Thank you for your advice. Catherine
Thank you for this information. The lady in question was diagnosed
'years ago' she states and is now in her 40's. Her attendance is 100%
and she is a very good worker. She has been advised she cannot have
anymore injections in her wrists and that surgery will be the next
option. She has been advised that it is best to delay surgery for the
shoulders as long as possible. She could have had days off for the
injections but chose to take annual leave - this is something I will
bring up with the Busienss. I was concerned that working in a
repetative although not heavy role may exacerbate symptoms and she
would therefore requrie surgery earlier in life. I have recommeded that
she does not work on cetain tasks for more than 30 minutes and to
report when she is feeling 5-6/10 pain and to refrain from the
particular activity she is undertaken. I was just concerned that
although she can work very well today and perhaps for the next few
years (on a cocktail of medication) that this type of work may have an
effect on what she will be able to do in the future and that she has 20
more working years ahead of her.
-----Original Message-----
From: Catherine Tye <[log in to unmask]>
To: OCC-HEALTH <[log in to unmask]>
Sent: Wed, 18 Jan 2012 18:15
Subject: Re: [OCC-HEALTH] Painful joints
Hi All,Tracey - you haven't said whether her shoulder/wrist problems
are ongoing to part of an active 'flare' or whether her performance is
an issue or not? I'd be intrigued to know when she was diagnosed as if
only diagnosed recently then she may have years of pre-existing joint
damage making her more prone to CTS and other problems.Her attendance
is good. In many companies she wouldn't need to take holiday but has
chosen to for hospital treatment, so depending on company policy I
would expect HR to decide whether that holiday day should be given back
and also she may come under the Equality Act so is entitled to time
off for treatment and not be put to detriment.Well, I'm going to
disagree with some of the comments raised so far. I'll apologize in
advance for getting on my soapbox but I'm rather passionate about RA so
here goes...... With RA there are so many unknowns. Why should she not
work in factory setting? How do you know her work is making her
symptoms worse or not? How do you know if the CTS/ shoulder pain is
caused by the disease process (joint erosion) or her work - you don't
and you will never know. She is the expert in her condition. She needs
to work. With inflammatory arthritis symptoms the activity often helps
manage pain (many are in more pain in sedentary jobs), promotes mental
health and sleep. Yes she may require injections in her joints to 'keep
her going' but is that really any different to a client requiring
osteopathy for a bad back or steroid injections for elbow/shoulder
problems?! In the factory setting I'm sure you have many staff with
chronic msds/pain but no 'label' who keep working and probably have a
worse attendance record.The challenge for anyone with a chronic
condition is managing the symptoms to enable them to continue working.
She sounds to me to be doing a sterling job. I find it a difficult
balance sometimes and I have to be aware of not over-protecting
clients. I can only ensure she has robust information to make informed
choices and she has had appropriate investigations and referrals where
required. (The drugs combos for RA are of the disease modifying and
biologics variety and are quite complicated these days tbh.) The only
thing that you have not referred to is completing a robust risk
assessment in relation to her condition and her work. The key to
rheumatoid arthritis is to think of the 4 Ps - pain (stretching, need
for splints, orthotics), joint protection, pacing & planning etc which
all aim to reduce the energy demands on the body to reduce fatigue from
the inflammatory process within the body. Her workstations will need to
be assessed to ensure that her posture is as neutral as possible to
reduce pressure on joints (this is no different to anyone else) and
review the job rotation setup. She may require more frequent rotations
or short pacing breaks. Has she been advised to wear splints whilst
working and does she have working splints? For ideas to consider see
presentation link below. I have been in similar situation recently with
a lady with severe pain including deformed joints in her hands as a
result of working as a sewing machinist for the last 30 years. She is
in pain, her work aggravates it, we cannot make any further changes to
her workstation, there is no opportunity for job rotation. She knows
her hands are better when she is away from work but she cannot afford
to go part-time (it has been offered to her) or retire and jobs are
scarce...... she is able to work and performing to a high standard, she
does not take time off-sick, she has sought advice from her GP to rule
out any under-lying pathology such as RA and better analgesia than
long-term ibuprofen and through open discussion her informed choice is
to continue for as long as she can. There is no point in sending her to
an OHP (not that we have one) as we already know the reality (she is
the expert in the reality of her condition - what difference is an OHPs
view going to make.........?) Who can say whether her condition is
caused by her work or by her own genetic makeup (family hx of severe
OA.) The above is on record. The management team will have to deal with
the situation if and when she becomes unable to work or her performance
is reduced.It is very rare in my experience to say someone is unfit for
a job role, they can either do it to the required standard with
reasonable attendance or cannot. If they cannot then they have to be
managed early on in the probationary period and out if no improvements
seen (not used often enough IMHO) or for longer-standing employees,
through the capability route. If they have a long-term health condition
they will often self-select out if they can no longer tolerate the
work. Equality and human rights legislation no doubt have a bearing in
relation to a 'legal right to work.'BTW - a reminder of the good work
that NRAS (National Rheumatoid Arthritis Society) does. They ran
workshops (which I was lucky enough to be involved in) aimed at
supporting people with RA in the workplace. Delegates included
plumbers, nurses, administrators, factory workers, farmers (men and
women of all ages). The resources and information is available on their
website......
:0)http://www.nras.org.uk/workwise/welcome_to_workwise.aspxhttp://www.nra
s.org.uk/workwise/expert_films/catherine_tye.aspx see video clip and
presentation slides re things to think about and topics that you can
discuss with the employee concerned - to ensure that everything has
been considered to assist her in managing her condition. I would
suggest record in her notes then monitor 2-3 monthly.(The Equality act
animation is good regarding pacing in inflammatory disorders)Hope that
helps!Kind Regards,CatherineCatherine Tye RN SPOH PgDipOSHHealth,
Safety and Wellbeing Practitioner Harmony Health & Wellbeing | email:
[log in to unmask] | www.harmonyhealthandwellbeing.com
Date: Wed, 18 Jan 2012 20:32:36 +0000From: Tracy Turner
<[log in to unmask]>Subject: Painful jointsGood evening. I have
seen a lady today who works in the meat factory. Has been diagnosed
with rhuematoid arthritis and carpal tunnel for several years prior to
starting in the factory. She was advised at post offer that this type
of role may not be suitable for her but she had woked 12 months at the
same factory with an agency and had not reported any problems. The
Busienss were advised of this. She was advised to report any
onset/increaase of symptoms. In November she went to the rhumatologist
and had injuctions to both shoulders and the second lot of injections
to wrists. if the wrists do not improve she will require surgery. She
did not report the pain just asked for annual leave days so she
couldhave the injections. She is insistant she can do he job. She has
not gone sick and in fact had injections all done on same day to
prevent absence. She is only 40 and I have done my best to advise her
that she should not be working in the factory environment. She is
adament taht she can do her job and that she does not require any
adaptations. Apparently her GP agrees with me. Apart from documenting
this what else can I do ? I am sure people have a legal right to work
even if it is exacerbating health. Any comments welcomed as ususal.
Thank you.********************************Please remove this footer
before replying.OCC-HEALTH
ARCHIVES:http://www.jiscmail.ac.uk/lists/occ-health.htmlCONFERENCES AND
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-------------------------Date: Wed, 18 Jan 2012 20:48:26 +0000From:
sharon naylor <[log in to unmask]>Subject: Re: Painful jointsIf she
has been referred to you are you required to report back to management?
If you are I would give my opinion and take it from there. Mention that
she is states she can do the job, (I take it this is repetitive
work?)Gettin something in writing from GP may help, as would OHP
opinion.If she has not been referred and she has been to see you
voluntarily - well thats a thorny issue I think.... > Date: Wed, 18 Jan
2012 20:32:36 +0000> From: [log in to unmask]> Subject:
[OCC-HEALTH] Painful joints> To: [log in to unmask]> > Good
evening. I have seen a lady today who works in the meat factory. Has
been diagnosed with rhuematoid arthritis and carpal tunnel for several
years prior to starting in the factory. She was advised at post offer
that this type of role may not be suitable for her but she had woked 12
months at the same factory with an agency and had not reported any
problems. The Busienss were advised of this. She was advised to report
any onset/increaase of symptoms. In November she went to the
rhumatologist and had injuctions to both shoulders and the second lot
of injections to wrists. if the wrists do not improve she will require
surgery. She did not report the pain just asked for annual leave days
so she couldhave the injections. She is insistant she can do he job.
She has not gone sick and in fact had injections all done on same day
to prevent absence. She is only 40 and I have done my best to advise
her that she should not be working in the factory environment. She is
adament taht she can do her job and that she does not require any
adaptations. Apparently her GP agrees with me. Apart from documenting
this what else can I do ? I am sure people have a legal right to work
even if it is exacerbating health. Any comments welcomed as ususal.
Thank you.> > ********************************> Please remove this
footer before replying.> > OCC-HEALTH ARCHIVES:>
http://www.jiscmail.ac.uk/lists/occ-health.html> > CONFERENCES AND
STUDY DAYS:>
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-------------------------Date: Wed, 18 Jan 2012 15:55:23 -0500From:
Tracy Turner <[log in to unmask]>Subject: Re: Painful jointsHiThe
lady was referred to me as the Business were concerned regarding her
health as they knew she had recieved the injections in her wrists and
shoulders. She is fully open to the Business about her condition. She
is a very good worker. Her determination keeps her going but at such a
high cost. Yes it is repetative workbut she does not need to lift more
than 5kg.-----Original Message-----From: sharon naylor
<[log in to unmask]>To: OCC-HEALTH <[log in to unmask]>Sent:
Wed, 18 Jan 2012 15:48Subject: Re: [OCC-HEALTH] Painful jointsIf she
has been referred to you are you required to report back to management?
If you are I would give my opinion and take it from there. Mention that
she is states she can do the job, (I take it this is repetitive
work?)Gettin something in writing from GP may help, as would OHP
opinion.If she has not been referred and she has been to see you
voluntarily - well thats a thorny issue I think.... > Date: Wed, 18 Jan
2012 20:32:36 +0000> From: [log in to unmask]> Subject:
[OCC-HEALTH] Painful joints> To: [log in to unmask]>> Good
evening. I have seen a lady today who works in the meat factory. Has
been diagnosed with rhuematoid arthritis and carpal tunnel for several
years prior to starting in the factory. She was advised at post offer
that this type of role may not be suitable for her but she had woked 12
months at the same factory with an agency and had not reported any
problems. The Busienss were advised of this. She was advised to report
any onset/increaase of symptoms. In November she went to the
rhumatologist and had injuctions to both shoulders and the second lot
of injections to wrists. if the wrists do not improve she will require
surgery. She did not report the pain just asked for annual leave days
so she couldhave the injections. She is insistant she can do he job.
She has not gone sick and in fact had injections all done on same day
to prevent absence. She is only 40 and I have done my best to advise
her that she should not be working in the factory environment. She is
adament taht she can do her job and that she does not require any
adaptations. Apparently her GP agrees with me. Apart from documenting
this what else can I do ? I am sure people have a legal right to work
even if it is exacerbating health. Any comments welcomed as ususal.
Thank you.>> ********************************> Please remove this
footer before replying.>> OCC-HEALTH ARCHIVES:>
http://www.jiscmail.ac.uk/lists/occ-health.html>> CONFERENCES AND STUDY
DAYS:> http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH
********************************Please remove this footer
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-------------------------Date: Wed, 18 Jan 2012 21:08:58 +0000From:
Carr Barnes <[log in to unmask]>Subject: Re: Painful jointsIs the
work just going to cause symptoms that she feels able to cope withor is
it actually going to cause physical damage? Those 2 points and
theirpotential impacts on attendance need to be outlined to management
for themto action as they choose. This is a case I'd definitely
progress to aphysician as a medical assessment is
required.Regards,CarrOn Jan 18, 2012 8:58 PM, "Tracy Turner"
<[log in to unmask]> wrote:> Hi> The lady was referred to me as the
Business were concerned regarding her> health as they knew she had
recieved the injections in her wrists and> shoulders. She is fully open
to the Business about her condition. She is a> very good worker. Her
determination keeps her going but at such a high> cost. Yes it is
repetative workbut she does not need to lift more than 5kg.>>>>
-----Original Message-----> From: sharon naylor <[log in to unmask]>>
To: OCC-HEALTH <[log in to unmask]>> Sent: Wed, 18 Jan 2012
15:48> Subject: Re: [OCC-HEALTH] Painful joints>>> If she has been
referred to you are you required to report back to> management? If you
are I would give my opinion and take it from there.> Mention that she
is states she can do the job, (I take it this is> repetitive
work?)Gettin something in writing from GP may help, as would OHP>
opinion.If she has not been referred and she has been to see you>
voluntarily - well thats a thorny issue I think....>>>> Date: Wed, 18
Jan 2012 20:32:36 +0000>> From: [log in to unmask]>> Subject:
[OCC-HEALTH] Painful joints>> To: [log in to unmask]>>>> Good
evening. I have seen a lady today who works in the meat factory.>>> Has
been diagnosed with rhuematoid arthritis and carpal tunnel for several>
years prior to starting in the factory. She was advised at post offer
that> this type of role may not be suitable for her but she had woked
12 months> at the same factory with an agency and had not reported any
problems. The> Busienss were advised of this. She was advised to report
any> onset/increaase of symptoms. In November she went to the
rhumatologist and> had injuctions to both shoulders and the second lot
of injections to> wrists. if the wrists do not improve she will require
surgery. She did not> report the pain just asked for annual leave days
so she couldhave the> injections. She is insistant she can do he job.
She has not gone sick and> in fact had injections all done on same day
to prevent absence. She is only> 40 and I have done my best to advise
her that she should not be working in> the factory environment. She is
adament taht she can do her job and that> she does not require any
adaptations. Apparently her GP agrees with me.> Apart from documenting
this what else can I do ? I am sure people have a> legal right to work
even if it is exacerbating health. Any comments> welcomed as ususal.
Thank you.>>>>> **********************************>> Please remove this
footer before replying.>>>> OCC-HEALTH ARCHIVES:>>
http://www.jiscmail.ac.uk/**lists/occ-health.html<http://www.jiscmail.ac.uk/lists/occ-health.html>>>>>
CONFERENCES AND STUDY DAYS:>>
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**********************************Please remove this footer before>
replying.> OCC-HEALTH
ARCHIVES:http://www.jiscmail.**ac.uk/lists/occ-health.html<http://www.jis
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uk/cgi-bin/filearea.cgi?LMGT1=**OCC-HEALTH<http://www.jiscmail.ac.uk/cgi-
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replying.>> OCC-HEALTH ARCHIVES:>
http://www.jiscmail.ac.uk/**lists/occ-health.html<http://www.jiscmail.ac.uk/lists/occ-health.html>>>
CONFERENCES AND STUDY DAYS:>
http://www.jiscmail.ac.uk/cgi-**bin/filearea.cgi?LMGT1=OCC-**HEALTH<http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH>>********************************Please
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ARCHIVES:http://www.jiscmail.ac.uk/lists/occ-health.htmlCONFERENCES AND
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-------------------------Date: Wed, 18 Jan 2012 21:13:57 +0000From:
janet oneill <[log in to unmask]>Subject: Re: Centre for Mental
health - Impact on Depression trainingHiTry the above and;-WORKPLACE
INTERVENTIONS FOR PEOPLE WITH COMMON MENTALHEALTH PROBLEMS - BOHRFthis
is lengthy but good and has a section on managersAlso there is quite a
lot of research on changing behaviors with trainingif you google. The
Sockal document has information on trainingfor behavior change although
not specifically aimed at managershope this is of some help even if it
is a bit obliquejanetOn Tue, Jan 17, 2012 at 1:42 PM, Susan Gorton
<[log in to unmask]>wrote:> Hi Team****>> I am looking for
anyone who has encounterd the Impact On Depression> training run by the
Centre for Mental Health. In particualr anyone who has> done any
evlauation around it. I know one of my OH colleagues out there has>
done some work in the North west NHS sector.****>> Also does anyone
have any references on the value of training to change> attitude or
behaviour.****>> In case it isn't transparent, I am doing research,
part of which will be> to pilot this training for managers and see if
it fills an important gap in> the knowledge, attitude and subsequent
behaviour of managers with regard to> managing employees with common
mental health problems.****>> Thanks in advance****>> regards****>>
Sue****>> ** **>>
*************************************************************************
********************************>> This message may contain
confidential information. If you are not the> intended recipient please
inform the sender that you have received the> message in error before
deleting it.>> Please do not disclose, copy or distribute information
in this e-mail or> take any action in reliance on its contents: to do
so is strictly> prohibited and may be unlawful.>> Thank you for your
co-operation.>>>
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-------------------------End of OCC-HEALTH Digest - 17 Jan 2012 to 18
Jan 2012 - Special issue
(#2012-19)***************************************************************
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