Returning to work: investigating and challenging fatigue

Returning to work: investigating and challenging fatigue


Posted by: Katya Halsall (Director, Voc Rehab UK)

Returning to the workplace environment is a major life milestone for someone who has been off work for a period of time. As a Vocational Rehabilitation Consultant working with serious injury clients, I often come across situations where one of the main barriers for a client’s return to work is fatigue.

I recently read in a Case Manager’s report that a client’s fatigue “is the rock upon which the waves of rehabilitation dash themselves.

This colourful expression prompted me to write this article, to explore the specific issues presented by a client’s fatigue, when planning a return to work following a serious injury or illness.

Being in Work is Good for People

Being in suitable work is good for our self-esteem, wellbeing and mental health. Work provides us with social interactions, financial independence and a sense of achievement.

For someone with health limitations, obtaining and retaining employment may be more challenging than for able-bodied people. Nevertheless, everyone should be given an equal chance to be in work and to be provided with all the support and encouragement that they need. Clients should feel empowered to overcome their limitations and build on their strength and abilities.

Abilities and Tolerances

A client’s “abilities / capacity” for work and “tolerances” are different entities and they should not be confused.

A client may have a certain “ability” for work. However, their “tolerances”, namely fatigue, may not be sufficiently managed, to enable a successful return to work.

Fatigue and Employment

A client suffering from fatigue may be told by their doctor that fatigue would prevent them from working in the future.

This client is likely to trust their doctor who plays a role of a “significant other”. Therefore, they are likely to completely believe in this statement and accept that they are unable to work.

returning to work

However, there are situations when we, as rehabilitation practitioners, should challenge such statements.

For example, if a client has certain capacity for normal daily activities, albeit with some difficulties, this may be an indicator that fatigue in the workplace could be managed – provided the appropriate type of work is identified and workplace support is in place.

As a Vocational Rehabilitation Consultant, I believe that our clients need to be encouraged and supported to become confident and productive in all aspects of their life. I do not believe in closing down avenues of opportunity and future work prospects because of fatigue.

It is essential to empower our clients to believe in themselves and build their self-confidence, to enable them to take meaningful steps and prepare them for an appropriate type of work. This includes using strategies to manage and minimise workplace fatigue.

Sometimes, because of a history of workplace fatigue, clients may no longer see being in work as a positive thing. This needs to be recognised and addressed as a pre-emptive requirement before considering any job search or a return to work.

The affected person needs help to understand how they can use the functionality that they have in the best possible way.

Vocational Rehabilitation Consultant – Role

Vocational Rehabilitation is defined as “whatever helps someone with a health problem to stay at, return to and remain in work” (Waddell, et al, 2013).

The role of a Vocational Rehabilitation Consultant is not to simply accept a client’s limitations, but to identify return to work barriers and provide solutions of how to overcome them. A Vocational Rehabilitation Consultant cannot be influenced solely by a medical diagnosis.

Focusing only on the client’s diagnosis (“fatigue”) could lead them to adopt a “disabling identity” which is based on limitations and inabilities. This approach dismisses the individual’s functional abilities – what they can and are able to do.

Medical treatments for fatigue are important for health improvement. However, on their own, they may not be useful in terms of workplace fatigue management.

I believe that when fatigue prevents a client from functioning in the workplace successfully, the primary aim should be to identify the triggers for this reaction. The client also needs educating as to how they can recognise what triggers their fatigue epis

odes and learn how to independently manage them.

Vocational Rehabilitation Consultants’ role is to help clients to identify their barriers for work. If fatigue is one of the barriers, Vocational Rehabilitation Consultants would work with the client to help them manage this issue, in order to achieve their vocational goals – be it returning to a specific job role or identifying an alternative occupation.

For those suffering life-changing injuries, there are likely to be many limitations and difficult obstacles to overcome when it comes to returning to work. 

Sometimes, those obstacles can appear insurmountable – until and unless they are broken down into incremental steps and dealt with one at a time.

As rehabilitation practitioners, we have to keep in mind that a return to appropriate and meaningful vocation will invariably improve the quality of life of many clients.

Vocational Goals

In terms of vocational goals, we need to begin with the end in mind.

The ultimate outcome of rehabilitation should be enabling and empowering the client to engage in suitable work and by doing so, enabling them to have a good quality of life.

If the question is “which fatigue management programme should this person engage in?”, then the answer would be to search for various fatigue treatment methods.

If the question however is “what causes the client’s workplace fatigue?” or “how could this person learn to manage their workplace fatigue?”, then the answer would be completely different, as would be the goals and the outcomes of the rehabilitation process as a whole.

I suggest that, when planning a return to work and if fatigue is a barrier for work, the following goals should be included in a vocational rehabilitation plan:

  • Investigating the triggers of workplace fatigue.
  • Helping the client to develop strategies to manage workplace fatigue.
  • Helping the client to develop a positive attitude towards work and recognise the benefits of being in work.
  • Ensuring that the client and the rehabilitation team set short, medium and long-term return to work goals.
  • Putting a step-by-step plan in place, to help the client achieve their vocational goals and work to the best of their abilities.
  • Encouraging and empowering the client to believe that they have a working future and that they have abilities and strengths which could help them to overcome their deficits.

Effective vocational rehabilitation provides a client with all the tools and support they need to engage in suitable employment. To learn more about Voc Rehab UK and the services they offer, click here.

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