In this new series we publish an actual professional problem encountered by
a reader and suggest some ways of dealing with it.
We are asking readers who may have come across similar problems in their own
practice to write in and suggest solutions that worked for them. The person who
sends in the best advice for dealing with the previous month’s dilemma will win
a bottle of champagne.
We also invite readers to send in their own dilemma for publication –
senders will be kept anonymous if requested. Champagne also goes to any reader
who has a dilemma published on this page
This month’s reply
A I agree that all your
actions listed could be followed but my initial action would be to interview
the employee concerned first, to take a medical history, a work pattern
history, check for raised blood pressure which can cause headaches and to
discuss any work or home issues which may be causing stress. This would then
give some clearer indication as to which route should be followed.
For raised blood pressure I would refer back to the GP with an offer to
monitor it regularly at work. For stress related problems counselling would be
offered either in-house or from an external agency.
If the problem appeared to be related to the work environment I would also
carry out a light level survey and check whether any lightbulb/ fluorescent
tubes have recently been replaced as these can significantly increase
brightness. A work place visit would also be useful to observe posture when
using a VDU and any other equipment and to see whether the desk position is
near any other equipment.
This month’s question
Q I am currently employed as
an occupational health nurse within a financial institution. Recently, a line
manager approached me expressing concern regarding an employee on whom I had
recently performed a pre-employment health assessment (by questionnaire) as
being fit for employment. The employee has been in the post for almost five
months and during this time has demonstrated a regular pattern of short-term
absence totalling five episodes of nine days with a diagnosis of back pain.
The manager has been informed, in confidence, that the employee has told her
work colleagues that she has a chronic back problem which caused some problems
in her previous employment, although she did not disclose it on her health
questionnaire in fear of not being appointed to the post. The manager has asked
me to disclose whether or not the employee disclosed her chronic back problem
in her pre-employment health questionnaire.
What should I do? Should I disclose what the employee declared on the health
I was recently approached by a team leader regarding some concerns from
fellow employees about a positive smell of urine surrounding a certain
employee. The team leader felt it was a very sensitive issue and asked If I
could deal with it.
The man concerned is nearing retirement age and has never been absent from
work in seven years. He is very conscientious and popular with his colleagues.
I had a challenging situation on my hands and I wondered how I could go about
addressing this tactfully in order to preserve the mans dignity and pride.
Within the facility we undertake respiratory surveillance; everyone over the
age of sixty has to have a lung function test annually. I decided to take this
route, so while out on the factory floor doing routine lung function
questionnaires I came to the man concerned did the questionnaire with him and
then identified that he was over sixty. I then pointed out to him company
policy on the lung function test.
While testing the man in the privacy of the occupational health suite I told
him I could use the time to do to an employee voluntary health screen if he was
willing. He consented to this When I asked him If he had ever had any trouble
with elimination, he proceeded to tell me he was experiencing dribbling after
he had been to the toilet and it had been causing him some concern. I reassured
him this was a common problem for men over 50. and asked him to visit his GP.
Around a month later I called on the man to see what progress had been made.
He told me he was now on tablets after a full discussion with his GP .The team
leader was very professional in approach as nothing more was said about the
incident. This enabled confidentiality issues to be upheld.