On 18/02/2008, Hawkes, Lynda <[log in to unmask]> wrote:

paula,

I fully agree that preparing an employee prior to their return to work helps
the actual return enormously.  I don't include this time in the RTW
programme - that time period begins when they actually attend and begin to
work again.  Bringing them on site a few times for perhaps a coffee or a
chat will help to overcome that initial dread of returning.  I have often
had employees saying that they dread the many questions they will get from
work colleagues when they return and bringing them in for short periods
before the actual return can alleviate this.

Lynda

-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]On
Behalf Of Paula Carroll
Sent: 14 February 2008 12:36
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] rehabilitation programmes

HI Jacqui

Havng worked in various industries and for several in house and external
providers my expereince is that RTW is generally not required for anything
under 2 months, the resistance of the managers to returning someone on
less than 100% can be challenging but my favourite flag is how do they
feel about thier at work employees picking up all the work when the sick
employee could take up 50% plus of this. Would they rather see the sick
pay covering the Gin and Tonics on the patio or contributing to reducing
the impact of the absence on  other employees. Clearly this is said tongue
in cheek but does cause them to take a different view.

Having used 6 weeks returns and 2 day returns for back pain, dependent
upon the norms of the business and our colleagues (which we do have to
work with!!) there appears to be no difference between the 2 for relpase
(this is only based on my expereince) It also address' the illness
behaviour by reminding people that thier bodies are far more robust as a
general rule than they realise. I have had mental health nurses suggest 1
day a week returns which in my opinion is neither use nor ornament as each
week they are having to overcome the RTW threshold resistance factor as I
call it.

A full return to work can begin before they actually return so that the
absence periods is part of the recovery. If they are able to maintain a
work pattern at home building up physical and mental challeneges then the
actuall return can be much more successful and seemless.

My honest opinion is that there is little effective research that I have
been able to find but I am wary of prolonged returns as these reinforce
illness behaviour, (a cure of this is so improtant)

Of course the hardest as ever are where the employer does not want
a 'failing' employee back and the employee is habouring a grivenace (and
these can be quite justified at times) Perception is all.

Another factor that I have observed is that we can be reluctant to
challenge the employee to a faster return as if they complain to thier
employer that we are being 'mean' we would rarely be supported. I do not
critisise any OHN for being cuatious on this rock and a hard place.

Using the multi disciplianry team is invaluable as a valkierie of a physio
can 'tell' an employee what the bottom line is and based on thier
specialism throw them into work apace. I always refer on to practitioners
who act in the patients interest rather from thier 'wants' few lay people
appraciate the damaging impact of unemployment and my feeling is that
our 'public health' role is to reduce unemployment and get peole back to
work ASAP.

Just a brief stab but hope it helps add another opinion as this is a very
grey area of practice and if anyone has some substantial research to prove
me wrong I would be delighted to see it PLEASE!!

Paula

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