Hi we have a translator onsite who is assisting
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-----Original Message-----
From: Susan Gorton <[log in to unmask]>
Sender: [log in to unmask]
Date: Mon, 20 Feb 2012 11:32:16
To: <[log in to unmask]>
Reply-To: Occupational Health mailing list <[log in to unmask]>
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
I guess we've all lived in the land of denial at some time in our lives - its difficult to short cut it to the land of reality. Is there a polish organisation that may help, family in this country/
Good luck
Sue
Susan Gorton | OH Nurse Manager | Occupational Health Department | Great Ormond Street Hospital NHS Trust | Level 3, Ormond House, 26-27 Boswell St., London WC1N 3JZ |020 7450 9200 Ext 0247 | DD to OHD 020 78138554 | Direct Fax 020 78138355 | Mobile 07833294568
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Tracy Turner
Sent: 20 February 2012 11:17
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
Hi Susan
I fully agree with you and this is what I have tried to do even making the GP appointment for him. I think he is definately in denial.
Thanks
Tracy
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-----Original Message-----
From: Susan Gorton <[log in to unmask]>
Sender: [log in to unmask]
Date: Mon, 20 Feb 2012 10:14:49
To: <[log in to unmask]>
Reply-To: Occupational Health mailing list <[log in to unmask]>
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
It may be that he hadn't taken a translator with him to his medical appointments and has misunderstood both the risk and the need for compliance. The difficulty with ESL is that people are unable to artcualte their concerns or questions very well and end up with a garbled account of events. If he is made to understand there is no 'cure', tha this medication is for life and if he donest take it, the restrictions imposed upon may put his job at risk (i.e. can you find a redeployed role for him temporarily or permanently is the question here), he may understand the need to be compliant.
We've had some good reports from specialist talking about the fact that compliance with medication (in this persons particular instance) reduced the risk of seizure to 4% which is only marginally more than joe bloggs in the street. That's why the 12 months is needed to ensure the level of meds works.
We restrict anyone who has had a seizure to 12 months removed from patient safety critical activity which in a childrens hospital is holding children/babies/very expensive equipment, using sharp instruments, lumbar punctures and phlebotomy. Imagine someone having a myoclonic jerk with something sharp in their hands or trying to insert a lumbar needle into an exact spot.......
I would see that you may have a role to play in finding out and helping his non-compliance which might help him keep a job.
regards
Sue
Susan Gorton | OH Nurse Manager | Occupational Health Department | Great Ormond Street Hospital NHS Trust | Level 3, Ormond House, 26-27 Boswell St., London WC1N 3JZ |020 7450 9200 Ext 0247 | DD to OHD 020 78138554 | Direct Fax 020 78138355 | Mobile 07833294568
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Tracy Turner
Sent: 19 February 2012 10:56
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
Thank you for your comments/ opinions they have all helped.
-----Original Message-----
From: Karen Shields <[log in to unmask]>
To: OCC-HEALTH <[log in to unmask]>
Sent: Sun, 19 Feb 2012 10:28
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
Hi all
I have dealt with a couple of similar issues with Epilepsy and the food industry. I cant think of any other advice as it appears that we are all in the same way of thought regarding safety, not only for the person concerned but also of his fellow work colleagues etc. I was fortunate that both of the people I dealt with were compliant with medication and specialist appointments. When it comes down to it we are advisors, so all we can do is advise of the best way forward to the company, if they wish to go down the route of dismissing him, as long as they have been advised of all alterations of job spec, area of work, safety aspects, then I cannot see anymore that you can do and as always if all is recorded then it is surely down to the company to make decisions now.
Karen
------------------------------------------------------------
Date: Sun, 19 Feb 2012 09:59:07 +0000
From: [log in to unmask]
Subject: Re: [OCC-HEALTH] epilepsy and non compliance
To: [log in to unmask]
'In my opinion he should be restricted from tasks where altered levels of awareness could endanger worker's safety'?
Regards,
Carr
On Feb 19, 2012 8:36 AM, "sharon naylor" <[log in to unmask]> wrote:
I dont think its a matter of "fitness" as that has a timbre to it thats open to an arguement (I have been there!) . In similar cases I have advised that it would be unwise for him to work in an area or undertake tasks where sudden unprecipitated alterations in levels of consciousness might cause harm to himself, colleagues and/or plant. I would particularly mention moving parts, sharp tools, lone working, working at height, in an area where he has to be vigilant, in an area that is safety critical etc. I would recommend redeployment
My rule of thumb is usually when DVLA allow them to drive they can go back to "normal" duties. However - if your guy is non compliant I cant imagine that he is necessarily following the rules, may well be driving without a lisence etc. Imagine the outcome if he were to have a fit while dealing with a carcass...
We have had previous discssions re paternalism - however in this case the outcome could be serious injury or death, if the employer wants to take the risk then its up to them. But maybe you need a frank discussion with them. I would state what my opinion is - if they want to go for OHP opinion then fine. You may have to live with the fact that they may sack him - but that doesnt alter the clinical facts - he shouldnt be working within his current environment
> Date: Sat, 18 Feb 2012 22:35:32 +0000
> From: [log in to unmask]
> Subject: Re: [OCC-HEALTH] epilepsy and non compliance
> To: [log in to unmask]
>
> Hello Tracy
>
> Its not the factory environment per se that is the issue it is the
nature of
> the tasks he carries out. For example, he may be able to work as a
cleaner
> on the shop floor but not as a process operative working with
dangerous
> machinery such as a butchery band saw.
>
> Just because he has not had a seizure in three months doesn't mean he
won't
> have a seizure in subsequent months eg month 4, 5 etc.
>
> I hope he is not driving - either his or anyone else's vehicle!!!
>
> My advice would be as you have already indicated ie that he should
not work
> on hazardous processes, nor at height and would recommend regular
reviews.
>
> So bottom line - link the health assessment with the risk assessment.
>
> Anne
>
>
> On 18/02/2012 22:16, "Tracy Turner" <[log in to unmask]> wrote:
>
> > Good evening
> > Yet another difficult situation...I will try to be brief 28yr male
> > Polish ( a translator present at all assessments)-
production
> > perative in meat factory. Had a seizure 12 months ago. non delcared
epilepsy
> > he stated that he had seizures before but not done anything about
it.
> > i referred him to his GP and the gentleman advised me that he had
medication
> > to help manage the symptoms. I advsied management to undertake a
work place
> > assessment and that he should refrain from working at heights,
alone or
> > operate heavy machinery for at least 12 months. After 12 months we
could
> > review the situation.
> > A month ago i saw him again with view for him to return to his
original role.
> > He stated that he had taken the three months medication and now was
cured as
> > he had not had any further siezures. I was not happy with this. He
consented
> > for me to obtain a Gp report.
> > The report states that he has epiliepsy - lesion on frontal lobe is
thought to
> > cause the siezures. Has not attended any follow up appointments for
EEG or
> > repeat MRI scan. Seen by GP nurse last August who entered on the
notes that he
> > has occasional seizures and is not complient with treatment. GP
states in his
> > opinion he should take the medication.
> > I have discussed the report with the employee. He still denies
further
> > seizures. I have advised that it is his decision whether or not he
is
> > complient with treatment however I advised that if he is not taking
> > medications I do not think he is fit to return to the workplace. He
said he
> > could not get a GP appointment so I made one for him with his
consent. He is
> > returning to GP next Tuesday and the work place is suspending on
full pay due
> > to medical issues.
> > In my opinion he is more likely than not to have a seizure without
medication.
> > Whilst he is not taking the medication the risk of injury in the
work place
> > are increased. If he continues to refuse treatment would you state
that he is
> > not fit to work in the factory environment? would you refer to an
OHP - I work
> > alone - Thank you for any help as ususal.
> >
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