Overtime expectation and fatigue

i am a nurse that works 40 hours per week. I was a case manager at a home health agency and when the position can open for alternate supervisor I applied and got the position. The reason I wanted the position is because I was devastatingly exhausted in the evenings, not able to get up from my recliner. I am much more active in the evenings after work now but my employer is beginning to require us to give baths and lift clients around after work if the field staff call in. I do not think I am going to be able to physically do this and function. My counts stay around 40,000. When I overextend myself, I have to lay on the couch for days. I get tired after my workday. I've had pred, Nplate and Rituxan to no avail. I hate to be "that kind" of employee but I'm not sure I can do this without illness. Suggestions?

That is a difficult situation and one that I was in myself for many years. After a lot of years of dealing with ITP and the treatments, I was diagnosed with Lupus. For seven years, I struggled with work...working through lunches and staying late. I'd go home and fall on the couch. My home life suffered and forget any sort of social life. There wasn't one. I kept plugging away because I had to keep working to keep my health insurance. There wasn't any choice.

I always felt that if the time came when I couldn't do my job properly, I should step aside and let my employer hire someone who could. So I kept pushing myself to do the best job possible. It took a major toll on my body and my health issues became much worse. Two years ago, I had to quit because I just couldn't do it any more. It took me about nine months to get my ducks in a row with health insurance and money, but I did it.

The point is that when things get bad like that, you need to consider some changes. There was a woman here a few years ago who had a similar situation as you and she was unable to keep up with her current job duties. She fretted and didn't know what to do; she was a basket case. In the end, she got a different job and was very happy with the changes. It turned out better than she could have ever expected.

BTW - Have you had a good work-up lately as far as blood work? Many people with ITP also have other health issues, sometimes simple ones like vitamin deficiencies that can cause fatigue. Sometimes it's a thyroid problem or other autoimmune issue. ITP could be the cause of fatigue but I wouldn't just go on that assumption. It can't hurt to look at other possibilities. I've been surprised quite a few times by blood work that revealed low vitamin levels, especially because I take some good OTC's!