Visit # 1 Hospital Health Care Facility Occupational Health Nurse

This is the first visit to what OHNIG hopes is one of many. Today OHNIG takes you on a visit to a busy Occupational Health Nurse in a health care facility. The detailed description of the work activities provides the many ways a hospital Occupational Health Nurse functions on a daily basis. Most important, are the variety of ways an Occupational Health Nurse influences, improves or maintains a worker's health using prevention, protection and pro-active health care interventions. An Occupational Health Nurse means productive healthy workers in a healthy workplace. Link to visit a Hospital Occupational Health Nurse

Marla, an Occupational Health Nurse, begins her workday early. On arrival at work, her first task is attendance management. She listens to her confidential phone messages, and finds that five workers have called in sick with respiratory infections. She returns their calls, assessing when they may be able to return to work (RTW). She informs them their return will depend on them being without a fever for 48 hours. Marla notifies the managers of their employee's anticipated RTW date. Marla then learns that three other workers on the same unit are also ill. As occupational health protocol requires, Marla notifies the Infection Control department of a potential outbreak. She continues to follow up on her other messages. Two workers have gastro-intestinal problems. She contacts them and advises them to stay home for 48 hours until their symptoms resolve.

Next Marla attends a scheduled employee return to work planning meeting. Several weeks ago, Dee suffered a hand injury in the workplace. The employee, her manager and Marla together discuss a plan for modified work hours and job duties to allow Dee to gradually continue her recovery while returning to full duties. Later, Dee's manager expresses to Marla a hesitancy to make these workplace accommodations. Marla provides information and education on the value of early and safe return to work (ESRTW) which includes describing the financial benefits to the organization by accommodating and reintegrating Dee. The manager agrees with the RTW accommodation strategy.

Fran visits Maria's office to discuss a personal issue about her teenage son who has become defiant and is skipping classes at school. Maria counsels Fran to seek help for herself and her son. She refers Fran for counseling through the organization's employee benefit program, the Employee Assistance Program (EAP).

Marla attends a meeting with her manager to discuss her role in reviewing policies for the upcoming organization health and safety assessment that is part of the accreditation process. She is asked to review and update all the workplace policies pertaining to Occupational Health and Safety in time for the review. After the meeting, Marla's manager requests medical documentation for Dee's injury. Dee's supervisor had voiced concerns to the manager about Dee's injury and so Marla diplomatically points out the requirement of confidentiality for all employee health files. Dee's health file cannot be accessed without her written permission.

When Marla returns to her office, she finds Dan waiting to see her with a completed incident report. Dan had a “near miss” for a slip and fall on a wet floor being cleaned in a hallway. Marla investigates the cause to provide corrective action to prevent a similar incident. She first calls housekeeping and asks to have the hallway floor cleaned of the “wet” slippery substance. Marla made inquires to the sanitation supervisor and the purchasing department to determine the name of the “cleaning liquid” on the floor. Marla then locates the Material Safety Data Sheet (MSDS) with the complete description of the liquid. Marla reviews with housekeeping department and Dan the material safety data sheet (MSDS), reinforcing the safety precautions, the chemical properties and the handling procedures of the liquid substance. The MSDS indicates workers must wear proper Personal Protective Equipment (PPE) i.e. non slip boots and gloves whenever using or being exposed to this product.

On returning to her office, Marla returns a call to the Workplace Safety Insurance Board (WSIB). The WSIB have medically approved Owen to return to work, however the WSIB case manager states that Owen has refused to accept the modified work he was offered. WSIB states that they have spoken with him, and will not be paying for lost time. Maria contacts Owen, who is upset; she advises that he should discuss the situation with his WSIB case manager.

A new employment pre-placement health review for Mark is completed and documented with clearance given to his supervisor. A N95 respirator fit test is performed. He is provided with education regarding proper hand hygiene practices, how to report incidents, how to report absences and is given a flu shot.

Over the lunch time, Marla conducts a wellness class that incorporates healthy eating, exercise, weight management and ends with a 15 minute fresh air walk using pedometers, provided by the workplace.
That afternoon, Marla attends the employee and employer Joint Health and Safety Committee (JHSC) meeting. She goes over the worker injury reports for the past three months, indicating a developing trend of employees at risk of musculoskeletal injuries due to lifting. Marla suggests specific training and education in the use of the workplace lifting equipment for employees. Marla further mentions that during her occupational health and safety walk-through inspection, first aid kits were being overly used by employees, allowing injuries to go unreported. She advises the committee to reinforce with the workers how to report injuries and complete incident reports.

Marla also notes to the JHSC another significant finding. Mandy, an employee who is deaf works in the computer equipment room which is glass enclosed. In the event of a fire in the enclosed computer room the fire sensor triggers the release of a special gas to extinguish the fire. Mandy would be unable to hear the alarm and would be exposed to toxic fire extinguishing gas. The JHSC agrees to have a flashing visual fire alarm installed. Later, Mandy personally comes to Marla and thanked her for caring about her health and safety.

Marla returns to her office to prepare her month-end report. This report includes a statistical analysis of the organization's return on investment (ROI) in the early and safe return to work program. The program, which has only been operating for one year shows a substantial reduction in lost work-days and related costs. Marla knows her reports to management are necessary. Marla also knows “what gets measured gets done”! Although these reports are time consuming, it is a necessary task to generate the organization's commitment for healthy workers in a healthy workplace.

Marla spends the rest of her afternoon working on a presentation for the new employees and supervisors regarding their responsibilities under the provincial Occupational Health and Safety Act and Workplace Hazardous Material Information System (WHMIS).

While closing her files and locking up, Marla is pleasantly surprised by her last telephone call for the day. Fran called to thank Marla. Fran took Marla's advice and she and her son had an appointment to see a counsellor. Marla leaves her office with a feeling of accomplishment. She had a good day! Marla looks forward to returning to work tomorrow.

OHNIG thanks Maila Riddell, OHNIG Professional Practice leader, for her job description of a hospital occupational health nurse.