Type 1: Work related stress

[samantha13]

Hi everyone. I'm really struggling with managing my diabetes at work. I'm a nurse in a dementia unit.

I'm on mdi and recently have worked hard to test that I'm on the correct basal dose and that my ratios are correct.

I have two problems. 1) my job in itself is very stressful. Due to the nature of my clients illness my working day is unstructured. I have the freedom to take my two 30mins breaks when I like and I try to keep them to 11am 3pm and on a good day this works. On other days it may be 4pm before I even get a break and at that it will be rushed. The work itself is stressful due to ongoing staff shortages and an unsupportive manager. And problem no 2) I'm actively being bullied by a small group of care staff.

I work 3 12hour shifts per week and my place of work is just a 5min walk from my home. On my days off I manage my bg fairly well but the stress of work and the unpredictability on workdays mean my bg is pretty much always in the teens.

I could look for another job. I'm at a loss as to what to do. I've spoken to my manager about the bullying and she's assured me she's looking into it but she's friendly with the girls so I don't have much faith anything will change.

Sorry for the rambling any advice would be appreciated.

 

[samantha13]

I should say I'm often able to check and correct for example I might quickly check around 11am be say 15mmols take 4u to correct check again but I never go below 11mmols I think it might be the adrenaline and stress hormones. Should I take a bigger correction on workdays? I'd also thought of increasing my basal on workdays but then there is no telling if it will be a smooth or hectic day :/

 

[Juicyj]

Hi @samantha13 Sounds like you're having a bad time of it at the moment. The bullying is unacceptable, can you speak to HR about this, from what you've said I don't think talking to your boss will resolve this. This in itself will cause stress and high BG as you have pointed out too. Can you also make a note of what's being said/when etc, so like a diary of this behaviour so you have a record ? Bullying is very often a sign of insecurity so flip it on it's head to help you cope better mentally - try and pity them, but whatever it's still not acceptable

I appreciate your on MDI, can you see about getting onto a pump, it will mean adjustments are easier, you can programme in different basal settings so if you're having a really busy/hetic day you can change your pattern to suit, I appreciate this is a more longer term goal, but will make work easier to manage. It may be that your basal levels need increasing but unless you are prepared to do any basal testing it would be difficult to work this one out, particularly with stress and being busy. I tend to be more insulin resistant over 10 mmol/l so need a slightly bigger correction dose to bring my levels down, I would do the correction dose but just try and analyse your results at the end of the day, as through doing this you can get a better idea of what is going on

 

[samantha13]

Thanks so much @Juicyj for that advice. I will definitely start to keep a note in regards to the bullying. Our nursing home is being bought over by a new company with new hr so I will try and speak to them once they are in place.

With regards to the pump..the waiting list in our trust is 9 months. My husband and I are hoping to apply for adoption this coming year so if I was to be approved it would be smack in the middle of that and I worry they might put us on hold until I settle with the pump. I have my clinic review in Jan so I could discuss it with the consultant then.

 

[Juicyj]

Just a thought but maybe the buy out is causing insecurity amongst the staff causing the bullying, a change in circumstances can very often bring about negative behaviour in staff, whether it's worry, whinging or bullying. It means that this will get nipped in the bud though at some point which is good news for you.

Yes definately push for the pump, not sure this would affect your adoption plans, i'm sure your consultant can advise you on this.

 

[samantha13]

No the bullying has been going on a good few months before we knew about the buyout but your right it definitely has put an edge on things with all staff.

I'm not sure how I feel about the pump. My clinic have suggested it before because I also work night duty at times. It's taken me 6 years to get some semblance of control with mdi and I'm awful with math. When I read about the pump it all goes over my head I'm not sure if it would be a waste on me. I realise this is very selfish of me due to all the diabetics who would love the pump.

But I'll see what the clinic says in Jan. I really do want the best control so that we have no problems with the adoption process so if that's the pump then I'll make it work

Thanks @Juicyj

 

[Juicyj]

Hi @samantha13 The beauty of the pump is the support you get from the pump company and your team in getting you on board with it, they will work out the pump settings with you so that all your ratios are set up ready to go, it's really not complicated and you will get ongoing support from your team with your adjustments, a pump would just improve your quality of life since you are already trying hard with your MDI regime this will improve it. As your work is stressful this could only help ease your situation. I hope the situation with these bullies disappears soon, there's one thing I cannot tolerate and that's bullying, that's my personal opinion of course, good luck lovely, things can only get better

 

[samantha13]

Thank you @Juicyj xx

 

[Janet_rabbit]

Hi Samantha,
I know how you feel. I find my BGs much harder to control when at work - i am a primary school teacher and it can be very stressful, although a lovely job in many ways. I am very lucky to have a supportive staff but sometimes I find it all a bit too difficult - especially when other types of stress kick in. I would definitely recommend the pump, as it makes it easier to control and honestly the maths is easier than MDI ever was. Your health care team will help you get it set up in the first place. I find i have had to adjust my basal rates quite a lot - but the pump has a wonderful feature called temporary basal rates so you can make adjustments to cope with higher sugars because of stress, or lower sugars because of exercise or whatever. It gives a lot more freedom than MDI. The upcoming adoption might be creating some stress too, although it is a lovely thing to look forward too. Best wishes for it all.

 

[AmandaD]

I am on a pump and I have a different basal pattern for when I am at work for me I need less insulin at work that I do when I am at home (with one exception, during exam times we're crazy busy, so my insulin needs go up during those two weeks cos of the stress) so mayb u do need different doses to cope with your workday especially with it being as stressful as it is. The upcoming adoption would also add to your stress and cortisol the lovely hormone that it is causes insulin resistance ergo more insulin needed during stressful periods. Really hope the bullying at work is sorted out sooner rather than later as I can just imagine what a horrible situation that must be to be in.

 

[AAP2]

Hi Samantha, I hope all the suggestions have been helpful. Bullying is so harmful and many managers do not know how to deal with it. It can be insidious and even though it may appear petty can be harmful. The organisation is responsible for the behaviour of workers, so if the bullying escalates or continues to be persistent they may be liable. I am attaching some links of where to go for help. ACAS may be able to assist. The NHS employers sometimes have an employee assistance scheme and you can find out from HR if you need someone to talk to. There is not much space here but I hope you find the following resources helpful.

Royal College of Nurses: https://www.rcn.org.uk/get-help/rcn-advice/bullying-and-harassment

NHS Employers: Tackling bullying in the NHS - HSWPG infographic

16 / 6 / 2016 11.32am Download the health, safety and wellbeing partnership group's (HSWPG) new infographic, which looks at how you can tackle bullying and harassment in your organisation. FIND OUT MORE


Help and advice from ACAS http://www.acas.org.uk/index.aspx?articleid=1864 that you can share with your manager. May be worth alerting HR. The employer is vicariously liable for the actions for their employees. If the bullying is related to your diabetes, you may be able to make a claim under the Equality Act 2010.

https://www.gov.uk/workplace-bullying-and-harassment

Information about the Protection from Harassment Act file:///C:/Users/Windows/AppData/Local/Microsoft/Windows/INetCache/IE/OHK2Q0J1/Journal1.pdf

Advice from Mind: http://www.mind.org.uk/information-support/tips-for-everyday-living/work/workplace-relations/#.WDVoiqxvjx4

Advice from The Tim Field Foundation Bullyonline website: http://bullyonline.org/index.php/bullying/recovery/8-regaining-control

Pro Bono lawyers: and students, courts and other legal advocates across the country.

LawWorks | The Solicitors Pro Bono Group www.lawworks.org.uk
LawWorks is a charity working in England and Wales to connect volunteer lawyers with people in need of legal advice, who are not eligible for legal aid.

Mediation can help to resolve workplace issues – if your manager does not know how to deal with the issues or is conflicted, you may suggest mediation with the bullies. This is not a soft option, but requires the bullies to confront their behaviour – worth a try if the organisation and the parties are agreeable to mediation.

Civil Mediation Council www.civilmediation.org The Civil Mediation Council is the recognised authority in the country for all matters related to civil, commercial, workplace and other non-family mediation.

 

[JenniB]

Hi Samantha, I hope all the suggestions have been helpful. Bullying is so harmful and many managers do not know how to deal with it. It can be insidious and even though it may appear petty can be harmful. The organisation is responsible for the behaviour of workers, so if the bullying escalates or continues to be persistent they may be liable. I am attaching some links of where to go for help. ACAS may be able to assist. The NHS employers sometimes have an employee assistance scheme and you can find out from HR if you need someone to talk to. There is not much space here but I hope you find the following resources helpful.

Royal College of Nurses: https://www.rcn.org.uk/get-help/rcn-advice/bullying-and-harassment

NHS Employers: Tackling bullying in the NHS - HSWPG infographic

16 / 6 / 2016 11.32am Download the health, safety and wellbeing partnership group's (HSWPG) new infographic, which looks at how you can tackle bullying and harassment in your organisation. FIND OUT MORE


Help and advice from ACAS http://www.acas.org.uk/index.aspx?articleid=1864 that you can share with your manager. May be worth alerting HR. The employer is vicariously liable for the actions for their employees. If the bullying is related to your diabetes, you may be able to make a claim under the Equality Act 2010.

https://www.gov.uk/workplace-bullying-and-harassment

Information about the Protection from Harassment Act file:///C:/Users/Windows/AppData/Local/Microsoft/Windows/INetCache/IE/OHK2Q0J1/Journal1.pdf

Advice from Mind: http://www.mind.org.uk/information-support/tips-for-everyday-living/work/workplace-relations/#.WDVoiqxvjx4

Advice from The Tim Field Foundation Bullyonline website: http://bullyonline.org/index.php/bullying/recovery/8-regaining-control

Pro Bono lawyers: and students, courts and other legal advocates across the country.

LawWorks | The Solicitors Pro Bono Group www.lawworks.org.uk
LawWorks is a charity working in England and Wales to connect volunteer lawyers with people in need of legal advice, who are not eligible for legal aid.

Mediation can help to resolve workplace issues – if your manager does not know how to deal with the issues or is conflicted, you may suggest mediation with the bullies. This is not a soft option, but requires the bullies to confront their behaviour – worth a try if the organisation and the parties are agreeable to mediation.

Civil Mediation Council www.civilmediation.org The Civil Mediation Council is the recognised authority in the country for all matters related to civil, commercial, workplace and other non-family mediation.

Really brilliant information here - many thanks. I hope it all works out for you and the easy option is to walk away and leave the job - b ut jobs are not easy to come by and you may regret this (I did)...

 

[AAP2]

Thanks JenniB. Not always easy or possible to walk away without loss or regret.

Bullying is never trivial. Bullying can lead to suicide
http://bullyonline.org/old/workbully/worbal.htm

“Approx 10% of cases involve contemplated suicide (I suspect the real number is much higher)
Approx 1% of cases involve attempted suicide (ditto) (click here to see why)
Twelve cases involve actual suicide (ditto)”

The Samaritans are available 24/7 and not just for those who are suicidal. http://www.samaritans.org/how-we-can-help-you/contact-us. “Whatever you're going through, call us free any time, from any phone on 116 123.” We're here round the clock, 24 hours a day, 365 days a year. If you need a response immediately, it's best to call us on the phone. This number is FREE to call. You don't have to be suicidal to call us.
I feel that bullying may pose an increased risk for people living with diabetes as depression arising from bullying could lead to self-neglect with intended or unintended serious consequences. The case of Helen Green illustrates how seemingly trivial actions can lead to psychiatric illness

“6-September-2006 - Bullying in the workplace has again made it to the headlines. The Helen Green v Deutsche Bank case filled newspaper columns last month splashing Helen Green’s £800,000 damages award all over the front pages.

Taken in conjunction with a recent House of Lords decision, the case opens the door to a new form of damages claim for employees complaining about bullying and harassment at work.

The facts

Helen Green sued Deutsche Bank in the High Court for personal injury and consequential loss and damages, alleging that the psychiatric injury she had suffered during her employment was the result of harassment and bullying by her fellow employees, for whom Deutsche Bank was vicariously liable.

Helen Green said that since she commenced employment in October 1997 she was bullied and harassed by her group. She said that her colleagues ignored her, laughed at her, made raspberry noises with each step she took and told her “you stink”.

In November 2000 she was admitted to hospital where she was diagnosed as suffering from a major depressive disorder. In March 2001 she returned to work, initially on a part-time basis. In October 2001 she suffered a relapse of her psychiatric illness, and at the end of the month stopped work. She did not return to work and her employment was terminated.”

 

[samantha13]

Thanks so much @AAP2 That information is invaluable. It's really isn't easy and is taking over my life. I've a history of depression/anxiety and since this has begun I've developed bad chest pains and hypertension (I'm 33). My counsellor who I see for infertility issues is helping me with coping strategies. I don't want to leave my job as it's very handy to home for me and I love my clients. Thank you for those links it really is appreciated.

 

[AAP2]

Thanks so much @AAP2 That information is invaluable. It's really isn't easy and is taking over my life. I've a history of depression/anxiety and since this has begun I've developed bad chest pains and hypertension (I'm 33). My counsellor who I see for infertility issues is helping me with coping strategies. I don't want to leave my job as it's very handy to home for me and I love my clients. Thank you for those links it really is appreciated.

Thanks so much @AAP2 That information is invaluable. It's really isn't easy and is taking over my life. I've a history of depression/anxiety and since this has begun I've developed bad chest pains and hypertension (I'm 33). My counsellor who I see for infertility issues is helping me with coping strategies. I don't want to leave my job as it's very handy to home for me and I love my clients. Thank you for those links it really is appreciated.

Samantha I am pleased that you found the links helpful. I am also very glad that you have a counsellor that you can talk to. It is so important to talk and not bottle up the issues. Through my work, I have witnessed the harm that bullying has done to people - sad thing is that bullies are usually weak and are trying to cover up their weakness. They need help but the focus is always on their target to cope and then to battle the organisation if the bully is unable to stop. Be strong, do not let the bullies grind you down.