Return to Work

employment after brain injury
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Shared Experience Blog

by Raymond Lynch (30-Oct-2020)
Returning to work was completely filled with anxiety for me as I was not sure I would be able to cope or even remember stuff which had been such second nature to me when I departed on vacation in August 1998. These anxieties and concerns were derived from just how poorly I had performed in the Headway test a few months earlier and in particular how poorly my memory was rated.
One strong key positive for me was that returning to work was returning to a world filled with structure and I loved that idea. However, I could never have predicted how challenging it would be to try to speak again (remembering names, terms, phrases, conditions, IT applications, excel, e-mail, Word, etc) and also just talking to my colleagues.
The next thing which became very clear to me was the sensory assault I felt especially while having lunch in the canteen, for example. I recall sitting opposite my friends/colleagues at the dinner table, seeing their mouths move (while talking) and not hearing a word. All I could hear was the sound of plates crashing, cutlery and knives scraping across plates, glasses crashing, water cascading (like waterfalls) as people poured water into glasses. I had no idea this was because of my brain injury and remember thinking that I would have a very long journey ahead of me in returning to the person I was before I went on holiday.
Another aspect which I could never fully understand was that my management had invited Headway to talk and discuss brain injuries with the management team without inviting either my wife, Ciara, or me.
Fundamentally I understood, because I looked ‘normal’ and not in a wheelchair or wearing a cast, that people automatically assumed lots of things. During my first 15 years, my focus was on:
  • Relearning to read and write again.
  • Walking straight, upright and pain free: this was an enormous task considering the pain that I was in from my spinal injuries and calcification in my hips (calcium crystals deposited between my hip bones and muscles making it difficult to put on my socks each morning and walking was just so painful for the first 7 to 15 years). I was obliged to complete almost 4 hours physio each day to help my spinal injuries. Meanwhile, I never wanted to admit to all of this because for me this was an admission that I was less than able to cope.
  • Relearning to talk and become more articulate: I forced myself to stand up in meetings and make presentations under enormous pressure to recall words, phrases and business results. In fact it was just so stressful that my left leg would begin to hop and I really did not want others to see that I was doing this, so I ended up standing on one leg for most parts of the presentation.
These were my only goals in the early stages and to others I must have appeared slow, shy and uptight. During these times, I was a very vulnerable person and managers knew that they could take advantage of me. This is exactly what did happen and my career suffered because of it.
The years rolled by and my managers were moved elsewhere or left the company and there was absolutely no information or knowledge transfer to the managers who followed them.  The new managers never understood anything about what I was going through every second of every minute of every hour. They never realised that I had had to relearn to read, write, talk and walk pain free again. During these years I continued to make notes of the many, many misunderstandings which were perceived of me by various managers and peers. Without knowing it at the time I was laying the groundwork for The Return to Work Accommodations Programme. 
In 2015, I realised that people who had suffered brain injuries all across the UK and in the USA were losing their jobs or being sacked, primarily because they could no longer do their old jobs as before or as well as their peers. I thought this was grossly unfair and that these companies and firms were losing an opportunity: enormous talent and experience was being lost while the brain injury survivors were thrown onto the scrap heap. If these companies had spent some time and resources retraining their ABI survivors and offering them different roles, surely it would potentially have been a ‘win-win’ for all parties.
In 2017, after a chance conversation with my new manager about the challenges I faced renewing my disability badge, I was invited to join Procter & Gamble’s new affinity group: People With Disabilities (PWD) and I somehow knew that this was the opportunity for which I had been waiting.
I began speaking to interested groups in the UK about the many, many challenges I had faced simply because I had a hidden or non obvious disability. As a result of this I was invited to present at our head offices in Cincinnati, USA.
As brain injury is such a global issue (almost 70 million people acquire brain injuries in the form of strokes, brain bleeds, brain tumours, car accidents and falls in the home every year), I asked a representative from the American Brain Injury Association and a brain surgeon/associate professor from the University of Cincinnati to join me in my presentation to the senior managers and directors of P&G. 
Following the presentations I asked both of these experts if they would like to work with me to create a Return To Work Accommodations (RTW) Programme for P&G staff unlucky enough to acquire a brain injury; they did.
The notes I had written down through the years were fundamental to providing the outline of the Return To Work Accommodations Programme which we developed in March 2019.
For reference, the essential features of this programme currently being piloted in the USA are outlined below:
  1. If an employee is suspected of having a brain injury they are assessed by Professor Ngwenya’s (University of Cincinnati Neuro Trauma/UC Neuro Trauma dept) to understand what exactly is different about the person. This is completed using an extensive sequence of Neurological tests. This battery of tests are based on the injury the employee has sustained.
  2. The University of Cincinnati Neuro Trauma team then make recommendations on preferred work programmes which fit with the employee’s test results. 
  3. These recommendations are then shared with both the P&G Global Medical Organisation and the employee’s managers. An appropriate work programme is agreed upon together with any other accommodations (an afternoon nap to accommodate neurological fatigue which the employee may require, for example).
  4. The employee then returns to the work environment and her/his progress is monitored by the global medical department. 
  5. Only when both Global Medical and the employee are happy with the new working arrangements, will the employee be released back into the work force. 
  6. Meanwhile, the employee completes a disability passport which ensures a record of what has happened to her/him and is perpetually on her/his work record to ensure any new manager is made aware of why the employee is different.
Most people work in small firms, companies and organisations with less than 50 employees. The problems and issues I have highlighted faced by ABI survivors returning to work in large companies and organisations are faced equally by employees of small and medium firms (SMEs) but with far fewer resources at their disposal. Once the Return to Work Accommodations Programme for Procter and Gamble is up and running we would like to consider ways and means of adapting this programme for small and medium enterprises and will be seeking partners to achieve this.