To each of us, work has a different meaning. It may provide an identity, self-esteem, financial security, health coverage, and fulfillment. The loss of an occupation can be a source of anxiety and depression (Peteet, 2000). Continuing or returning to the workplace allows many patients to maintain a sense of normalcy or control.
According to DeBoer (2009), cancer survivors are 1.4 times more likely to be unemployed than healthy people. A meta-analysis showed that the risk of unemployment is 37 percent higher for cancer survivors compared to healthy individuals. This higher rate of unemployment has negative social and economic impact on patients and on society at large.
Experiences of cancer survivors and supervisors regarding returning to work after cancer were assessed in focus groups and identified that support from colleagues and supervisors aids in returning to work (DeBoer). Interventions are needed to address the plan to return to work. These may include:
- The topic should be addressed early on by the oncology nurse as part of the normal consultation. The aim of this meeting is to list potential problems concerning returning to work and to plan the interventions that best suit the individual patient.
- Subsequent meetings may include guidance regarding the best way to inform colleagues and supervisors about the patient's illness and to keep them informed during treatment and aftercare. This step is most important as the employer needs to know about the plan to return. I found it helpful to communicate via email to my superior. It allowed me to ensure that she was aware of my physical status, plans to return, and tentative schedule.
- The patient should be advised to contact the HR department to discuss legal aspects such as a medical leave, impact of FMLA (Family Medical Leave), and any relevant contractual issues affecting employment.
- Discuss the process of returning to work. How is the patient feeling? Do schedules need to be changed to accommodate fatigue or ongoing treatments?
While returning to work is an individual decision, patients should be provided the opportunity to consider all options. Depending on the particular aspects of the job, are there restrictions? How will the patient manage exposure to infections, episodes of reduced white blood counts, fatigue, and schedule for chemotherapy and physician visits?
From a personal perspective, I have been able to return to work after the incapacitating fatigue subsided with the completion of the Bendamustine cycles. My colleagues and supervisors were updated on an ongoing basis and I was provided the much needed support and care during this most difficult transition. My work provides great satisfaction and allows me to appreciate life.
It is strongly recommended that clinicians address work-related concerns directly and appreciate the significance of this issue to their patients. Is this issue identified in your practice? Can you share strategies to support our patients?
References:
- DeBoer A, Taskila, T. (2009) Cancer survivors and unemployment- A meta-Analysis and meta-regression. Journal American Medical Association.301:753-762. doi:10.1001/jama2009.187.
- Peteet, JR. (2000) Cancer and the meaning of work. General Hospital Psychiatry.May-June:22(3):200-5.
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