I’m angry. I’m having a hard time concentrating because I’m angry. This is going to be a long rant and it’s mostly for my own benefit, because I hope if I can say everything in my head, I’ll be able to concentrate on finishing my dissertation.
As you might know, student nurses are being invited to opt-in to a paid placement to help the NHS through this pandemic. We were sent out the opt-in form at the end of March and told we had until the 6th of April to submit it. I completed it the day we were sent it out, it was a Google form, I’ve got the confirmation email. So far so good. Uni’s job was to upload the forms so that Health Education England could pass on the names of students to the Trusts they had asked to work for. Two weeks, no contact. As a cohort of mental health nursing students, we talk to each other, nobody had heard anything. Okay fine. Fast forward to 14th April, at about 8:30pm, I get an email from a lecturer at Uni, who for confidentiality purposes, we’ll call Karen. The email from Karen was to organise a Google Hangout to discuss me having left my last placement (which I would have been moved from anyway when the opt-in placements started) – the circumstances for which I will describe below and to discuss my ‘understanding’ of the opt-in placement. Reluctantly, I agreed to this meeting. 15th April, most people in my cohort start getting emailed by the local Mental Health Trust asking them if they have got jobs lined up for when they qualify and if they don’t asking them where they would like to be placed for the opt-in placement. I hear nothing. 3pm roles round and I meet Karen and my link lecturer who, for my own amusement we’ll call Little Karen, on Google Hangouts.
It starts off with me being asked what happened when I left my last placement a week ago. Bearing in mind I had already sent quite a detailed explanation of what had happened to Little Karen.
Before I start a work Placement for my nursing course, I let my mentor know I’m autistic. I explain my reasonable adjustments and my mentor agrees to meet them. One of my adjustments is that if I feel overwhelmed, I need to leave to have some space and be left alone. This is because I can’t talk coherently when I’m on the edge of a meltdown.
Last week, I felt overwhelmed and needed to leave. I had only just arrived and hadn’t even seen my mentor. A senior nurse saw me, and I said I needed to leave. Instead of allowing this to happen, I was prevented from leaving and my mentor tried to force me into a conversation. I was beginning to meltdown at that point and I can’t even remember what was said.
According to Uni my mentor felt I behaved unprofessionally. I explained that this is why I asked to be able to leave the situation. Uni’s response was that as a nurse, my mentor’s instinct was to make me stay because I seemed upset and that I had to understand that her ‘nurses’ instinct’ overrode her memory of my reasonable adjustments. Well my autistic response to being overwhelmed overrode my ability to be professional because I wasn’t allowed to use my agreed coping strategy.
According to Karen, my mentor had also told her that I had ‘put my needs above the patients’. I don’t really understand how that can be true, given that I had no interaction with patients in the day and a bit I was on the ward. The one shift I did do, I spent five (5) hours sitting in the tiny staff room reading through ward policies. One of the things I asked for was to spend the first couple of shifts with my mentor so I could get to know my way around the ward and learn how the ward worked. 5 hours in a crowded room, reading policies for a ward I wasn’t going to be on for very long didn’t seem like a particularly productive use of time. Little Karen seemed quite surprised to learn that this had happened.
Karen asked me if I was ‘working on my coping strategies for these situations’ I said that being able to leave when I felt overwhelmed was the coping strategy I had, which was why it was my agreed reasonable adjustment. Instead of accepting this, Karen carried on with the ‘how are you going to cope when you’re qualified, there will be situations you can’t walk away from’. I could not help showing some frustration at this point, given how many times I have had to answer this question over the last few years and how incapable neurotypical people are of understanding what I’m trying to explain. But that should be besides the point, because in this instance, patient safety wasn’t an issue. Me leaving when I needed to had been agreed. I had even been told I didn’t need to tell anyone, because I was supernumerary. I had in fact been told that if I needed to leave and something was going on with a patient, all I had to do was tell someone, so they could take over. So, in this instance, which is what we were purportedly discussing, I had done exactly what the agreed plan said I was to do. Yet somehow, according to Karen, I was still in the wrong.
There was no point arguing that point with Karen, because she wouldn’t get it. So instead, I tried to explain that had there been a need for me to stay calm, say in a situation where a patient was having a meltdown, that would have overrode my need to get away until the situation was dealt with. Isn’t adrenaline and amazing thing? Predictably, like most neurotypicals, Karen was incapable of understanding this nuance. Of course, if I can do something sometimes, I should be able to do it always. I suggested that maybe it was just unreasonable to expect a busy acute mental health ward to be able to make my adjustments given everything that’s currently going on. I didn’t say that I had tried to check this point with the ward when the state of emergency was declared. I didn’t say that it would have been nice if the ward could have just been honest about it. Karen agreed and seemed pleased that I was being understanding of how difficult it is for neurotypicals to support me.
Then we moved on to ‘do you think it’s reasonable to expect anywhere to be able to support you at the moment?’ here was the crux of why we were having this meeting then. Here was Karen saying that, instead of opting-in, had I considered deferring. I have told the university, in writing, at least five times this year that I don’t want to defer, take time out, go part time or in anyway delay my graduation. I chose to opt-in. I had the same information when making that decision as everyone else did. I chose to opt-in. We have been told, repeatedly, that if we opt-in we can opt-out at any time. With this knowledge, I opted-in, because if the Trust, the people in charge of allocating this placement, not Karen, put me somewhere that was going to be too difficult for me, I would opt out and reconsider deferring. I explained this to Karen. I explained that if I could have a community placement – which is possible, some of my friends had already been allocated community placements – I would be fine. I don’t like wards. I have no intention of ever working on a ward. I have a job in the community. Which I hope I’ll be quite good at. Karen agreed that I could do this. Little Karen suggested I contact the woman at the Trust in charge of sorting out opt-in placements. Karen told me not to do this. Quite quickly after that the meeting ended.
A day later, everyone in my cohort who opted-in had had contact from the trust and were beginning to get contracts sent out and being invited to an induction on Monday. I had no contact. None. So, I emailed the woman from the trust, on advice from my friends who had been in touch with her themselves.
No response. So I email again, because by now it’s Friday 17th and if I don’t get things sorted out, I’m not going to be invited to this induction, which means I won’t be able to start placement at the same time as everyone else. On my friend’s advice, I contacted the person who was sending out contract and ‘job information’ forms. She said my name wasn’t even on her list and to contact Uni, because maybe they hadn’t uploaded my form yet.
Some hours later, I got an incredibly pissy response from Karen saying that my had recently been uploaded and maybe the trust just hadn’t checked yet. She then went onto express her ‘disappointment’ at me having ‘complicated matters’ by emailing the woman at the trust in direct contradiction to what she had told me to do. Somehow, I managed to write a polite response and predictably, I have heard nothing since. I have had nothing from the trust. I have not been invited the induction day. I am, essentially, being completely fucked over. So, here is the email I would have liked to write:
I assume by ‘complicated matters’, you mean having drawn attention to your utter incompetence? My cohort are all in touch with each other, the university typically takes this for granted because it’s not unusual for some of us to be missed off university mailing lists. So, I know that everyone else who has opted in has been invited to a trust induction on Monday, meanwhile I have had no contact whatsoever. Given that, due to your incompetence, I have several hundred placement hours to make up, I’m sure you can understand that I am keen to start placement as soon as possible. The information I sent to the trust, was the information other people had been asked to give, I was trying to help the process along. I assume your issue is that the trust then asked you why I was contacting them, given that my name wasn’t on their list. I guess that it’s at that point you hurriedly uploaded my form. Which should have been uploaded a week ago. Rather than apologise you have chosen to blame me for your mistakes.
You’re disappointed that I acted against your advice. Let’s discuss that, shall we Karen? The university chose to send me the opt-in form. There are quite clear guidelines on who should be allowed to opt-in, I meet those guidelines. I am an adult. As a nurse yourself, you’ll be familiar with the Mental Capacity Act (2005), which states that even when a person has a disability, you should presume capacity, even if you think a decision is unwise. I chose to opt-in. I had the same information available to me as everyone else. I have the capacity to make that decision. You chose to ignore my choice and try to push me into deferring. I had stated my intention to opt-in to various members of university staff (besides filling in the form), so you had plenty of time to talk to me about that decision, if you really felt the need to. You chose to wait until the last minute, when everyone else was being contacted by the trust. You have deliberately held me back and prevented from me being able to start at the same time as my peers.
I’m going to give you the benefit of the doubt and assume you think that you’re helping, with your paternalistic, patronising attitude towards me. You’re not. You might think that you’re bending over backwards for me, but has it occurred to you that bending over backwards isn’t helping me in the slightest when what I actually need you to do is listen to me? I have offered the university so many suggestions and work arounds over the past year to try to make this degree work for me. You have tied yourselves in knots telling me that my suggestions are impossible, when all you’ve actually done is stuck to your original plan and refused to budge. You have consistently presumed that you know what’s best for me while actively ignoring what I have to say. I’m 26 years old Karen. I have my whole life’s worth of experience of being autistic. I know what I can and can’t do much better than you ever will. I didn’t need you to attempt contortion for me, I just needed you to listen and respect what I say. Frankly, I am disappointed by the discrimination I have experienced from a university that prides itself on its student support.
I hope that you will learn from this experience and be more considerate of the next autistic person that crosses your path.
What do you know? I feel slightly calmer.