Thinking about clinically vulnerable colleagues

Ewan Main

Product Manager, Mental Health at Work

I had no idea I was among the delightfully-named ‘clinically extremely vulnerable’ until the letter landed on my doorstep in March. I’m not unwell at all; just have an old, invisible vulnerability that has never reared its immunocompromised head until this year.

Technically you can, but you really really shouldn't

Others are very much less fortunate – by definition, the category includes most of those with the most serious health issues​Complexities and challenges: working with multiple health conditions PDF This report explores the impact of managing multiple health conditions, both for the individual and the employer.Free By: The Work Foundation View resource. While the country discusses reopening offices and shops, looks forward to a meal out and makes plans for their festive bubbles, there are thousands of us – randomly distributed amongst the workforce – who exist still in a state of “technically you can, but you really really shouldn’t”.

A person leans out of an empty window frame, with their face hidden from view, holding a mobile phone

I spoke to Karen Ver, a Digital Projects Manager at CIPD CIPD CIPD is the professional body for HR and people development. View organisation, who was diagnosed with renal cancer seven years ago and is on a continuous treatment programme. She’s used to working from home Coronavirus: Coping with the challenges of working from home We've put together some ideas to help you if you're homeworking as the pandemic continues. It includes tips on supporting vulnerable colleagues and managing anxiety. View toolkit, to adjusting her expectations and considering her safety: “Cancer probably prepared me better for a worldwide pandemic than anything else would have done,” she said.

It’s a worrying time. The Asthma UK and British Lung Foundation Partnership have been surveying their supporters throughout the year. Sarah MacFadyen, their Head of Policy, told me that “many had to shield for months, and for some this took a huge toll on both their physical and mental health. During the peak of lockdown in the spring over two thirds of people said they were very anxious. We’ve heard from people throughout the pandemic who’ve felt scared, confused​Coronavirus and your wellbeing Web page This short guide from Mind explores some of the worries and difficulties you might experience due to the coronavirus pandemic, and some ways to ensure your mental health is protected.Free By: Mind View resource and uncertain what will happen next.

The whole experience of wearing a mask was beyond me - I'd not been going out

It’s hard to express how strange it is to be told by the Government on a regular basis that you’re in more danger than those around you. The pulse quickens whenever the next familiar-looking envelope arrives. Karen agrees: “When I received the extremely vulnerable letter I was already feeling really anxious about everything, and my anxiety levels went through the roof then.” And the changes and new experiences come on a different schedule from the rest of the country – “The first time I had to go into hospital in the summer, the whole experience of wearing a mask was beyond me – I’d not been going out. I felt quite frightened. But actually, once I’d experienced the reality of it, it felt a lot calmer.”

A letter from the NHS informing somebody that they are at risk of severe illness if they catch coronavirus

As with so many wellbeing issues, there’s a part that workplaces can play in helping things along. Karen is keen to emphasise that her employer, CIPD, has been exemplary in adjusting to homeworking, offering support where needed and making sure there’s no pressure to return to the office. I can happily say the same about Mind​Mind’s line manager guidance during coronavirus PDF Throughout the pandemic, there are new issues for line managers to consider. Mind produced this guidance to support and inform their own line managers. It's a useful example of the subjects you might cover with your own colleagues.Free By: Mind View resource. But those things apply to everybody, and they don’t really get at the hidden-narrative side of this: the fact is, there are those in our teams experiencing the quiet loneliness of feeling very different about, well, the whole thing from others. How should colleagues respond?

Be aware, and be supportive

For Sarah at Asthma UK / British Lung Foundation, “It’s really important that employers are aware of the toll shielding and taking extra precautions has had on people and the huge change they’ve had to adapt to. Staff need to have someone they can turn to and must have access to mental health support.” It’s worth factoring into how we perceive and interact with one another too: Karen at CIPD mentions that “constant low-level anxietyAnxietyAnxiety is familiar to everyone; it is usually a normal, useful and effective response in times of heightened stress, and something which can be understood and resolved. However, some people experience intense and prolonged periods of anxiety, which if left...Find out more does have an impact on your performance and how you present yourself. There needs to be empathy around that.”

It’s not easy to say “I feel terrible about the new developments” when everyone has just said the opposite

So, a supportive culture makes a difference. We’ve written here often about the value of being able to talk openly in teams, and that still applies. But, as with any situation where an individual’s priorities and feelings might not match the “norm”, it’s worth focusing on individual discussions​How can you have the right conversation to support an employee at work? PDF As a line manager, it’s important to recognise how to manage the emotional wellbeing of employees at work. This two-page guide from Nuffield Health explores five key steps to help staff move from emotionally barely surviving back to thriving.Free By: Nuffield Health View resource and one-to-one tools like wellness action plans​Working from home: a wellness action plan PDF A wellness action plan (WAP) is a useful tool to help us identify what keeps us well and what impacts our mental health. This revised WAP has been modified to support you when you’re working from home during the COVID-19 outbreak.Free By: Mind View resource too. It’s not easy for someone to say “I feel terrible about the new developments” when everyone before them has just said the opposite. Things like randomised coffee trials​Randomised coffee trials Web page Randomised coffee trials are the simple idea of connecting pairs of people in an organisation at random, and giving them time to talk. This article explains the benefits and how to get started.Free By: Conversational Leadership View resource can really come into their own here too – a chat with a randomly-matched stranger can be a great spur for honesty.

Flexibility – in our practices and expectations – is vital too.

For Karen, considering specific individuals’ needs is all part of a broader shift towards flexibility. “Every single person’s situation is different. We can’t just have a big, broad brush approach as though everyone in lockdown is the same. But this is giving businesses an opportunity to rethink wellbeing for everyone. It’s a cultural shift, towards managing outcomes and outputs rather than watching the clock.

For many, that may well include specific practical decisions made with their medical safety in mind. While some are anxious to get back to offices and other workplaces, for others it’s a different matter. For people with cystic fibrosis, for example, the physical work environment is critically important. Becky Kilgariff, Head of Information and Support at Cystic Fibrosis Trust, said “Many people with cystic fibrosis are understandably feeling anxious and worried about going to work and some key workers with cystic fibrosis are telling us they feel unsafe in their workplaces.” The same is true for many others – 15% of people in the Asthma UK / British Lung Foundation survey, for example, said they were willing to lose their job rather than return to a workplace they thought was unsafe.

Speak to your employees... they are the experts of their own condition

For Becky at Cystic Fibrosis Trust, the advice to employers in this context is quite straightforward: “Employers can make a really big difference to the physical and mental health of their staff by allowing people to work from home​Remote working: a practical safety guide for businesses Web page Remote working is the reality for more and more of us. Whether you're already doing it, or are considering implementing it for the first time with your staff, this guide runs through the issues to think about.Free By: Glide View resource where possible. If this is not possible, then they should do everything they can to make sure the workplace is safe through social distancing, ensuring face coverings are worn and good hand hygiene.” So, much of this is about the practical measures we’re all already familiar with​Returning to the workplace after the COVID-19 lockdown PDF This PDF guide covers some of the areas you will need to think about as staff come back, including managing the risk of the virus transmitting, providing reassurance, and teaching line managers about new procedures.Free By: The Society of Occupational Medicine View resource. This stuff is helpful – and, for me just as importantly, reassuring – no matter what the specifics of somebody’s health might be. Beyond those basics, employees themselves are your best source of information: “Speak to your employees with lung conditions and ask what would help them feel supported. They are the experts of their own condition and will know what is best for them.

A woman sits at a table working at a laptop, with several unoccupied tables near her

As I write, in December, great change is on the horizon. But, again, not at the same rate for everyone. Different tiers of lockdown will put us all in different positions for some time, and the miraculous vaccine rollout will reach us all at different points. It’s likely I’ll receive it before many of you, and I certainly hope Karen does. (I’m already planning the celebration.) These factors, combined with differing life situations and levels of anxiety, probably just mean that there will be even more ways in which one person’s experience will be different from the colleague on the other side of the screen.

There is no one single story, but many overlapping ones

So, amid the “when can we all go back to the office/pub” talk, it’s worth remembering there are many who are feeling the opposite​Managing feelings about lockdown easing Web page As the UK begins to lift its lockdown, many people are returning to their usual places of work. This page from Mind explores what you might be feeling about the lockdown lifting, and offers ways to help you manage these changes.Free By: Mind View resource, and they might well be the quieter ones. In many workplaces the dominant culture is a sociable, confident, pub-orientated one, an issue we plan to write more about shortly – so it’s not surprising that the narrative has largely assumed people all want to get out, mix, and do the maximum they can do within the restrictions. In the end, as with so many other aspects of health and wellbeing, it’s a reminder that there is no one single story, but many overlapping ones. It’s a chance to think about diversity as a concept, taking a wider view of the fact that everyone’s needs might be different in ways that aren’t necessarily obvious.

In fact, as a terrible year draws to a close: it’s a chance to be kind.

For more information on looking after your mental health while living with a lung condition visit the Asthma UK and British Lung Foundation websites.

People living with cystic fibrosis and their families can get practical support, advice and information through the Cystic Fibrosis Trust’s website, emailing helpline@cysticfibrosis.org.uk or calling their helpline, Monday to Friday, on 0300 373 1000.

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