How can employers support people to sustain or return to work with fatigue? A personal example of sustaining employment following burnout.
Introduction
Coming from an HR background and having an invisible disability myself has meant that I have been particularly interested in how work is managed, and how sustainable work can be supported by an employer. Vitality360 is a rehabilitation provider working to support people with debilitating long-term symptoms of fatigue or pain and who struggle to get back to or sustain work. I am employed at Vitality360 as HR, Business Development and Compliance Manager and have learnt a huge amount working alongside our team, who have many decades of experience supporting people to return to work (86% of our clients achieve their work goals, following our rehabilitation programmes). Being responsible for HR within Vitality360, coupled with having a health condition myself, gives me a unique perspective, and I hope this will be of benefit to employers and HR professionals to inform how they manage similar situations.
Personal story
When I was diagnosed with burnout back in 2003, it was because I simply couldn’t function anymore, physically or cognitively. Of course, emotionally I had run dry and was teetering on a nervous breakdown because of persistent and prolonged stress. I had treated my body like a machine, ignoring its reasonable needs for rest, pleasure and pacing activities/demands. Sometimes, we must learn the hard way (and I am still learning!).
When my contract with my employer at that time was eventually terminated after an assessment from an Occupational Health (OH) provider following a year’s absence, things looked pretty bleak. The OH assessment was very limited in its scope and its perspective as it just considered the role as it was then without an awareness of potential changes that could have been made.
CPD Awards
Fast forward fourteen years and I was in a place of significant change in my life situation, which meant that I had to consider re-entering the workplace. I truly believed that I was not able to work, and had I not been ‘forced’ to return I wonder if I would have done. It was hard at that point to imagine what benefits there might be from working, given what it had cost me before - so there was a lot of fearful thinking and catastrophising going on in my mind. A part-time role came up which I jumped into. In hindsight, some kind of professional support about how to manage this transition might have been helpful - but as I said, I learnt the hard way! Our fabulous Specialist Career and Employment Consultant, Amanda Mason, who has just been shortlisted for an award with the Career Development Institute for her work, offers services such as Career Re-Direction, exactly to support people in this kind of situation.
What I soon discovered was that the hours I had agreed to were not configured in a sustainable way for me. I also found that something came alive in me that had been dormant for quite some time, around feeling a sense of purpose, agency and accomplishment by working. The world of work has certainly changed since the pandemic with more awareness of the positives for an employer and an employee of working remotely, and a shift from perceiving value at work to be solely related to hours worked, rather than quality of output, and how this might be best served through ‘job crafting’.
Activity management diaries
Over time it became clear that the nature of this role, which involved a need to regularly interact with the public, was not aligned with my needs either. I realised this by filling in an activity management chart (similar to what we use at Vitality360 as part of our assessment process and rehabilitation programmes). These charts are designed to give a visual record across a period of one or two weeks. I recorded what were high, medium and low demand activities in terms of symptom activation etc.
Another crucial part of this process was learning more about how different activities correlated to how the nervous system is activated, and how I needed to develop awareness, skills and tools to be able to regulate this system better. This included a huge piece of work around managing rest in a way that helps to soothe the system and is restorative rather than “booming and busting” (as it’s called in fatigue circles).
I have just been enjoying reading a book about pacing (not that I particularly like that word for various reasons) called ‘Pace yourself; how to have energy in an exhausting world’ by Amy Arthur. She considers questions similar to those our team frequently hear from our clients during a rehabilitation programme, such as, ‘How can I make rest enjoyable-when it feels so frustrating!’ and ‘How do I set boundaries around my energy use?’ and ‘How do I know if I am doing too much, too soon?’
Empowering people
As an HR specialist, I had tended to think of accommodations for these kinds of hidden disabilities in terms of ergonomic adjustments, such as better lighting to ease tiredness, supportive specialist software, or chairs to help alleviate postural activation of pain symptoms. Of course, these aspects are crucial and need to be considered.
Perhaps more significantly for me though is awareness of the impact of changes to behaviours. I have been well coached in this through my role for Vitality360.
Capability vs Capacity
Individual employees need to be supported to understand what capability they already have. Just because I have a fatigue condition this did not mean that I had lost all my skills or education. I had simply lost confidence. This needed to be built back up and my thinking and attitude explored, alongside a compassionate and supportive clinician.
I was coached to recognise all the tools I had at my disposal, such as how the behavioural strategies I was already using to manage day-to-day life without work could be transferred to the workplace, with appropriate support and guidance. Learning how to integrate behavioural changes into my working life has been crucial to being able to sustain work.
Of course, there are more significant aspects about a role to consider, such as whether the role is actually suitable anymore, and we offer a careers redirection service which helps clients for whom this is the case to consider other options, perhaps within the company itself. For example, I need to work fully remotely, and in a ‘back of house’ role, rather than operationally.
Supporting employees to negotiate with employers/colleagues
Back to work plans are very helpful tools to support discussions with employers about adjustments. I have an agreed flexible working pattern, whereby I rest in the afternoon and continue my work into the evening. However, an ongoing analysis of tasks and their impact on symptoms is also invaluable to monitor progress and changes, and is something we support clients to use. These tools help a new way of thinking for employer and employee and can be continuously reviewed.
Final word
I will give the final word to our Specialist Career & Employment Consultant who is quoted in a recent article in the IOH Institute of Occupational Health
“I believe it is so important to help people understand that they still have the same skills, experience and knowledge that they had before they became unwell, but they just might have to do the job differently – even if only temporarily. Those adjustments might mean reduced hours or shorter meetings, or it might mean asking someone to check your work before you send it. Anything that helps build confidence and capacity. One client really stays with me and illustrates this perfectly. When we talked about her still being just as capable but having a different capacity it completely changed the way she felt about managing her long-term health condition at work. She realised that despite having stepped back from some of her role, and working less hours, she was still a productive and valued member of the company because of her skills and experience. This realisation gave her the confidence to feel OK about setting her boundaries, suggesting other and more efficient ways of working in terms of organisational processes (often something that helps one person helps everyone in an organisation) and using her extensive knowledge and experience to support colleagues. An even bigger win was that her employers gave her a promotion!”
Amanda Mason DipCG, PGCertEd (Guidance), MCDI