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Nurses help to keep it safe at work

The role of the occupational nurse has moved from mainly clinical duties to involve more on-the-job training and risk management. By Mardi Chapman

Occupational health nurses might have to wear high-visibility vests on the job but their size and prominence as a nursing speciality is fast-diminishing.

Specialist occupational health nurses were the mainstay of occupational health from the late 1970s to the ’90s, but in recent years their numbers have declined and the nurses’ role has taken on a more generalist Occupational Health and Safety function.

The specialty’s professional body, the Australian College of Occupational Health Nurses (ACOHN) effectively disappeared when it was absorbed into the Australian and New Zealand Society of Occupational Medicine (ANZSOM) in 2009.

And their numbers are so small they don’t even rate a specific mention in the latest Nursing and Midwifery Workforce report, although they are probably represented in the 0.4 per cent of nurses employed in commercial and business settings.

As workplaces have changed, so too has the traditional role of the occupational health nurse, says Sally Kane, chair of the Victorian branch of ANZSOM. Kane has worked as an occupational health nurse for more than 25 years and says the traditional focus on treatment-orientated care has largely gone.

“As industry has changed, so has our role. It’s rarely a clinical environment now. We would argue that we’ve expanded our scope of knowledge and practice to reflect what the job market wants.”

That scope of practice can also include responsibilities for safety and risk management, environmental health, and even security depending on the employer or industry.

Like many other occupational health nurses, Kane found herself working in the role before she had any specific training. Later, she was in the first cohort of students through a postgraduate diploma in occupational health at the Lincoln Institute of Health Sciences in the early 1980s before it merged with La Trobe University.

“Nurses are very resourceful and willing to have a go. However, we were also very keen to get qualifications and official recognition for the work we were doing,” she says.

For many occupational health nurses particularly those who specialise in sectors such as mining, industry specific courses are often the way to up-skill.

Kane has worked in hospitality, retail, heavy industry, as a consultant, and in the technology field.

Not surprisingly, the job can vary significantly.

In her current role at Agilent Technologies her duties can range from conducting staff health checks with a visiting occupational physician to providing advice on the health implications of new processes or products. “It’s such an interesting and dynamic job and I’ve had the opportunity to make it my own,” she said.

Sandra Code, health services manager at pharmaceutical company Hospira Australia, also loves the variety in her job, which ranges from injury management to rehabilitation, pre-employment health checks and exit medicals.

She says health surveillance of some 600 staff is an important part of the job especially when cytotoxic drugs are on the company’s product list.

“Travel health is also important as the company is in 92 countries and we have a duty of care to make sure our staff are safe wherever they are. That includes vaccinations, medications and ensuring workers are fit and healthy to travel.

“I like the fact that I am dealing mostly with healthy people and when they have been injured or unwell, helping them back to work.”

She also co-ordinates an employee assistance service for staff and their families to access counselling. In a previous position at another company, Code had the challenge of turning around a “WorkCover culture” where people thought they could be on ongoing restricted duties.

“I’m always trying to be proactive so that workers feel well supported, which is cost effective for the company in the end. I’ve seen workers with serious fractures who can’t believe how much the company has supported them to get back to work.”

She says many companies, including some she has worked for in the past, no longer employ occupational health nurses. “I think a lot of companies don’t realise what an occupational health nurse has to offer. Instead they might use first-aiders and a return to work co-ordinator.”

Many companies are also are outsourcing the role.

Wendy Hayes moved into occupational health nursing after a car accident meant she couldn’t return to her physically-demanding job in a rehabilitation unit.

“I know from experience that an injury can have long-term consequences. Essentially we are dealing with well people who may be temporarily requiring some assistance with an injury,” she says.

“Occupational health nurses need to be generalists and know a little or lots about many things. I love helping people whether it’s for a debrief, assessing whether their job is compatible with existing health issues, or monitoring occupational exposure to risks such as noise and chemicals.”

Hayes, who works for Dulux, also enjoys the autonomy of the job and says other nurses are attracted by the regular hours, especially after years of shift work in hospitals.

There is a general feeling that occupational health nurses may be a “dying breed” but initiatives to better define and eventually accredit OHS expertise offer some hope.

A document Core Body of Knowledge for the Generalist OHS Professional, auspiced by the Health and Safety Professionals Alliance (HaSPA) and supported by the Safety Institute of Australia, was published earlier this year.

It recognises the many professions such as occupational physicians, nurses, hygienists, ergonomists and rehabilitation providers whose work overlaps on tasks such as workplace and risk assessment, health and environmental monitoring and injury management.

“This is the start of a process of trying to capture knowledge from the different industries and disciplines for generalist OHS accreditation,” says Kane.

“We’re also trying to articulate the different levels of expertise that an occupational health nurse might have that others don’t, so there is still room for specialisation within that group. I’m passionate about the fact that my core training is nursing and that got me to where I am now.”

Fact file
• 53 in every 1000 workers experienced injury or illness associated with their workplace in 2009-10, according to the Australian Bureau of Statistics.
• Many workplace injuries are mild injuries such as sprains, strains, cuts and other wounds; only about half involve taking more than a day or shift off work.
• 216 deaths were recorded during that same period relating to a workplace injury.
• In 2008-09, costs associated with workplace injury and illness were estimated at $60.6 billion, according to Safe Work Australia.

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