Blog – Reflections from a former Occupational Health Nurse

Blog – Reflections from a former Occupational Health Nurse  

Insights into how Occupational Health really works.

When I was asked to write this blog about my experience as an Occupational Health Nurse, I thought it would be quick and easy. After all, I have twenty years’ worth of specialist training, experience from different industries, organisations, and locations, not to mention working as an employee, contractor, ad hoc, on-site, and remote to draw from. How could it be difficult? I quickly realised I had enough material to write several volumes! I’ve spared you that and will focus instead on the benefits I found of working on site.  

Understanding the organisation and its culture

I have experienced a wide range of corporate and local cultures and seen just how deep their impact can be. I found that when working remotely and only knowing an organisation through referrals, it was impossible to get an accurate picture because of missing information and nuances. For example, I remember walking into a large open-plan office and immediately being aware of a very tense atmosphere. It was silent, too silent. During my visit, I felt the atmosphere change to a more relaxed one (but still silent) and then revert again about 10 minutes later. It coincided with a particular manager leaving and re-entering the room. I’d spotted several people who were on my current list for mental health conditions. (There had been a recent rise in manager and self-referrals from this site). I hadn’t appreciated that they all worked in the same room. It proved to be an important common denominator in all the cases and one I would’ve missed if just working remotely.  

Having access to an organisation’s policies and procedures enabled me to give more bespoke advice and guidance, as it was easier for me to quickly find what was available, possible and how it could be accessed. For example, knowing how to find out what software the organisation has licences for and how people could access it immediately, or the services that their EAP offered, what that meant and how to access them.  

I have often found that where the culture is good, referrals are made early when much more can be done to help the employee and the manager. There is trust and a ‘can-do’ attitude, which often results in no absences or a successful and quicker return to work where absences are needed. There is also a lower risk of a person developing other conditions and flare-ups of pre-existing ones, such as depression and anxiety. Early intervention is better for everyone.  

Late referrals are often indicators of problems that need to be investigated. There are myriad reasons that may be behind them at an individual level to an organisational culture. The most common causes I found were a lack of training for managers, a ‘toxic’ workplace culture, and previous bad experiences of OH. I used to get so frustrated with late referrals as the negative impacts on the individual, their family, team and the wider organisation were so clear to see, and avoidable.

Knowing the jobs

I’m nosey and love finding out about people and the jobs they do. I loved going out on site, or onto the floor to see how things were made, maintained, and skills needed for every job. This information was a vital part of my role. How could I assess a person’s fitness for the role, plan their return to work, or work to prevent ill-health or acquired disabilities if I did not understand the tasks involved, and the working environment? For example, wearing full PPE on a hot day, and following someone spending much of it climbing up and down stairs or vertical ladders, and watching them carry out tasks, in an awkward place. All to gain an understanding of the physical and mental impact on the body and the real or potential challenges people face. It was truly eye-opening, especially in different weather and lighting conditions and a realistic way to assess a person’s medical fitness to carry out their role and identify any difficulties. This is true of any job in any environments be it desk-based, store, factory, ‘on the road’, or a combination. Desk-based site visits could be just as informative as the more ‘glamorous.’  

Being able to carry out site and workplace visits also gave me the opportunity to ask a lot of ‘why?’ questions. Why do you do that? Why do you do it this way? It was also an opportunity to tweak the bad habits we all develop, such as desk ergonomics, carrying too much stuff we don’t need for the job, and identifying areas for improvement as I was coming in with fresh eyes.  

Delivering training was both terrifying and motivating. Having the opportunity to work with managers, Safety and HR and give them the tools and understanding behind processes, actions and OH recommendations was amazing. In some organisations, these groups are met with distrust and suspicion and so to help support them support their teams and turn that around was so gratifying. Being on-site meant I could do this more informally too through conversations with managers on a one-to-one basis.  

The people

No two people are the same and we all come with our own unique experiences, beliefs, attitudes, challenges, and skills. This makes us complex and interesting. It also means that one solution does not fit all when it comes to disability, health and work. The holistic approach is so important to me.  

Going out on site, attending all staff meetings or training, helped me get to know people and, for better or worse, them me. I was part of the overall team, just like everyone else.  

I found that getting to know people outside of the consultation room really helpful for building trust and reducing the understandable worries individuals may have when they were seeing me in a professional capacity. For example, eating lunch with different teams broke down barriers as we talked about non-work topics, and had a laugh. It was also inadvertently often a way of demonstrating the importance of confidentiality. I remember one person saying, ‘Well, there is no point asking you as I know you won’t tell us.’ So true.  

Being able and feeling comfortable enough to contact a colleague for advice is important. Most experienced OH professionals will have special areas of interests. These might be at the local level within the organisation, or as industry or world-experts in a particular niche. Access to these people can make a big difference to the level of advice OH can give an employee, manager and HR, and can mean the difference between thriving at work and losing their job.  

Personal highlights

Working on site meant that I felt part of the wider team. I was often working mostly remotely from the rest of my team. OH can be a lonely role in many ways as in many cases people only know you if they are referred to you. In most of the organisations I worked for, I was lucky to be involved in a range of other related duties where I could meet other people. For example, safety meetings, pre-retirement talks, health promotion, global challenges, planning new projects and construction, and training. It also made it easier for people to talk to me without the perceived stigma of having seen OH.  

I enjoyed the prevention side of the role, such as pandemic and major incident planning, working with safety to identify and introduce changes to reduce workplace hazards. My proudest moment on this is drastically cutting the number of occupational dermatitis at one site. Another is when an HSE inspector credited OH as the only reason a site wasn’t shut down immediately.  

I liked following people through their journeys from referral to discharge. In most of my jobs, I was able to arrange reviews to monitor progress and tweak recommendations if necessary. Just seeing a person once and not knowing if the advice was implemented or it worked was not for me. Reviews were also opportunities to satisfy my problem-solving and ‘can-do’ needs.  

Making a difference

Like most people, when doing a job, I did not really appreciate the difference I was making. I’d hear the complaints as I did my job (thankfully rare), but the good results, you usually only hear when you leave. Having people from all levels of organisations drop in to say, ‘thank you’, the cards and emails with heartfelt comments of appreciation, presents and leaving events are things I will always cherish. For me though, making a difference was seeing people develop and thrive against the odds and knowing I’d been part of team behind it was, and still is, my main motivator.  

If you have reached this far, thank you for staying with me through this meandering and self-indulgent trip down memory lane. I hope it was of some interest and has given you a lesser-known perspective of OH.