One of our members had been treated for cancer and, as part of her treatment during radiotherapy, had to wear a moulded face mask, leaving her to breathe through two straws. She had been shielding at home for medical reasons for several months from the outset of the pandemic.
By autumn 2020, she was ready to return to work. Although she was looking forward to working with patients, she was understandably extremely nervous about having to wear a face mask again. Even the thought of them provoked high anxiety, making her feel quite breathless, and bringing back difficult memories.
But she was really keen to give it a go. Working from home had exacerbated her sense of isolation and she wanted to be back on the wards again. With the support of her line manager and HR, we devised a plan that included a phased return combining clinical and non-clinical days.
Working from home had exacerbated her sense of isolation
She was supernumerary initially and given support to understand the new COVID-19 procedures. Importantly, she was also given face masks to wear at home, so she could gradually try to get used to wearing one.
Just as she began to feel hopeful that things were moving forward positively, her line manager was changed, for the third time in a relatively short period. Unfortunately, she began to lose confidence in her ability to return successfully without consistent support. With the help of a senior manager and occupational health, we started to explore permanent redeployment to a different role.
After some negotiations, she secured a post at the same band, but with the ability to be based at home, focusing on a specific project that is leading to significant improvements in the service by reducing waiting times.
New sense of purpose
She can use her knowledge productively, feels she has a purpose, and as a result, she’s very happy. Meanwhile, further work to enable her to return to working clinically with patients is progressing.
It’s been a good outcome in so many ways. I think that without the RCN being involved and working in partnership with HR, she would have left the organisation.
In fact, several times she told us she was going to hand in her notice. If that had happened, her considerable knowledge, skills and experience would have been lost to the trust.
Helen’s advice on supporting a member’s flexible return to work
- Take the time to prepare with the member for meetings with HR or line managers. It’s important they feel as confident as possible and are enabled to be an active part of the discussions.
- In terms of redeployment, encourage members not to rule options out too quickly. Stepping into a non-patient facing role is often not appealing, but could provide a new and rewarding way of using clinical skills.
- Work as collaboratively as possible with HR. These types of situations can be incredibly stressful for members, so a clear understanding of issues and plans is really helpful.
Top RCN tips
- Take a solution-focused approach and work with the member to determine what is possible, rather than what’s not possible.
- Check the RCN’s flexible working advice guide. From 13 September 2021, all NHS employees in England and Wales have the right to request flexible working from day one of their employment and to make more than one request a year.
- Ensure that occupational health has been asked for support.
- Consider a phased return at full pay ahead of the member using annual leave or taking a reduction in pay.
- Have a regular review of how the return is going, with the option to amend or extend.
- If substantive changes are required, consider if there could there be a trial period before contractual changes are made. Make sure to check on the impact on pay and pension.
- See the RCN’s Nursing Workforce Standards for guidance on workforce planning and rostering.