it goes, the general consensus seems to be that if I say I struggle with something I’m admitting I “can’t do the job”.

I heard that the counselling was good.

You’re not saying you can’t do the job but that ypu need adaptations (that legally they are obliged to do for you under the Equalities Act 2010) to do the job. They have to offer you reasonable adjustments at work under this Act. That’s why I had loads of adjustments done before I retired at the age of 52. We exhausted all means of adjustments. If you need more info on this feel free to PM me.


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Hi Seren,

Sorry to not get back to you sooner but your question is something AtW or your Union could debate with your employers stating it is a reasonable adjustment. Otherwise if they do not use this as a reasonable adjustment they may lose a valuable member of staff.

AtW can also arrange taxis to and from work to save you the hassle of driving or the tiredness of using public transport; you only pay what public transport would cost. See it’s a large document suggest you ring EHRC with specific questions.

Use every piece of legislation there is; never give in although at times you want to. Always take a colleague; Union rep in all meetings they request more or less to be a witness to what is said. Your right; no one with you; no meeting.


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Hi Seren

Do you get tax credits? Because if you get DLA or PIP, you should get the disabled component as long as you work over 16 hours a week. Getting it has made a huge difference to me, and allowed me to reduce my hours.


This is a guide on Reasonable Adjustments; a quite confusing phrase


Hi Dan. Nope, I don’t get tax credits. I earn too much. It would be a bit too much of a risk for me to drop hours in the hope. Especially when Mr Cameron is trying to screw over everybody on tax credit. My mortgage needs paying. Eek.

a pertinent question - were you to have any/all the reasonable adjustments you wanted could you do the 37.5 hour week at work?

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If I had a limit to the number of patients I need to key work, an agreement that I didn’t work more than 7 shifts in a row and protected time for link work/PADR stuff/paperwork and longer breaks (even if I did have to extend the length of my shift) then yeah. I’d love to work 37.5 hours because I love my job (except the stupid box ticking/politics).

I spoke to one of my senior colleagues before the start of tonight’s shift. I mentioned some of the reasonable adjustments I would like. His response “if you’re saying you can’t do the job here they could just move you…” I’m so angry right now. I can do the job. I want to do the job. I’m one of the most experienced members of staff here and one of the few who actually still wants to do the job. The couple of nurses who have been here longer than me both openly admit that they are counting down to retirement later this year. You know what? If they are that short sighted, if they can’t see that I’m still motivated and just need help, then screw them.

I’m going to ring all the agencies that have been suggested but I’m not going down without a fight and I will not be intimidated into not even trying. If they do end up moving me then it is their loss. In the mean time, I’m ready for a fight.