How to assert myself?

[braveheart]

I saw my GP again this morning.

My GP is still of the opinion that we don't have to run to follow Occupational Health's recommendation. My GP doesn't believe I need mood stabilisers, and that I'm not bipolar. My GP said that re-referral to the psychiatrist is something we can bear in mind, but doesn't see it as necessary at present at all.

My GP also said that the Occupational Health nurse could phone her if she is so inclined, and speak with her.

However I am really worried that the Occ. Health nurse will still try to pressurise me. She's one of those women who will try and override anything someone says. For example suggesting I'm bipolar before even meeting me. I find it hard to firmly stick up for myself with people like that.

What I do have on my side is the fact that I've been much calmer at work the past few weeks. I haven't been agitated when customers lean on the counter, and I've been my natural and helpful self.

Beneath all this is how important it is to be trusted. My GP and psychotherapist clearly see that I am intelligent enough to be trusted to work safely through the impact of my trauma history, and minimise as far as possible its impact upon my work.

My father never trusted me. He never trusted anyone.

When I feel trsuted I feel safe.

I am not dangerous.

I don't need silencing. I was silenced for far too long. I now need to moderate as far as possible the uprush of voice and existance. I also clearly see how how the internal dynamic works.....

How can I assert what my GP has said clearly and show belief in myself?

 

[David Baxter PhD]

Honestly, braveheart, alll you need to say is "I've discussed this with my doctor, who doesn't see the need for any medication changes at this time". If the occupational nurse has more to say on the subject, simply say, "You'll have to discuss that with my doctor".

But I doubt that she will be able to say anything, really. She doesn't have the background or authority to override a physician.

 

[ladylore]

You may even ask your physician to write a letter to the occupational nurse stating that you do not need mood stabalizers. Then it is in writing and part of the record. Only a suggestion.

 

[Into The Light]

i know it's hard to speak up when dealing with strong personalities. maybe it would help to know that she can't actually make you change your treatment because it's up to the people under whose care you are.

i read somewhere that assertiveness comes down to a combination of two things:

1. stating the facts, and
2. do not show any emotion one way or the other. if upset, anxious, angry, etc., do not show it. remain neutral when stating those facts.

i am kind of waiting for the next time where i need to be assertive to try this out, and i know it'll be a bit scary too, but i do believe that practice will help.

maybe you could practice in the mirror what you could say and how you would say it should she push the issue. i think what david suggested would be great to say.

 

[David Baxter PhD]

You may even ask your physician to write a letter to the occupational nurse stating that you do not need mood stabalizers. Then it is in writing and part of the record. Only a suggestion.

That sounds too much like reinforcing the Occupational Nurse, in my opinion. As I said, the physician sees no need for a mood stabilizer at this time. That's all, everything the nurse needs to hear. Period.

If I were the physician, I might very well refuse to write such a letter on principle.

 

[poohbear]

I agree with the Doc. If this nurse has any questions, she should not be presenting them to the patient, she should present them to the GP caring for the patient. Since she has no prescribing power (unless she is a Nurse Practitioner, like here in the US, they can prescribe), she needs to discuss her feelings with your GP instead of trying to put you in the middle of this--that is hoghly unprofessional. I see alot of nurses that think they "know better", just because they have that licensure. The whole purpose for limiting the prescribing power to only advanced degree practitioners is to eliminate prescribing errors made by the under-educated. This is definitely a power struggle that you should not have to witness!

 

[ladylore]

That sounds too much like reinforcing the Occupational Nurse, in my opinion. As I said, the physician sees no need for a mood stabilizer at this time. That's all, everything the nurse needs to hear. Period.

If I were the physician, I might very well refuse to write such a letter on principle.

Thats cool. It was the advocate coming out in me.

 

[David Baxter PhD]

I don't mean to criticize you, ladylore. It's more the intrusiveness of the nurse in this case. And I'm not knocking nurses, either. But in this case, she represents the employer and is acting for the employer, NOT the employee. As such, she has a right to ask certain questions, make certain suggestions, and have her own opinions. But the employee also has a right to privacy and a right to follow the advice of her own physician. That's what I'm reacting to.

I encounter this sort of thing from time to time with employers or insurance clients, and I'm very clear about the boundaries: IF the client agrees (and authorizes the release of information in writing), then I will release certain information to insurance companies or employers, but only the minimum amount of information that they need.

The primary physician or primary therapist is the "expert" in such cases, and the one who is in the best position to diagnose and treat the patient, not the employer or other employees, regardless of their professional backgrounds.

 

[ladylore]

Got it. And its a very ethical stance.

 

[braveheart]

Thank you everyone. I'll bear all this in mind.

It means a lot that you're all on my side. I know the OH nurse is on my side too, but her perspective is kind of blinkered by her position and training, and well, her personality I guess. [she asked me things like why I paid for my therapy and didn't see someone on the NHS...another, as you put it, David, intrusive question/comment.]

I start back at therapy tomorrow, so hopefully that'll boost my strength up.

 

[braveheart]

OH is tomorrow at 2pm UK time.

Moral support welcome. Please.

My therapist says I am doing very well, and that the meeting should just be a formality. I do see my GP tomorrow morning too. So that'll be a boost....

I've got my 'speech' prepared.

 

[Into The Light]

it sounds like you're prepared for tomorrow. that usually helps me feel a little more confident, so you as well, hopefully. i am keeping my fingers crossed! :crossfingers: and let us know how it turns out. :goodjob: