Hi Carr,
Thanks for the clarification!
Kind Regards,
Cath
------------------------------
Date: Wed, 18 Jan 2012 23:45:03 +0000
From: Carr Barnes <[log in to unmask]>
Subject: Re: Painful joints
Hi Catherine
I agree with all you say. My view was that OHP assessment would be more
productive than a GP report in providing a report to management to help
facilitate ongoing and informed discussing between employee and employer.
Regards,
Carr
On Jan 18, 2012 11:18 PM, "Catherine Tye" <[log in to unmask]>
wrote:
> 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.aspx
>
> http://www.nras.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,
> Catherine
>
>
> Catherine Tye RN SPOH PgDipOSH
> Health, Safety and Wellbeing Practitioner
>
> Harmony Health & Wellbeing | email: [log in to unmask] |
> www.harmonyhealthandwellbeing.com
>
>
> Date: Wed, 18 Jan 2012 20:32:36 +0000
> From: Tracy Turner <[log in to unmask]>
> Subject: Painful joints
>
> 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.
>
> ********************************
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>
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> ------------------------------
>
> Date: Wed, 18 Jan 2012 20:48:26 +0000
> From: sharon naylor <[log in to unmask]>
> Subject: Re: 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
> >
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> ------------------------------
>
> Date: Wed, 18 Jan 2012 15:55:23 -0500
> From: Tracy Turner <[log in to unmask]>
> Subject: Re: Painful joints
>
> 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.
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> ------------------------------
>
> Date: Wed, 18 Jan 2012 21:08:58 +0000
> From: Carr Barnes <[log in to unmask]>
> Subject: Re: Painful joints
>
> Is the work just going to cause symptoms that she feels able to cope with
> or is it actually going to cause physical damage? Those 2 points and their
> potential impacts on attendance need to be outlined to management for them
> to action as they choose. This is a case I'd definitely progress to a
> physician as a medical assessment is required.
>
> Regards,
>
> Carr
> On 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.
> >
> >>
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> ------------------------------
>
> Date: Wed, 18 Jan 2012 21:13:57 +0000
> From: janet oneill <[log in to unmask]>
> Subject: Re: Centre for Mental health - Impact on Depression training
>
> Hi
> Try the above and;-
> WORKPLACE INTERVENTIONS FOR PEOPLE WITH COMMON MENTAL
> HEALTH PROBLEMS - BOHRF
> this is lengthy but good and has a section on managers
>
> Also there is quite a lot of research on changing behaviors with training
> if you google. The Sockal document has information on training
> for behavior change although not specifically aimed at managers
>
> hope this is of some help even if it is a bit oblique
> janet
>
> On 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****
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