To set this up, I’ll give you a bit of background. A) One of my jobs (although technically it’s contract work rather than a job) is as an injection nurse. I administer certain kinds of recurring injection medications to patients, and I teach patients how to self-inject various biologic medications. B) I have a tremor as a side effect from lithium. This tremor gets worse when I’m tired, over-stimulated, stressed, uneasy, or just generally feeling unwell.
Anyway, yesterday evening I was seeing one of my regular patients for her monthly Abilify injection. I had taken a prn dose of propranolol an hour before the appointment to help keep my tremor under control. On the last few visits, I’ve been clumsy preparing injections, and the last couple of injections have been a little bit shaky. But yesterday evening, my hand started shaking considerably just as I was sticking the needle into her. She didn’t say anything, but I imagine it must have hurt.
That brings me to the question of whether I should be doing this job. I don’t accept many patient assignments to begin with, in part because travel time isn’t paid fairly. Also, I’ve been hesitant to take injection training patients, since that would involve my shaky hands being on full display, and it would require me to remember and spout off all the teaching points for meds I don’t deal with that often (most of them are non-psych meds). And now I’m concerned about administering injections. It’s not like yesterday was a totally isolated incident; I’ve been fumbly for a while now, and I’ve had a noticeable decline in work-related functioning over the past year.
In making a decision about this job, I need to prioritize patient care over and above what I want to do for my own sake. I have a professional obligation to ensure that my practice is safe and effective. I really shouldn’t be doing injections if I can’t do them properly, it’s as simple as that.
At the same time, there’s something scary about the thought of limiting myself to just my other job, which I don’t like. And this isn’t the kind of thing where I could request an accommodation, because a) I’m not an employee, and more importantly b) there is no form of accommodation that would stop me from being shaky while sticking needles into people.
I need to think about it some more before I make a decision, but either way I don’t think it’s going to feel very comfortable.
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