# Healthcare Workers with Crohn's/IBD Support Group



## JM1

Support group for healthcare professionals with Crohn's/IBD.  Hopefully this can serve as a forum for those of us dealing with IBD in our personal lives and the special demands of our career's. All of us have various coping mechanisms we use on a daily basis to overcome our illness and, hopefully by sharing our experiences, we can incorporate successful mechanisms into our daily routines while sharing these coping strategies with our patients and loved ones.


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## JM1

Dealing with the long, irregular hours/shifts in medicine is a challenge. Trying to establish a routine is almost impossible and the fatigue and frequent ( urgent) needs for bathroom breaks can be debilitating. While most employers can make accommodations, health care is somewhat different in that when we are engaged in taking care of a patient it can be extremely difficult to say time out.  What coping strategies have you developed in working around the challenges of IBD?


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## wondering

I've been fairly lucky in that my disease was at its worst before I started clinical rotations so I could manage ok although did take some time off.  Luckily my disease has been well controlled since although I'm concerned that I'm having my first flare in awhile.  I struggle with figuring out who to tell.  I find that even though we take care of sick patients, the mentality in the field of medicine is to suck it up and not take sick days.  I think that's something I also find challenging is figuring out when to call out.  For example, last night I was up sick for part of the night and am still queasy.  I ended up going in as I'm not contagious sick and me calling out would create a lot of work for others.


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## JM1

I, for one, have faced the same issues although call for me required in house coverage. Calling in sick really put a burden on my colleagues, so I had tired as much as possible to "suck it up" like many of us. Realization was slow to set in that I wasn't doing myself or my patients any favors, and was very likely contributing to my less than optimum health. In the back of mind was the thought that if I wasn't 100% then how could I deliver the best care possible to my patients.


DX 1996
5 bowel resections and balloon dilatation of stricture . anastomotic leak requiring re- exploration
recurrent incisional hernias. Seroma
Crohn's related EIM; Lap Chole 2011, Renal stones, Fissures, Arthralgia and arthritis. 

Current Meds:

Cimzia
Azathioprine
Imodium
Colestid
B12
Protonix
Tramadol
Zofran
Vit D2

Previous meds:
remicade
prednisone
Entocort
6 MP
Asacol
Pentasa
Flagyl


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## Nicole86

Thanks for starting this forum. Medicine is certainly demanding and though our colleagues should be the most sensitive and aware about the impacts of IBD, we are also pressured as doctors, nurses, etc, to somehow be superhuman and work impossible hours with poor self care. 

I am still in my training and although it is difficult, I find that the best policy is to be open about my diagnosis with supervisors. It is awkward and I too worry about burdening my colleagues. Sleep is incredibly important in regulating my symptoms and yet I have still not requested accommodations for call, partly because I don't want the stigma and pressure of burdening my colleagues. You're right that at the end of the day, what use is it to put others' needs before our own when we'll end up less helpful and healthy in the process! 

I'm having a moderate flare currently for the first time since 2010 and I think I'll have to be more open with colleagues. I have a strong urge to minimize my symptoms and try to hide it from colleagues, but that just makes me feel worse, like I'm keeping a shameful secret. 

It may be difficult to negotiate, but ultimately your health comes first. Nothing is more important. And you may love your job and colleagues, but you're compromising both if you're neglecting your health when it's most important. This is what I try to remind myself. 

More than call, right now I'm concerned about an upcoming grand rounds I am scheduled to present. This is probably my biggest current stressor and I'm wondering if it would be appropriate to reschedule to a time when I'm in less distress. What to do?


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## kristihelene

Do any of you work with the same patients for extended periods of time (eg home health, LTC facilities, OP practice?) I work in pediatric home health, and had to take off starting the week before Thanksgiving for surgery and kept postponing my return as I ended up with complications then a flare that put me inpatient around Christmas. When Jan 1 hit, I went on long term medical leave because I couldn't justify continuing to string my patients along. Also, there are soooo many sporadic days I have to call off and again feel like it's totally unfair to my patients to lack continuity of care...


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## JM1

It must be very difficult for you especially since you are dealing with a pediatric population. I can appreciate the difficult situation and the frustration of not being able to provide continuity of care in this setting and also the frustration of dealing with Crohn's. Has Remicade and methotrexate offered any relief? Have you had any issues with recurring infections or increased susceptibility to infections, especially since you are dealing with pecs.? I hope your health has stabilized and improved since you are taking some time to recoup. Although it is difficult, sometimes we just have to step back and put ourselves first in line for healthcare.


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## wondering

On a positive note, there definitely are some things that are easier being a healthcare provider than it might be in other fields.  When I do tell people that I have crohn's, I don't have to try to explain it.  Also, since my doctor is at the hospital where I work, he lets me email him directly rather than going through the office staff.  

One of the bigger concerns I have is the infection risk working in a hospital and being on immunosuppressants.  I'm in a field that has a decent TB exposure risk and while I am not currently on Remicade or humira, if I flare those would probably be the next steps...


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## JM1

Has you GI discussed the risks of caring for patients that are on isolation-i.e. patients that have MRE, MRSA, c diff, VRE etc and the risks to you that exist with immunosuppressant therapy? TB is the most talked about especially with the emergency of multi drug resistant strains(MDR TB) however,  the risk of taking care of those patients with other infectious agents should also be part of the discussion. Has anyone else discussed these risks with their PCP or GI?


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## jdpar

I find it ironic that even though I work in healthcare (I'm a nurse at a multi-speciality doctor's office), and my boss is a nurse, they still don't understand very well when I have to call in sick to work.  I often get the "you don't look very sick" from my boss and co-workers.  I don't think that Crohn's is well understood by others, even if they are in the medical field.  My boss and another co-worker have had breast cancer.  Now I'm not trying to compair my Crohn's to any kind of cancer.  But people understand cancer more and look at it like a very serious issue.  Whereas no one really understands my pain and other symptoms from my Crohn's.  I shouldn't complain though, because I've been very lucky to be able to keep my job after all my absences from being sick and being in the hospital 4 times since December.


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## monkey

I love this thread!!
I work in outpatients, so see a whole bunch of people coming through the doors, when I've been on immune- supressants I've been sick loads, my colleagues have been good, in not making me see people we know may be an infection risk etc
Its great if your colleagues understand and you don't have to explain it, sadly my colleagues don't really understand whats going on and will often ask if I'm eating the right things etc...

I do find it really helps to understand my patients better though, having a chronic condition makes me totally 'get' what the patients are going through and understand some of the emotions involved much better than other people!!


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## yosemitegirl

jdpar... I can guarantee that co-workers and management don't understand usually. It's a luxury when they do. And worse, if management wants to lean on you for your attendance record alone, with no compassion, they will unkindly show you the door. Happened to me after decades working at the same place. It became a hostile work environment. Yep... that was upsetting on top of being so sick.

Hopefully, things settle down for you and it won't turn out like that. 

As if Crohn's weren't bad enough all by itself. People can dig the hole a little deeper. I was stunned by that... I no longer am.

Take care...                  Michele Lea


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## valleysangel92

I'm not a health care worker as yet,  but I have a place for a nursing degree (specialising in peads) as of september,  provided that things are all under control and I pass the health checks , so I thought I'd join and see if I can pick up some tips for dealing with the long hours and stress of being a student nurse.  I know my university lecturers will be understanding ( I've been there before,  they are ultra supportive and very caring)  but not sure what to expect from placements. I appreciate any tips.   .


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## yosemitegirl

Valleysangel92... You already know the most important issues such as absences and fatigue. Hopefully, you will continue to receive understanding and support.

On the job, bathroom issues a big problem for me, having had 10 surgeries in the 45 years with Crohn's. Used different meds to reduce this problem, but ultimately my best choice was working every other day to get a break. No 12 hour days either, impossible.

Each of us has many variabilities in our lives. Having had Crohn's for so long I have come to an understanding and acceptance about my limits. I never give up, but I know when to give in to its' demands. You will, too.

Best wishes to you...      Michele Lea


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## kristihelene

Cool story Id like to share: my husband earned an award through his job and the ceremony was in Punta Cana for the employees and their spouses, all expenses paid for a few days! Anyway, my CD has been really bad so I have been off since Nov and missing working w/my patients. I was looking forward to a few days of relaxing, and was settled in for the 6 hr flight. Suddenly the flight attendants asked for someone who could provide medical assistance emergency! I was the only one to step forward, and came to a passenger who had been so dizzy he passed out into his chair and soiled himself. Long story short, I got to jump back into my medical role, treated the man with what they had available on the plane, organized the ground EMTs, and helped him feel a lot less embarrassed and scared!! I was so thankful I was there to help him! The airline was thankful too, and gave me a $200 voucher for a future flight!  Crohn's or no crohn's I was still able to help!!!!


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## JM1

Crohn's doesn't diminish the person that you are, if anything, it enables you to be more empathetic in your role as care giver. That passenger was lucky you were aboard the flight


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## skylardaisy

I don't know what to do. I am a nurse and have been working a .4 eft for the past year. Previous to that I had taken early retirement because of CD. I had a small bowel resection in 2012 and was feeling a lot better so decided to go back to nursing part time. I work in a personal care home.
Fast forward to the present. My symptoms are coming back-lots of D, extreme fatigue and joint pain. Sometimes I think I'm also having brain fog. I'm on Remicade and am having an MRI this week to see if the disease has reared it's ugly head again. I'm so discouraged at work, spend a lot of time just catching up with what has gone on with my patients since my last days off. Yesterday, my manager put out a general memo stating that "some nurses" weren't pulling their weight and a low eft was no excuse. I feel that this was directed at me and am really offended. I do my best and don't use my CD as an excuse for anything. Now I'm wondering if I should just quit. Do I really need this in my life ? I have a pension but it was hard to make ends meet before I went back to work. I am willing to make sacrifices to be able to retire completely. 
Any advice would be appreciated. Thanks.


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## JM1

CD isn't an excuse - it can and does have a major impact on one's life. Finding ways to adapt and overcome seems to be the undercurrent of daily living for those dealing with Crohn's and UC. Working in healthcare is highly stressful and physically demanding. Swing shifts, lack of sleep and heavy workloads can wear down even those without the added burden of a chronic illness. 
You seem to have already addressed the issue and are asking yourself the right questions-do you need this stressor in your life and what impact is it having on your well being? If you are not taking care of yourself,  are you able to fully care for those at work? Are there other options for you to remain in healthcare but not in a direct patient care role once you are feeling better? If you can't get into remission or are having frequent flairs is there a Canadian Government support system in place that could assist you financially? Can you put your experience to work in other avenues to help patient's and their families?  For what it is worth, the most important thing you can do is to first care for yourself: talk with your GI and Primary Care giver and get the answers you need from the healthcare perspective. 
Best wishes and please keep us updated on your progress


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## skylardaisy

Thanks so much for your thoughtful reply. You are so right when you say that we have to look after ourselves before we can take care of others. I just wish that other people  realized how devastating this disease can be.
I am going to speak with my doctor and my banker (lol) and then make a decision. I will keep you posted. Take care.


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## Trysha

Very sad to see you are being treated with less than compassion.
Surely they should be able to give you a place in the office which will use your knowledge.
Feel better soon
Prayers and best wishes
Trysha


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## Saratay05

Skylardaisy and JM1:

Thank you for putting into words how I've been feeling. And feeling very guilty feeling the way I do, like somehow it's selfish of me to want to take care of myself for a change. 

I work in a dental office and if I am having a bad day I can't exactly stop in the middle of a procedure which would put a halt to the doctor's work and upsets the schedule. And then there is feeling I have to explain myself, while the last thing I want is to draw more attention than absolutely necessary. I know it's probably not as stressful as nursing, but as you are aware, it's very difficult to put on a happy face and care for others when you feel lousy or worse.  

I am very lucky in that my boss is very understanding, but I feel now that I can no longer be effective, as well as it puts a lot of stress on other coworkers to help me out more than they should have to. After much soul searching and encouragement from my husband, I put in my notice and have decided to retire after I train my replacement.  

I now agree that my health has to come first.  This was a huge shift for me, from always doing my utmost for my patients even if it was detrimental for my health.  It will be a bit of a strain (we have 4 kids going to be in college in the fall) but nothing is worth sacrificing my health or  future quality of life. 

Good luck in your decision Skylardaisy.  Sending hugs your way.


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## JM1

Every job, especially in healthcare, has it's own set of unique stressors. Having the support at home is key in helping you through a difficult decision and it sounds like you have a very understanding and compassionate husband. 
Having four kids in college at the same time is tough, and I am sure a financial strain, but giving yourself the opportunity to be at your best physically and mentally for their graduations and future endeavors is a priceless gift that you are giving to yourself and your family. Best wishes


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## skylardaisy

Saratay05, I applaud you ! Good for you to have the courage to put your health and wellbeing first. As JM1 said, you are giving your family the gift of a healthy wife and mother and that is indeed priceless. Best of luck !
As for me, I am still waffling but I definitely know that I have to make some changes.


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## skylardaisy

Has anyone been diagnosed with a thickened ureter ? I had an MRI last week for my CD and while there are no big changes there, apparently this thickened ureter showed up. It could be from infection or stones but now I have to undergo more testing. Feel like I can't catch a break !


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## Saratay05

skylardaisy said:


> Has anyone been diagnosed with a thickened ureter ? I had an MRI last week for my CD and while there are no big changes there, apparently this thickened ureter showed up. It could be from infection or stones but now I have to undergo more testing. Feel like I can't catch a break !


I have not had that issue. Any new developments from your testing?  Hope it's only minor and you're doing better now.


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## skylardaisy

Hi Saratay05,
Thanks for your reply. I've had a urine for culture and sensitivity done which I'm assuming was negative. I took in 3 urine specimens for cytology last week and haven't heard anything back yet. Am now waiting for a date for a CT scan. I'm a little nervous about it and will be glad to have it resolved. Will keep you updated. My GI doc said it could possibly be related to my CD, which I didn't know before. Thanks again.


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## Guest18

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## littlemissh

I think it is also helpful when patients see that you too are human.
The looks I get off patients when they walk in and see me with an NJ tube are priceless.
A few ask, and a few comment on how impressed they are that I am still at work.
Some have even gone up to other staff to ask if I am ok!!


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## JrPsychologist

I have very recently been diagnosed with Crohn's Disease and am still trying to get my head around it all. I'm relieved to have an explanation for the crippling symptoms I've been suffering with but I would be lying if I said I wasn't overwhelmed and frankly a little scared by my diagnosis.
I work in a mental health hospital and am quite nervous about telling my employers. I have not been in my job very long and have already had to had time off due to ill health. Like any healthcare setting it requires a certain am


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## JrPsychologist

*amount of physical, mental, and emotional strength which I feel I currently lack. I am wondering if this is where I should be working? I don't want to feel like a quitter when I have barely experienced the disease in ways so many of you have and are still working in a similar setting. I feel I am constantly stressed and have such a high level of anxiety. I'm sorry to complain when everybody seems to be coping so well! I just feel I need some advice on how to approach my job and employers? Any advice will be greatly appreciated!


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## Trysha

Hello Jr Psychologist
Welcome to the forum.
It is quite natural to feel overwhelmed by the diagnosis of Crohn's as many of us have been.
The service in which you work should provide help and compassion.
It is a decision that only you can make but where there are likely to be episodes and many appointments associated with crohn's it may be a good move to talk to human resources
This could relieve some of the pressure on you.
You may well respond to treatment and hopefully a remission of some or all of your symptoms.
Have you been offered biologicals such as Remicade or Humira?
Try to continue working and this will help you to know if you have chosen the right field in which to work.The experience may prove valuable to you.
The diagnosis is overwhelming at first but you will learn to cope as time goes by and you have the benefit of modern medicine.
Feel better soon
Hugs and best wishes
Trysha


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## skylardaisy

I'm feeling so guilty right now. Had no choice but to call in sick for my evening shift due to huge amount diarrhea. But it's a long weekend and I am violating the unwritten rule that you are never supposed to call in sick on a long weekend because it's hard to find a replacement. Hope nobody had to work overtime because of me.
Does anyone else feel guilty when you have to call in sick even though it's beyond your control ?


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## Trysha

sorry you are so unwell and hope you soon feel better
working with patients is an  onerous responsibility whichever way you see it and we have a duty to them not to further hazard their health with a possible cross infection.
you have done the right thing in calling in sick, these things happen and I am sure the powers that be and the infection control team would rather you stayed at home till you are better
Feel better soon
Hugs and best wishes
Trysha


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## Madmouse

Hi guys,

I have just found this forum, and am really pleased I have as it is great to be able to speak to people in a similar situation!

I am a paramedic in the UK, and am currently having a huge battle with work - my management team dont seem to understand the impact of IBD and the time it takes to try and get a balance of medication and some sort of remission. I am struggling with fatigue currently (my GI symptoms and joint problems are not perfect but manageable most of the time) and am facing the real possibility of loosing my job as I cant do the shifts they require at the moment. It is so frustrating!
I completely understand your frustrations about 'letting colleagues down' and putting on a brave face (my fav phrase is 'man up, take a pill and get on with it') is something we have all done, and continue to do. But, we are no use to our patients if we are acutely unwell and can't care for them safely. Its such a delicate balance isnt it? Hopefully one of us will come up with a magic solution soon!


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## littlekit2013

Hi everyone. Such a relief to find this! My diagnosis is as yet unconfirmed but Gastro is positive its Crohns. I work in Neonatal ICU and I'm struggling. The pain can be quite distracting and obviously in my place of work that can be dangerous. I've been off for a week with severe pain and am only able to eat tiny amounts at a time. I'm going back tomorrow cos we are short staffed, I can't afford to be off sick, and my mum is very unsupportive despite my dad having UC!! She thinks I'm just being a wimp. Really not sure how I'm going to manage tomorrow to be perfectly honest! Thankfully its only 1 long day beforev2 weeks annual leave. I have a possible stricture which is making life somewhat difficult!


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## RNGirl

Hello everyone!  
I am newly diagnosed (within the last year) and glad to have the opportunity to discuss with other health care professionals.  I have been an RN for 28 years, currently in a very stressful job in a large medical center.  I have felt the need to keep my diagnosis somewhat private because I don't want my co-workers to look at me and think "crohns".  I too feel obligated to work when I'm not feeling well and since I am an "exempt" employee and salaried, I work tons of extra hours.  Of course doesn't help my crohns either.  I am very invested in my patients and families and don't want to let my physicians, nurses and therapists down either.  I am trying to work on self care, but as most others on this forum hard for everyone else too.  Thank you for listening


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## lilac

I've been having an "active resistant" flare for the past 14 months and been through 6MP, Humira (weekly), methotrexate and mesalazine with 10 hospital admissions because of severe perianal pain. I'm a mental health nurse, 2 years qualified now and it's been really difficult juggling meds, appointments and dealing with the day-to-day symptoms. 

 I think if I didn't have my job I would probably end up feeling suicidal as it's the only thing I have just now. Lost friends, relationship, potential relationships and constantly digging into savings because of absences from work. I'm trying to save for a mortgage and living with my parents which makes me feel like a failure in some respects, but has to be done just now and I'm so thankful to have a supportive family.

Most days I have a "sod it" attitude and just get on with my job as the distraction is a relief to be honest.I personally think we should all be proud of ourselves. Without disrepecting anyone, i don't think a lot of people would be able to do the stressful jobs we in healthcare do with the symptoms we experience. I don't think of myself as "chronically ill", "sick" or "a patient". I just think of myself as having symptoms from time to time.


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## RNGirl

Lilac,
So sorry you are going through all of lifes struggles right now.  Hard enough to have Crohns then add job, money issues etc.  Being a nurse is extremely stressful regardless of what specialty you are in.  Try to be good to yourself and walk away from your job each day and TRY to leave it behind.  Wish I could have figured how to do this many years ago, maybe my gut we be better for it.

Take care!


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## CrohnsNewbie2

I work for a service desk that supports several different hospitals.  Although I'm not on the patient floor the Crohn's does affect my work.  I find that bring my heating pad with me to work helps a lot.  I also bring my medicine and vitamins everyday.  I also have water, peppermint tea, and Imodium (just in case).  For emergencies I have a change of clothes.  I'm learning day by day of things I can do.


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## baistuff

RNGirl said:


> Hello everyone!
> I am newly diagnosed (within the last year) and glad to have the opportunity to discuss with other health care professionals.  I have been an RN for 28 years, currently in a very stressful job in a large medical center.  I have felt the need to keep my diagnosis somewhat private because I don't want my co-workers to look at me and think "crohns".  I too feel obligated to work when I'm not feeling well and since I am an "exempt" employee and salaried, I work tons of extra hours.  Of course doesn't help my crohns either.  I am very invested in my patients and families and don't want to let my physicians, nurses and therapists down either.  I am trying to work on self care, but as most others on this forum hard for everyone else too.  Thank you for listening&#55357;&#56842;




I don't think other medical professionals will look at you and think that. Many of my MD colleauges know about me, and if anything, they kind of look at me as a GI expert, even though I'm just a general internist.  I've never had one negative look, comment, and everyone I work with was fascinated when I went through the FMT. Many of the nurses I know in my hospital have chronic medical issues and those of us who know don't treat them any differently than anyone else. 

It's not my place, and I'm certainly not telling you to share your diagnosis. You have every right to every little bit of privacy you want.  As a fellow medical professional, my only thought would be to let YOUR feelings be the driver of that decision and not fear about what others might think. 

Nurses have the hardest job in all of medicine. We docs would be nothing without you. Thank you for your service to patients and families and also for keeping us from screwing up. It's a very tough profession even when perfectly healthy.  Best of luck to you! 

(can you accept this post as a verbal order?    )


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## lilac

CrohnsNewbie2 said:


> I work for a service desk that supports several different hospitals.  Although I'm not on the patient floor the Crohn's does affect my work.  I find that bring my heating pad with me to work helps a lot.  I also bring my medicine and vitamins everyday.  I also have water, peppermint tea, and Imodium (just in case).  For emergencies I have a change of clothes.  I'm learning day by day of things I can do.


Hi, Peppermint tea can be a godsend sometimes. Good idea about the heatpad - never thought of that one. I'm a community nurse so I get a day here and there in the office so I think that would come in handy


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## RNGirl

Hi Baistuff,

Thank you for your kind words.  I am very blessed to work closely with a wonderful group of peds hospitalists and specialists at our children's hospital.  I have shared with a couple of my doctor friends.  We are a really tight knit team all working together for our kids and families.  That's what drives me to work each day.  I also coordinate all of the family/team care conferences and am in awe when I look at all of the brilliant doctors around the table supporting our families.  And for that, I thank you for all your years of medical school and residency.  Thank you for the insight, yes I will take your advice as verbal/written order to share.  Guess I just needed permission---thank you, hope 2015 is a healthy year for you


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## Mysty84

So far, I have found that working takes my mind off of some of the frequent bathroom urges. Not all the time though. And the pain usually doesn't go away (if I have any). My coworkers know that I have Crohn's and usually they try to help me feel better (not that they can do a whole lot for me, but it's the thought that counts). I work in the lab and we have private bathrooms around us (thankfully). It is tough to help others when you don't feel 100% yourself and even more difficult that usually others don't care that you don't feel well.


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## Jennifer625

Hey everyone!!
I work as a hospital operator in a large city (San Antonio, Texas) for a large network of hospitals. My coworkers are EXTREMELY helpful and understanding. I sit in a cubicle directly by a bathroom so that helps (lol). My coworkers definitely go above and beyond making sure I have time off for doctors appointments and when I was in the hospital having my gallbladder removed. I really lucked out with this job . The only problem happens when we have a high call volume (sometimes we have up to 100 callers waiting to have their calls answered) but they made it very clear if I need to use the bathroom it's not a big deal.


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## RNGirl

Just curious if anyone else is having trouble getting and keeping Family Medical Leave Act (FMLA) coverage?  My very large healthcare employer (5,000) my medical center and tens of thousands in the whole system is self insured.  I took one 2 week stretch and a couple of one day leaves last year.  They are really giving me a hard time while trying to renew this year.  Almost to the point of harassment.  I work more than full time and drag myself to work even when I feel like garbage.  Really chaps my hide and ready to get a lawyer.  Sorry, just had to vent.  Have given over 28 years of dedicated service to the medical center.  I've never called in unless I've been on my death bed.  Ok, feel better now.  Thanks for listening!


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## 2much

FMLA renews every year.....it is unacceptable and illegal to harass you when the benefit is available to you.  Sometimes, I feel the healthcare community are the biggest offenders of harassment of staff who are chronically ill.  Minimal support and compassion.  It all comes back to money.  My supervisor was awful.....he complained if I was 5 minutes late, usually due to having to stop and find a bathroom......his complaint was that if I am not on time it throws off the whole clinic which is not true.
I am sorry you are going through this but it is unlawful.  Do you have a union rep that can help support you


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## RNGirl

2Much,

Thank you for your support.  My doctor asked to allow me to be off for 5 days in a row if needed for my flares.  The stupid self insured company for the hospital rejected his recommendation and is making me re-submit again to my doctor.  Anything over 3 days in a row is considered a continuous leave versus intermittent.  Really hard with Crohn's to say I wont be off over 3 days. When I'm sick, I'm down for the count till I can get my strength back and make it to work.  I am in an exempt position, so no Union unfortunately.  I did talk to a nice lady at the self insured and she told me off the record that it is up to the person who manages your case to use their discretion when denying or approving your case.  My person sounds like a teenage boy, who obviously has no experience with people who have chronic disease.  Obviously, not a health care professional either.  Still fighting the battle and waiting for the revised paperwork from my doctor.  Hate this stuff


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## woops!

I work 12's in a busy ER. I do like it, but sometimes the stress is just not good. The good thing is I don't have to give any explanations about crohns. The bad thing is, I always need to go to the bathroom at the worst times..... Thinking about changing, and have been looking at case management..
Anyone got any feed back for me in this area would be great?
Woops!


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## 2much

RN Girl....the 5 days in a row is very reasonable and while there is someone that approves or denies requests... I still can't help but think that you have a doctor's order In hand and that there shouldn't be any discussion on how you use the 12 weeks .....that is our lawful right.
This is the exact reason why we have this law......to give us the opportunity to take care of ourselves without having the fear of losing our job and to certainly not be harassed.
I am very a sorry this is happening....would it would worth it to meet with an attorney to learn more regarding your rights and how you can navigate this without the double burden of harassment and need to fight for what I thought was your legal right to use in any way you and your doctor discuss and agree upon.
Please keep us posted and I wish you success on getting what you need and deserve.


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## RNGirl

Hi 2much,

My next step is a lawyer.  I'm already suffering from adrenal fatigue and this is not helpful.  I will probably file a complaint by going to administration at our medical center.  Our mission statement at the medical center is:  "Know me, Care for me, Ease my way".  The company that manages the FMLA is brutal.  I'm going to make an appointment with the head Nun administrator, she will be shocked.  Been therer 28 years so know the right channels.  I don't neccessarily like the fact that the decision can be so subjective on the part of your personal reviewer either.  I usually tackle these problems and don't give up until I get to the bottom of it.

Funny you should inquire about RN Case Management---that's my job.  I do complex discharge planning and Utilization review.  Very interesting and rewarding.  I really do love it, but not stress free of course.  No nursing job is and I know you know this.  Very complex now with Obama care and all of the particulars in each state.  Very rewarding when you put all of the pieces together for the patient and family to make their lives easier during the worst times in their lives.  I work in a children's hospital.  

Thanks for all of your kind words and support!  Good luck with your nursing career decisions.  Feel free to ask more about case management.


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## RNGirl

Sorry 2much, my last reply should have been to reply to "woops".   Just tired out this Friday night.  Been a tough week


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## RNGirl

I meant in regard to case management.  Appreciate your kind words 2much


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## magy35

Great idea. I am new to this forum. I am a psychiatric nurse practitioner. While I find myself greatful for my career, I can definitely say my health impacts my ability to muster empathy at times. I don't share my personal struggles with my patients but I know the struggles I have to just be present at work are sometimes harder in comparison to some of their issues. Again, pain is subjective and I do not want to say I do not care. I care a ton. It is just difficult when I struggle to arrive to work only to be yelled at for not prescribing an addict xanax or other such issues. Anyways, I digress. Thanks for this forum. 
Maggie


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## Caitlin84

Magy35,
   I am a psychiatric RN, so I totally understand the stress you face. Sometimes I think my struggles give me more compassion for patients, esp pain patients, and other times it just makes it harder. Hang in there.


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## Diver jude

I too was only diagnosed with crohns back in dec , but I worked in a private hospital ( mainly surgical )who gave me little or no support , was hospitalised for 6 weeks when no one contacted me , but since then I am constantly badgered because of my attendance record , have even been threatened with a written warning, despite having gp sick notes and consultants in put . I have decided the stress is only making things worse , so have given notice , but feel angry and sad that fellow healthcare workers could or would not understand .


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## RNGirl

I understand the stress factor and wanting to quit.  If you are in the U.S. You qualify for Family Medical Leave Act.  It is your right.  I was given hell by our self insured company managing my place of employment as well.  I was ready to get a lawyer.  Harassment is a better way of putting it.  If you have the energy to pursue, talk to your doctor and fill out the FMLA paperwork.  You need to work at least 1250 hrs a year I think.  You can take about 12 weeks off per year.  This just protects your job for you. I'm ticked off at my employer too for allowing this harassment as well.  Good luck with this, I don't wish this stress on anyone.  Take care


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## Diver jude

Thanks RN , I'm in uk,so doesn't apply but glad to hear it's not just me xxx


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## Toni68

Hi I'm a homecare worker with the elderly. I'm currently out sick since last October with all the various crohns related symptoms . The big D is my problem. I just don't know when I'll need to go and that's just impossible to work with when I've to change and shower elderly people.how can I leave someone maybe half dressed or showered because I need the loo and then TMI the smell so so embarrassing. Once I was with a patien and just had to go the next day the ladies daughter told me she arrived an hour after I left and asked did I get a smell from the drains said she was getting someone to check the sewer jeez this is after I scrubbed and bleached the toilet and sprayed everywhere... I could have literally died I was so embarrassed


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## erinjayee

what a wonderful group!! 
I am a Acute Medical nurse. I have had crohn's disease since during my training. The bathroom visits, exhaustion, days off, pain that you all talk about definitely impacts on my working life also.
I am however, very lucky to work with an amazing group of people. They are all aware of my condition and being a medical unit are all quite aware of how severe Crohns disease can be. I am often excusing myself from Handover or meetings and everyone just accepts that. 
I used to try and force myself back to work after a bout of illness but I have recently learnt that this is an injustice to myself and to my patients. I now happily take the sick leave I need. Or otherwise I just bounce back worse and I am not the good nurse I want to be for my patients. 
My current issue at the moment is money!  I have run out of sick leave and now have to use my holiday pay. Not the end of the world and we have savings. But it sucks all the same! Not to mention the costs of my healthcare. Specialist appointments, copious amounts of drugs, MRI ($500 ouch).


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## Toni68

Hi erinjee you're lucky you have sick leave as a carer in the community in Ireland such things don't exist so every day you have to take off be it through sickness r any of the numerous hospital visits ,comes out of your holidays first.We r thank god trying to change this.Also there's huge benefits working as teams as in you can call on someone to cover we mostly work on a one to one basis with each client with usually a max time to shower r bed wash and dress and continence care and breakfast of 3 quarters of an hour try fitting a toilet break into that haha


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## erinjayee

wow Toni68 - I feel for you, that's tough. The joys of healthcare and time contraints!! And then throw Crohns in the mix! xx


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## hcsbcs

So I am newly dx officially today by my GI with Crohn's. Not exactly a great day. I have been doing a lot of reading for the past several days on these forums and they have helped me a lot! I am an ER nurse. My passion is the ER, but over the past year my health has deteriorated quickly. I even changed to a smaller ER in hopes that would help with my fatigue and stomach problems.....not so lucky! My health is the worst it has ever been. I just had 6 days off and stayed in bed all but 1 of those days. My joints hurt so bad, I am SO exhausted, along with the stomach problems. I saw my GI doc today who is putting me on budesonide to hopefully decrease these symptoms. I am really nervous about being on this medication and working in an ER. We often place pt's on isolation after the we have exposed ourselves by assessing them. I was on prednisone a few weeks ago and ended up with shingles. My immune system sucks! Any advice now that I am starting this medication? Thank you in advance!!!


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## elz100

bit late but just to say i have been on 2 immunosupressants and steroids sometimes and have always been ok at work. you can ask occ healthy if there is something you arent sure about like treating tb and other infections. when we had a patient with gastroenteritis, i just asked if someone else could see to them, which they did. didnt want to catch that!


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## ChronicallyAwesome

Currently undiagnosed, but going through some similar issues. I work as an RN on a very busy Medical-Surgical unit, twelve hour night shifts. I just started the job about three weeks ago before some new health issues popped up unexpectedly. Thankfully, my new health insurance kicked in on my 2nd day on the job. Unfortunately, I have no PTO at the moment, so I'm having to schedule appointments on my days off. I'm still in the orientation period, and will come off of it in about a week and a half. 

I'm hoping, praying, that whatever is wrong with me doesn't require surgery or a hospital stay in the near future...I haven't had this job that long, and I'm afraid they wouldn't "hold" it for me if I did have to be out sick. I would probably be able to go back to my previous job part-time or something, but I really don't want to do that. This whole ordeal is upsetting, and I don't know how to feel about it.


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## mk67

Hi everyone,
I was diagnosed with Crohn's last year after suffering from symptoms for awhile. I am starting college, specifically nursing school, in a few short  weeks. I was wondering if anyone had any tips for navigating nursing school, college, clinicals and the healthcare field in general while being chronically ill?


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## jnette

Have suffered with IBS (with unrelenting diarrhea and dumping syndrome) for 4 decades, then dx’d with proctitis and UC back in 2014. Was a Hemodialysis Nurse for years (outpatient clinic), then switched to Home Health and spent the majority of my time on the road visiting patients. It got to where I could no longer manage my symptoms , so I swallowed my pride and sat down with my employer to explain that I could no longer risk being on the road out on rural roads with no bathroom in sight. (I can’t count the times I had to pull off the road and jump behind a tree or bush or into a ditch.) She understood my plight and was gracious enough to allow me to work in house at our agency preparing education packets for our nurses to take to their patients regarding their conditions and their medications. It was perfect and took so much stress off me. 

I have since retired so I don’t have to worry about work and hogging the bathroom all the time, or explaining to my colleagues. That said, it’s always best to be open and honest with your employer about your condition. We’re in the health care business after all! You might be surprised to find they will often be more accommodating than we think.


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