Getting the most out of occupational health

With the support of occupational health and tailored adjustments, veterinary anaesthetist Rachael was able to continue thriving in her role, despite the challenges of living with multiple sclerosis. 

I was diagnosed with relapsing remitting multiple sclerosis (MS) in 2014, while I was working in mixed practice immediately following my anaesthesia residency. Although I was initially very ill, I returned to work doing small animal consultations – no surgery, large animal work or on-call. Although this was okay, and I was glad to be working again, I missed large animal work and anaesthesia. 

I returned to the Royal (Dick) School of Veterinary Studies, where I had undertaken my residency, in 2016 as a full-time anaesthetist. There was no on-call, although there was shift work, and I felt I could cope with this – a self-imposed adjustment. I worked on submitting my credentials and achieving European Diploma status, and I had several rounds of treatment for the MS, which seemed to remain quiescent. 

I reached breaking point, and was signed off work for several weeks. 

This continued as I completed my credentials and sat - and re-sat - my diploma exams. However, by 2022 I was really struggling with work, particularly with long shifts and night shifts. Furthermore, the MS became more active, with new symptoms such as increased fatigue and emotionalism. Eventually, I reached breaking point and was signed off work for several weeks. At this point I was referred to occupational health (OH) on the advice of my GP. 

The assessment was performed by the university’s occupational health department, with an independent OH consultant. The assessment took an hour, with the doctor taking a full history, performing a physical examination and discussing my work capabilities. The assessment was comprehensive, which was reassuring, as was the written report which was sent to me, my line manager and the human resources department at the university.

At first, I felt the recommendations were overly cautious – I was feeling much better after some time off – but I appreciated that they were not just for my wellbeing, but for the safety of both my colleagues and the health and welfare of the animals under my care. In particular, I was not to undertake any lone working, and a senior colleague would observe my practical work to ensure I was coping and not making any unexpected errors.  

The OH guidance gave me justification that I wasn’t being lazy or faking.

These assessments were very useful. The OH doctor was able to objectively assess me and give clear guidelines about what I should and should not be attempting. MS is such an individual and changeable disease, meaning one day I couldn’t do things I could do yesterday. 

One of my problems was the difficulty I had accepting my reduced capabilities and trying to work beyond them. Even the very simple guidance of not working beyond my contracted hours and taking regular breaks made a huge difference. My line manager was very supportive and gave me the agency to step back from tasks which were overstretching me. 

The OH guidance also gave me justification that I wasn’t being lazy or faking, but that this was an accepted and mandated system of working, in much the same way that you might have to wear PPE or follow a standard operating procedure. It was also reassuring to hear that the colleague who had been observing my work was happy that I was managing the tasks I was attempting. I am very aware that MS impacts my sustained concentration and working memory, meaning I am always double and triple checking myself – it was a relief to know this was effective and I was still able to work to an appropriate standard. 

In particular, pulling back and only working my contracted hours made a huge difference to my productivity. I may have been in work a little bit less, but I was much more capable and useful when I was there. My concentration improved and I was less fatigued and temperamental. This led to me finally passing my diploma exams and becoming a European Specialist in Anaesthesia and Analgesia in 2024.

 I’ve had to readjust, learn to say no and ask for help when it’s needed.

One of the most difficult things for me about becoming chronically ill is that nothing is predictable anymore. I can’t do what I used to do, can’t remember or multitask like before. And the real kicker, with MS, anyway, is that every person is different, and every day is different, meaning there is no standard guidance. I have to work more slowly and work within my team rather than trying to take on things alone. 

However, although it crossed my mind more than once, I haven’t had to stop working. I’ve had to readjust, learn to say no and ask for help when it’s needed. The input from occupational health allowed both me and my colleagues to have a bespoke structure to work within. The limits imposed are for everyone’s safety and wellbeing - not least the animals and people I work with - as well as to protect my own professional reputation and that of my employer. I know this structure will have to be revisited as time goes on and that more readjustment will be needed, because I’m not going to get better but, with effective teamwork and communication, I hope to keep working in one shape or form for as long as I can. 

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