Returning to Work After Severe Brain Injury

Returning to Work : Betty Part Six:

Returning to work for Betty involved reeducating herself. Betty received intensive vocational rehabilitation for nine months, which included more work with a speech pathologist and enrollment in a dental assisting program, even though she was already a license hygienist.   “The problem was I knew almost more than the teachers knew and so that was difficult for me also but I got through it and I finished that program.”

Returning to work for Betty wasn’t an immediate success. She explains the problems she had for reemployment:

Once Betty had finished her vocational rehab, she was returning to work as a dental hygienist, but surprisingly, her first job was her easiest and it got progressively harder to stay employed after that.  She made what was likely a brain injured mistake in quitting  her first job.  Jobs got harder to keep and when she did find one with some longevity, she quit that again.

I stayed for four years at that position and not a good idea on my part but I quit and then from then on I looked for another position and in between I had been terminated from two or three other places but then I found a, a dental hygiene job on South 27th Street and I stayed there for four years and then I just decided I had had enough of the office and I left and probably my biggest mistake so far.

Issues for brain injury survivors returning to work:

For anyone to maintain employment, they not only have to have the skills to do the job, but also the appreciation that work is work, and that a good job may be irreplaceable.  That is far more difficult to remember, when judgment, mood and initiative is impaired after a brain injury.

However, Betty had another problem. She had already known how to be a dental hygienist before her accident and after rehab, was able to do much of what was required of her because it required her to use skills she had learned before her accident.  But the field of dentistry, like any profession, changed, she couldn’t learn the new techniques, acquire the new skills to adapt when returning to work.

Especially with taking X‑rays.  I mean I had taken the class.  I had passed it at Loyola and coming back up here all of a sudden they say we’ve got these new X‑rays.  They’re digital.  This is how you do it.  They’d show me once and then I would forget and I’d say could I write this down and they would say oh you should be able to remember this and it was just very difficult for me to remember how to put the X‑ray – you had to put the X‑ray in the mouth perfect – and the X‑ray had to go in the mouth in a perfect form and I could take the X‑ray but putting it in the mouth and getting it in the proper form in the holder was something I had a difficult time with and I couldn’t remember how to do it.

As I said, I remembered – I’m grateful I do remember my dental hygiene work and I can do that and I can do that well but new dental – I mean the dental field changes all the time and all these new aspects that come in are difficult for me to learn and to implement in my work that I’m doing.  I mean, I, I know how to use the scalers, I know how to use a Cavitron but all of a sudden now there’s all these other instruments and things that you have to operate with electricity that I don’t have – that I sometimes I forget how to operate them or work them.

Any plan for vocational rehabilitation following brain injury must take into account not only the simple issues of preparing the brain injured person returning to work, the work environment as detailed by Angela, but must also factor in the challenges that the brain injured person will have in learning new things in the non-structured classroom that is the workplace.  For Angela’s workplace problems, click here. Further, any successful program must constantly reinforce to the survivor the value of a job when returning to work and when they find one and progressively harder task of getting a replacement job.

For Part Seven, click here.