Job update

Hello? Is anybody out there? Is anyone still listening?

Apologies for the radio silence over the last few months. It wasn’t for lack of ideas and thoughts to share, but more for lack of motivation and follow through. It’s been a long, cold winter for me! How about you?

The run-down of this winter is coming in instalments, because a lot has happened despite the long cold. First off, and the main event, an update on work.

I quit my old job in August, yep the same one that I started in April, and moved on to another job. I’ve never “given up” so soon! But it was a good move, probably the best career move I’ve ever made despite quitting being seen generally as a negative thing. Four months in community pharmacy, and I’m done! It wasn’t the community, it was the pharmacy, more specifically the management of the pharmacy, and more especially the owner/manager/slacker/ingrate/greedy pig/jerk. I’ve done that fight in a job once, and it changed the course of my mental health for life! This time, I knew enough not to stay, and I’m proud of that! It shows that I learnt something that first time around, and that’s a victory. As soon as I realised that the situation wasn’t going to change (another thing I’m proud of recognising this time around) and that my initiative was unappreciated, I started planning my departure.

And karma smiled. Well I don’t believe in karma, or the universe, or fate. But everything fell into place like it would if you did believe in one or the other of those things. I monitored the regular SEEK pharmacist job alerts that I’d signed up to receive before this job, as well as the Society of Hospital Pharmacists job register. I was still searching for my escape route (you know, never leave a job until you’ve got another job), when I got a call from Slade Pharmacy at Epworth Private Hospital in Richmond asking if I would like to interview for a casual position! Ah yes! I would definitely like to interview for a job with flexible hours in a hospital, albeit the dispensary! Especially since you called me; is this a dream come true? So why did they call me? Turns out that when I interviewed for them last year and didn’t get the job, they said “can we keep your resume on file?” and meant it! How about that? I thought it was just a line that everyone says when you don’t get a job as a consolation that maybe in the future there’ll be something there for you. But this time there’s an actual consolation prize in form of a job! Amazing.

So, interview, check. Job offer, check. Give notice that I’m leaving, check. Get obnoxious response from boss, check. Leave job feeling even better about my decision to leave, check. His response when I said I was leaving? “That’s a relief. Return the keys. Retail is not for you”! Sorry. You’re wrong. Retail pharmacy is for me, in fact during uni days I worked in retail pharmacy for 3 years and had a great time. But you’re right, the way you mis-manage it, it’s not for me. Ciao!

Usually when someone is looking for work, changing jobs, planning a career or whatnot, they consult their own needs and maybe that of a partner or family member. It comes down to what you want from a job, where you want to work, what you want to do in your job and that’s it. That’s true for me too, but in my case, there are a few other factors that contribute as well.

Number one: how will this job affect my health? That’s always the first consideration nowadays. Do you ever even think about this when considering a job? I certainly never did before I got sick. Could I work fulltime, could I manage the stress, how would I manage my workload? I never even thought about these as issues, I never thought about it period. I just knew inside myself that I would manage whatever came to me. I never doubted being able to do whatever job I got. I didn’t understand there being any option but doing the job well and going home to rest before going back the next day. Until the last year of my first job led to my physical health falling apart, and my mental health beginning to deteriorate. My second job was endlessly fulfilling but my mental health was already on the way out and too far gone for me to hold my head together, so I had to bow out. Ever since then I’ve been returning to work and thinking about what I can physically and mentally manage in a job.

Number two: what do my doctors think? Their opinion isn’t the end of the matter, but it has a lot of weight and sometimes it does decide the issue. My psychiatrist for instance has an old-school understanding of what hospital pharmacists do, but a very up-to-date understanding of how my previous jobs have affected my mental health. His current stipulation has been no hospitals, which of course I’ve found very challenging to accept! Hospitals are my place, I’m sure of it, but the politics of my first and third hospital jobs have been tough on my health for different reasons. So, I did what he suggested and tried retail pharmacy. I wasn’t very enthusiastic at first, but I tried to see it as a challenge, as a chance to update and broaden my drug knowledge and expand my mind with a different type of practice. But unfortunately, I found a great job in a terrible environment. I tried hard to make it work, but it began to drag me down after a couple of months and my psychiatrist could see that clearly, once referring to my ex-boss as Frankenstein’s brother, and another time as a peasant which amused me greatly! But still, when I broached my new job at Slade Pharmacy with him, I went cautiously and emphasised the words dispensary, retail, community pharmacy, and minimised the word hospital. But as it turns out, that first job as a casual dispensary pharmacist starting in September was easy to sell. Meanwhile my GP is supportive of anything that I want to put my hand to, even recommending I just not work for a while longer if it suited me. But getting back to work has always been a driving force with me, for better or for worse.

A week into my casual dispensary role, I heard someone dropping the words job and emergency department!! Wait!! What?? My favourite ever job so far! On offer right here? Where I already have a job? Ears pricked, senses heightened, on full alert I went into action finding out as much as I could. As soon as possible I interviewed for and was then offered later that week a role in the emergency department, 2 weeks into my casual dispensary position. I was more hesitant in telling my psychiatrist about that. I used words like part time, structured, working with another pharmacist, dedicated time, no involvement with the main hospital. But it went over easily. He saw how the community pharmacy thing went; we tried that. So now this is a new thing that I wanna try, and we’ll watch and wait this time.

The third and last factor is a third party checking in on the progress of my work. I’m receiving income protection payments from an insurer, and they check in on me every month. There’s a lot of filling in of forms by myself and my GP, supplying payslips when I’m working, and periodic check ins with a “rehabilitation consultant” who keeps tabs on my work and my health, and a case manager who keeps tabs generally. They do keep the pressure on to remain in paid work, of course, and they aim to get me back to full time work, something that I’m by no means convinced is possible. When I wasn’t happy in that retail job, I did experience some pressure from them to keep going rather than quit, but I was sure I was doing the right thing, and now in hindsight they agree. It’s just another little something in the mix that complicates my plans for what work I want to do and how I want to do it.

Exams

I don’t know how many times I’ve had this dream, or something like it. It’s 5.30pm on Saturday afternoon. My final Year 12 exam starts in 3 hours and I’m absolutely not ready. Why an exam is scheduled for 8.30pm on a Saturday is never made very clear to me! I don’t have a cheat sheet ready, I haven’t studied all semester, I know nothing and I’m in a despairing panic. Or I’m in the last class of the term doing trial exams and unable to answer a single question. Or I’m studying at home and don’t even know where to start. Or I’m in a group study session and the others know everything and I’m absolutely lost, up the creek without a paddle! The subject of the exam is never one that you can cram overnight like biology or history; it’s always physics, maths, or chemistry where you have to understand the equations and be able to manipulate them in the exam to show your understanding. Or lack thereof in this case. There is no way that I can shove enough knowledge into my brain in time to pull it back out again in time for the exam. In other words, I’m doomed! Can you imagine the panic, stress, anxiety, despair, terror, the feeling of utter failure and of the future being bleak? In the middle of the night in my sleep it’s very real and very upsetting! Wishing I’d done better, afraid of the moment my teachers find out I’ve failed them, fearing my peers finding out I’m dumb and incompetent. Cheery stuff!

The thing is, I passed my Year 12 exams. I received my Victorian Certificate of Education in 2005. I did well in fact. I was in the top 10 of my year level, number 6 I think. I achieved 94.55 out of 99.99. This isn’t a brag. It’s an attempt to make my brain remember that actually I have finished this part of my life, and finished it well. I no longer need to fret, stress, despair, panic, etc about facing exams. I mean for goodness sake, it’s 11 years since Year 12! It’s 7 years since I finished my Bachelor of Pharmacy, a lot less academically brilliantly but still. Those years are done, finished; there’s nothing that can be done to change any of it. I can’t go back and do it again. And after all I did those exams and passed them. But these dreams, largely about Year 12 exams, persist! And it’s tiring to spend so much emotion in my sleep during the night on a situation that would never occur to me to think about during the day. But during the night, my brain can’t rationalise. It’s susceptible to the strangest things. And never more so than since I’ve been on antidepressants. Prior to starting antidepressants in mid 2013 I may have had this dream, but I can’t remember. I never dreamed that much and I remembered even less of what I did dream. I’d wake up and any dream would rapidly fade and become a vague thought, or just drift away. But then.

SSRIs, selective serotonin reuptake inhibitors, are the first class of antidepressant that you get to know if you experience your own battle with anxiety, or depression. They are the first line of treatment. Lexapro, Prozac and Zoloft are some brand names you may have heard of. I prefer the generic names because they never change: escitalopram, fluoxetine, sertraline plus paroxetine, citalopram and fluvoxamine. These medications can have a side effect of strange, or even frightening dreams or nightmares (NPS), otherwise described in some places as vivid dreams. Can, being the operative word. They don’t occur in all people, or all the time. I seem to go through phases then have a break for a while, then another series. I was amused at the beginning. I had these super realistic dreams of utter nonsense that were really quite entertaining. I just wished I could have hit the video button and recorded them; I’m sure my name would have gone down in history along with the famous movie directors. I could never write them down quick enough and in enough detail to really proper capture them; quite a shame. But then I started getting variations on this exam panic and it’s not anywhere near amusing; it’s very stressful and I wake up next morning entirely exhausted, as if I’ve hardly slept! It’s draining. And to what end? My psychiatrist doesn’t believe in finding the meaning in dreams, neither did my psychologist, nor does my GP. Rationally I know that dreams are just my subconscious processing data. But sometimes I’d just like a reason why I’m fighting with these emotions during the night. I mean I know why, in that it’s because of the medication. But why this kind of dream, why this stress about failing?

So. What to do about it? In my case, not a lot right now. I’m on an SSRI plus 3 mood stabilisers. Theoretically for bipolar patients, the antidepressant is no longer necessary once the mood stabilisers are in place. Theoretically. So in order to get rid of the dreams, and the sweating, my psychiatrist started slowly weaning my high dose of antidepressant. We got down to 375mg from 525mg, but when we went to 300mg, things started falling apart. It wasn’t worth it so we went back to the last dose that worked. We might try it again later, especially now that one of my mood stabilisers has been bumped up. But it’s a balancing act. Sometimes you have to accept some side effects for an otherwise good healthy life. That’s just reality.

In the meantime, my energy is going to trying to wake myself up out of these dreams and remind myself that although I did have some close calls with studying at the last minute during my university years, that’s long gone! It’s in the past and it needn’t bother me anymore. What’s weird is that it was my years at uni when I was less studious, but the dreams are always about high school. I guess that’s just proof that this is an irrational thing, and to just let it go as much as possible, let it pass, let it slide. Breathe in, 2, 3, 4, out, 2, 3, 4. Ahhh.