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I agree with Chris, So a treatment service is out of the remit of an OH Nurse, I'm afraid not! We are supposed to practice holistic healthcare.what was it the WHO said "The effect of work on health and health on work". Great in a big organisation where you can justify your 40 hour week with policy and advice on work related risk and statutory compliance but what about the nurse in a small manufacturing company. My previous role was as the senior nurse manager in a multi site independant provider where perhaps the organisation buys in a nurse for one day a week principally looking at sickness absence and statutory compliance because that is all these companies want or can afford to buy. For that they will pay over 12k for one day a week over a year, personally we have gone into factories who traditionally employed nurses full time to provide treatment services, health surveillance, counselling and anything else that came along, on such sites the requirements for High level OH intervention only took a few hours a week, but the staff felt supported and it was good for their welfare. So now the independant provider comes in and says you dont have to have this treatment/welfare service because to ensure statutory compliance you only need one day a week "We can save you money" but bye bye full time nurse. So what is wrong with providing these support services, we all trained as general nurses, we all give advice on absence based on (I hope) medical knowledge, many of us train first aiders and some have A& E Experience, my first OH job was on a DERA site employing 180 people and I was part of an emergency crash team, then a few jobs later I was OH manager in a major Dockyard with its own treatment/centre, in between I have done jobs with no treatment service but OH has many different forms, the world is not square. I have in the past tried to recruit degree level nurses who state that "they do not want to do health surveillance because they have moved on from that" Do I get a feeling that providing treatment is also below some of us" ITS A BIG WORLD OUT THERE Comments please David R Maslen-Jones RGN BA Spohn MIOSH Clinical Nurse Manager, Occupational Health Plymouth Hospitals NHS Trust Derriford Plymouth PL6 8DH Tel: 01752 517592 int:57592 [log in to unmask] -----Original Message----- From: Harrop, Chris [mailto:[log in to unmask]] Sent: 30 January 2004 13:04 To: [log in to unmask] Subject: Re: TREATMENT SERVICE from Kaaren 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 ~~~~~~~~~~~~~~~ Please remove this footer before replying. Visit http://www.jiscmail.ac.uk/lists/occ-health.html for list archives "This transmission is strictly confidential and intended solely for the addressee. It may contain information which is covered by legal, professional or other privilege. If you are not the intended addressee, you must not disclose, copy or take any action in reliance on this transmission. If you have received this transmission in error, please notify us as soon as possible." ~~~~~~~~~~~~~~~ Please remove this footer before replying. 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