“Whether we work to live or live to work, our occupation often contributes hugely to our identity.”
Will I still be employable after I've been diagnosed with
breast cancer? Will my employer still see me as someone worth investing in? How
will I be seen if my organisation needs to make cuts? How should I approach my
employer if I need support?
As a group of women with primary and secondary breast cancer,
our experiences were very varied. We heard of supportive employers as well as
shocking examples of discrimination and injustice, which not all of us felt we
had the emotional or practical resources to challenge. Some had felt forced to
give up careers they loved, others had taken early-retirement. Many of us
wanted to continue in careers that we loved but were struggling.
A few of us maintain our continuity at work
throughout, describing our careers as a refuge in the storm of cancer. Others
shared how they had valiantly used up precious annual leave to recover from
surgery, either from unsympathetic employers or small businesses. Others had
taken an extended period of sick leave.
Erosion of self-confidence was a common response.
Self-doubt creeps into the mind of the most competent of us, and the
realisation that we are not the same person we used to be adds to our anxiety.
So many of us have little voices inside our heads telling us that we can’t be
successful now. And yet, we do not want to be seen as less capable or less
competent than our peers in workplaces which are increasingly competitive and
under pressure as a result of economic and legislative demands.
The gap between expectation and reality creates
huge pressures when we are feeling vulnerable and fearful.
A supportive line manager or supervisor can make a
huge difference - someone willing to try to understand our experiences and who
is willing to help us to balance our needs and our capabilities. Those of us
who had received robust support, suitable adjustments and flexibility valued it
enormously and felt our performance improved as a result.
Our experiences highlighted that employers and
sickness procedures often view us as idlers and shirkers. This can lead us to
feel worthless and severely undermined.
Many of us take stock and consider our futures. We
make tough decisions about work, including reducing hours or responsibility,
changing roles or finding something completely different to do. Some of us give
up work altogether, perhaps via medical retirement or redundancy. Others are
determined to prove themselves as capable as they always were, and take on
perhaps more than we should in order to continue to keep ahead of the game.
Despite clear legal requirements and guidelines for
employers, our experiences indicate that they are not always being followed,
and when challenged, the resulting stress caused can be just too much for us.
Occupational health teams, designed to assist both employer and employee in
coming to a suitable agreement regarding reasonable adjustments, can be
helpful, or punitive. Some of us had chosen to fight for our rights, others
walk away.
A common theme was managing unrealistic demands and
some of us felt we had been set up to fail. We don’t always have knowledge of
our rights or the energy to challenge discrimination and poor practice. We can
end up being managed out of jobs by employers based on capability. We also feel
uncomfortable or a nuisance for continued reduced capability or significant
sick leave, and employers often show their displeasure by reducing or removing
sick pay once they have delivered on their legal obligation.
Very few of us have found excellent bosses with
whom we can be honest and admit our vulnerabilities. These bosses are rare, it
seems!
What we
need is supportive adjustments such as a smaller workload, staggered
start-times, reduced hours, time off for hospital appointments and regular
breaks. We need helpful colleagues not snide remarks about shirking. We hope,
if you are a line manager or colleague of someone with a breast cancer
diagnosis reading this, that you understand the legal and moral obligation on
you to support us, and how much we have to offer given the right assistance.
We've been to hell and back, and if we ask for time off for an appointment then
this is key to our well-being. We know how precious time is, and we aren't
going to waste it. We will give you our best, every minute of every day, as we
want our time to count.
For those
of us who have had to change careers, reduce our hours or give up work, it is a
huge decision that isn't taken lightly. Following a breast cancer diagnosis,
with the battering our bodies take and the psychological toll stripping us of
our former energy and capability, we may become depressed and our
self-confidence plummets. We are fragile and vulnerable. For some, the decision
to find a less stressful job or to give up work (for those lucky enough to be
in a financial position that allows this) is triggered by a change in
priorities. Having faced serious illness, we find we no longer want to spend
our days working flat out. For others, it's going back to work that helps us
feel normal again, that gives us a sense of purpose and satisfaction, and fills
our days with productive activity, helping us not to dwell on our thoughts
about our cancer.
For women
with secondary breast cancer and who need continuous treatment, the only option
may be to stop work as sustaining productivity levels commensurate with their
position may not be possible. For these women, priorities often centre around
spending time with family and friends. While giving up work may be a relief,
there is still loss – the loss of career and routines; it can also be very hard
to give up who they were as professional and working women and there is, of
course, often significant financial implications.
There is
often a conflict for many of us returning to work, particularly those of us who
are young, ambitious women and who are on a career path. How do we balance the
desire to succeed, to climb the promotion ladder, with wanting to see more of
our families, to spend more time doing things we enjoy, to take it easy?
Being understood in our workplace can be a defining factor in helping us
re-build our self-esteem upon returning to work, or, conversely undermine our
already fragile confidence and self-esteem.
There are,
we discovered, no easy answers. We need to try and adapt and adjust, to cope
with the feelings of being lost and bewildered, as if we don't quite belong. A
phased return to work can be really helpful, with the intervention of
occupational health professionals as appropriate. Macmillan also provide
objective advice and guidance to women who need it. Not
everyone was aware of the protection afforded to us by Equalities legislation,
or that this would continue for the rest of our working lives.
Those working in organisations with clear procedures seemed to fare better, but
not always. We learned that it helps if managers can have a conversation with
us about our cancer and can separate poor performance, from support to help us
to perform well.
To conclude, here are some practical suggestions for both employers and
employees:
· A
realistic phased return which introduces us back into the workplace
· Part-time
working
· Staggered
start and finish times
· Reduced
workload/caseload
· The
ability to rest in the day
· Support
to plan and prioritise work
· Equipment,
for instance if we have lymphedema
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