Thank you Christine, as nurses surely not only morally and as part of the
NMC's code of practice, but also according to HSE and DOH guidelines and in
the interest employee health and the company, we are to practice
holistically. Work impact on health and health on work, naturally home life
and in fact the persons entire health both mental and physical is a part of
that. I would be very interested to know how a OHN considers they fulfil
their role by only attending the meetings and advising on how the Company
can prevent ill health. I am surprised to learn that the advice is where
many of you say you stop, the company I work for tell me they employee me to
take action and follow it through to evaluate whether or not the action
taken has worked and you can not do this unless you also look at employes
general health. As they pay my wage ultimately, with respect I feel a duty
to include their requests in my action plan. Vice versa I am surprised to
hear Occ Health seems to have such a low profile in these areas that
confrontational situations arise. Where I work the opinion of the OHN is
very highly regarded or it seems so, if we say something valid I feel our
opinion is always valued. I always believed and also based on evidenced I
have read and from others, that you are not able to assess a person's
health in the workplace and assess the impact hazards may have had on
health, unless you also look at their general health and well being.
Regards
Kaaren
Ext 3311 Page 157
-----Original Message-----
From: Christine Leek [mailto:[log in to unmask]]
Sent: 30 January 2004 10:03
To: [log in to unmask]
Subject: Re: TREATMENT SERVICE from Kaaren
Imust disagree both should goe to gether my hands on practice doe not
interfer with my Occ Health work . infact it works very well. but thats just
me
-----Original Message-----
From: Car Barnes [mailto:[log in to unmask]]
Sent: 30 January 2004 09:28
To: [log in to unmask]
Subject: Re: TREATMENT SERVICE from Kaaren
I used to work in a large retail store where walk-in treatment was
paramount and I must admit it turned me off for life! One of my concerns
was being asked to back up first aiders in areas I had no experience (my
background was ITU/recovery) which often delayed the call for an
ambulance unnecessarily. Another problem was that Managers often came
close to crossing the line in "forcing" staff to stay in work by
insisting they came over to us to lie down before considering letting
them go home if unwell. I also found that explaining to 18 year olds
that the reason they felt dizzy at 10am on a Sat morning was likely to
be due to their hangover not hypotension a waste of my time. I'm
strictly of the opinion that I'm not, not do I ever want to be, a
practice nurse and if an employer wishes to run a treatment service - go
for it but not out of the OH department - keep the two separate as they
should be.
Car
-----Original Message-----
From: Christine Leek [mailto:[log in to unmask]]
Sent: 30 January 2004 08:19
To: [log in to unmask]
Subject: Re: TREATMENT SERVICE from Kaaren
I agree with everything you say, Ieven teach all my First Aiders my self
as
I have my own First Aid licence, we even to 6 monthly First Aid up date
sessions . The First Aiders agree this is good for them. Giving
medication
keeps the work force happy & at work .
-----Original Message-----
From: Harrop, Chris [mailto:[log in to unmask]]
Sent: 29 January 2004 15:23
To: [log in to unmask]
Subject: Re: TREATMENT SERVICE from Kaaren
Dear Elaine
I must say, despite being a reasonably young nurse in Occ Health, but of
8
years experience and with prevention as a main aim, I agree with
Margaret in
that there is a definite benefit to a treatment service, providing it is
managed well. The guidelines as clearly stated in Securing Health
Together
(HSE 2000/1) and subsequently Taking a Public Health Approach (2003), we
must reduce sickness absence. In my experience Margaret is quite
correct
in saying employees who are used to having an hour lie down if genuinely
unwell and then going back to work once better (if they are fit to do
so) is
better than them going home. In these circumstances you are most
likely to
have the ones who get cross and just leave or the tuffies, who stay at
work
but become a safety risk as ill health may cause lack of attention. So
treatment in these cases are, in my mind, prevention. Prevention of a
worse scenario.
I too agree with the empowerment of first aiders, but not to the extent
that
the nurse is unavailable should further medical attention be required as
this then may prevent unnecessary hospital referrals when the first
aider
would need back up.
Furthermore providing it is coupled with good preventative health
screenings
and proactive health promotion I have, by listening to employees who
come
for paracetamol found in fact in many cases their trouble is not simply
the
headache. There is often another issue, such as work related stress,
working conditions, stress at home, sickness in the family, or in some
cases
severe illness that the GP ignored but we knew the employee better and
could
put a case forward for them as we new they were not usually the
malingering
type. By referral up to Occ Health Doctor they were referred back to
the
GP and successful diagnosis of a serious illness was made for which the
employee now receives treatment. So again in this case prevention of
death.
On a final note although I can understand your desire to change the 'old
fashioned approach' I found it sad to hear your undertoned comments.
The
Company must have been happy with the nurse to have employed her/him for
so
long. Whilst I support underpinning practice with the best possible
research based evidence, I have no doubts in my mind that a good
Enrolled
Nurse with 20 years Occ Health experience (who may also have some
evidence
for what she does - we don't know) would be preferable, to a young
inexperienced, Degree Registered Nurse with no knowledge of the Company
in
which she works as there is evidence to suggest it is essential to 'know
your company'. Keeping on that note, it is said in a number of health
promotion books including one by Ewles and Simnett (1999) it is better
not
to try to change the internal politics in these situations but to learn
it
and work around it.
So in summary, I agree a compromise would be sensible, with a good sound
knowledge of the company, to avoid conflict and anarchy in the ranks.
A
gentle shift towards prevention with introduction to how to help
yourself,
health promotion including work related things, but also when to ask OH
and
when to see the GP etc etc. and some health screenings etc and work
place
monitoring, but with the employees knowing they are still cared for, may
be
the way forwards.
Regards
Kaaren
-----Original Message-----
From: Reddoch, Margaret [mailto:[log in to unmask]]
Sent: 29 January 2004 13:21
To: [log in to unmask]
Subject: Re: TREATMENT SERVICE
Dear Elaine
What about suggesting compromises? If the staff are used to this
'nursing'
service, they are not only going to miss it if it is discontinued at a
stroke, but are likely to feel resentful which could be
counterproductive to
overall OccHealth service. What's wrong with having a rest room where
women
with dysmen. can lie down with or without a hot water bottle? the OH
nurse
doesn't necessarily have to minister to them, or even be around.Ditto
people
with migraine, post epileptic fit etc etc.most of these people will go
back
to work after half an hour or so whereas otherwise they would more than
likely have gone home. I've found giving people a chance to discuss
their
general health concerns reaps benefits both in their view of the overall
OH
service and in keeping them productive at work and it doesn't have to
take
up much time. A paracetamol machine will solve most peoples OTC
medication
needs. I agree about empowering first aiders
Allthe best
Margaret
From: Elaine Dobson [mailto:[log in to unmask]]
Sent: 29 January 2004 11:37
To: [log in to unmask]
Subject: TREATMENT SERVICE
Dear All
I have prepared a presentation for a company who has asked for an
assessment
and recommendations for the future of their OH service. I am happy with
it
so far but would like some more "ammunition" as to why the present
treatment
service should be discontinued.
Current service
SEN who has been in post for 20 years and is retiring - wears uniform!
Rest room with two hospital beds, she gives hot water bottles to women
with
dysmenorrhoea!
Not surprisingly I was shown a cupboard full of OTC medicines!
I was hoping to be able to quote some legislation as to why the OHN
should
not be administering OTC medication to back up my arguments. None of
this
medication is specifically related to hazards on site. It appears that
if
the Dr is willing to produce a standing order for this stuff then why
shouldn't the OHN continue to administer it. I can not find any
evidence to
back up my recommendation to remove this service.
I have covered cost effectiveness in use Of OH time
Safety issues keeping people at work who are ill and who work on
production
line
Promoted pro active rather than reactive service
Empowerment of First Aiders as she still sticks the plasters on
This is a good time to reshape the service. Your comments would be
appreciated.
Many thanks
Elaine
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