Occupational Health: Core Areas of Knowledge and Competence, Part 2

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OHA’s can contribute by helping managers to manage sickness absence more effectively. The nurse may be involved in helping to train line managers and supervisors in how to best use the OH service, in how to refer staff, what type of information will be required, what to expect from occupational  health . By developing transparent referral procedures, ensuring that medical confidentiality is maintained and that the workers’ rights are respected the OHA can do much to ensure that employees referred for assessment due to sickness absence are comfortable with the process.

OH nurses, with their close relationship with workers, knowledge of the working environment and trends in ill-health in the company are often in a good position to advise management on preventing sickness absence. In my experience referral to General Practitioners have a limited use for work related issues, and gain best results by as well as keeping the GP aware, referring to a specialist occupational physician.

Planned rehabilitation strategies, can help to ensure safe return to work for employees who have been absent from work due to ill-health or injury. The nurse is often the key person in the rehabilitation programme who will, with the manager and individual employee, complete a risk assessment, devise the rehabilitation programme, monitor progress and communicate with the individual, the OH physician and the line manager. Nurses have also become involved in introducing proactive rehabilitation strategies that aim to detect early changes in  health  before such conditions result in absence from work. Improving and sustaining working ability benefits many groups, the individual, the organization and society, as costly absence and other  health  care costs are avoided.

In many cases the OH nurse has to work within the organization as the clients advocate in order ensuring that managers appreciate fully the value of improving the  health  of the workforce. OH nurses have the skills necessary to undertake this work and may develop areas of special interest.

The occupational  health  nurse may develop pro-active strategies to help the workforce maintain or restore their work ability. New workers, older workers, women returning to work following pregnancy or workers who have been unemployed for a prolonged period of time may all benefit from  health  advice or a planned programme of work hardening exercises to help maintain or restore their work ability even before any  health  problems arise. Increasingly the problems faced by industry are of a psychosocial nature and these can be even more complex and costly to deal with. OH nurses, working at the company level, are in a good position to give advice to management on strategies that can be adopted to improve the psycho-social  health  and wellbeing of workers.

 Health  and safety

The OHA can have a role to play in developing  health  and safety strategies. Where large, or high risk, organizations have their own in-house  health  and safety specialists the OHA can work closely with these specialists to ensure that the nurses expertise in  health , risk assessment,  health  surveillance and environmental  health  management is fully utilized into the  health  and safety strategy. Occupational  health  nurses are trained in  health  and safety legislation, risk management and the control of workplace  health  hazards and can therefore make a useful contribution to the overall management of  health  and safety at work, with particular emphasis on ‘ health ‘ risk assessment.

Hazard identification

The nurse often has close contact with the workers and is aware of changes to the working environment. Because of the nurses expertise in the effects of work on  health  they are in a good position to be involved in hazard identification. Hazards may arise due to new processes or working practices or may arise out of informal changes to existing processes and working practices that the nurse can readily identify and assess the likely risk from. This activity requires and pre-supposed regular and frequent work place visits by the occupational  health  nurse to maintain an up to date knowledge and awareness of working processes and practices.

Risk assessment

Legislation in Europe is increasingly being driven by a risk management approach. OHA’s are trained in risk assessment and risk management strategies and, depending upon their level of expertise and the level of complexity involved in the risk assessment, the nurse can undertake risk assessments or contribute towards the risk assessment working closely with other specialists.

Advice on control strategies

Having been involved in the hazard identification and risk assessment the occupational  health  nurse can, within the limits of their education and training, provide advice and information on appropriate control strategies, including  health  surveillance, risk communication, monitoring and on the evaluation of control strategies.

Research and the use of evidence based practice

Specialist OHA’s utilize research findings from a wide range of disciplines, including nursing, toxicology, psychology, environmental  health  and public  health  in their daily practice. The principal requirement for an occupational  health  nurse in practice is that they have the skills to read and critically assess research findings from these different disciplines and to be able to incorporate the findings into evidence based approach to their practice. Research in nursing is already well established and there is a small, but growing, body of evidence being created by occupational  health  nursing researchers who investigate occupational  health  nursing practices. OHA’s should ensure that they have access to and the skills necessary to base their practice on the best available evidence. At the company level occupational  health  nurses may be involved in producing management reports on for example sickness absence trends, accident statistics, assessment of  health  promotion needs and in evaluating the delivery of services, the effectiveness of occupational  health  interventions. Research skills and the ability to transfer knowledge and information from published research to practice is an important aspect of the role.

Ethics

OHA’s, along with other  health , environment and safety professionals in the workplace  health  team, are in a privileged position in society. They have access to personal and medical information relating to employees in the company that would not be available to any other group. Society has imposed, by law, additional responsibilities on clinical professionals to protect and safeguard the interest of patients. The ethical standards for each discipline are set and enforced by each of the professional bodies. Breaches of these codes of conduct can result in the professional being removed from the register and prevented for practicing. Nurses have a long and well-respected tradition in society of upholding the trust placed in them by patients. This level of trust in the occupational  health  nurse’s professional integrity means that employees feel that they can be open, honest and share information with the nurse in the confidence that the information will not be used for other purposes. This allows the nurse to practice much more effectively than would ever be possible if that trust was not there. The protection of personal information enables a trusted relationship between employees and the nurse to be developed and facilitates optimum working relationships and partnership. The International Commission on Occupational  Health  (ICOH) has published useful guidance on ethics for occupational  health  professionals’. This guidance is summarized below “Occupational  Health  Practice must be performed according to the highest professional standards and ethical principles. Occupational  health  professionals must serve the  health  and social wellbeing of the workers, individually and collectively. They also contribute to environmental and community  health  the obligations of occupational  health  professionals include protecting the life and the  health  of the worker, respecting human dignity and promoting the highest ethical principles in occupational  health  policies and programs. Integrity in professional conduct, impartiality and the protection of confidentiality of  health  data and the privacy of workers are part of these obligations. Occupational  health  professionals are experts who must enjoy full professional independence in the execution of their functions. They must acquire and maintain the competence necessary for their duties and require conditions which allow them to carry out their tasks according to good practice and professional ethics.”


Source by Craig Michael Page



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