Devil’s advocate: RCN restructure is a golden opportunity for OH

The restructuring of the Royal College of Nursing’s (RCN) professional advisory department has been greeted with almost universal dismay. Support for an online petition on an OH issue is unprecedented. And while political leadership in occupational health nursing is nothing new, this issue may mark a milestone even if it was too late to change the outcome.

Aside from the fact that one of OH nursing’s most energetic leaders will no longer be employed by the RCN, we should consider carefully the wider implications of this change. Is this change a setback or an opportunity?

Past progress?

Some may argue that OH nursing has made substantial progress in recent years. I would not. Changes in OH nurse training have not proved beneficial changes in OH nurse registration have been unhelpful innovations in practice have been uncommon participation in nursing politics has been limited and, there seem to be fewer OH nurses in influential academic, public and private sector roles.

This lack of progress is not attributable to the work of the RCN’s professional leads, but there are few tangible and enduring benefits that might justify their retention as a driver of OH professionalism.

Future potential

Certainly the professional leads have been a valued source of experienced advice. However, the evolution of online forums means it is easy to tap into a wider pool of experience for free. These forums have the advantages of rapid responses, access to a wide breadth of knowledge, peer review and debate, and the learning is shared among all participants.

A key role for professional leads has been as a focal point for OH issues. It is this issue that I fear has been counter-productive in the past but provides the most opportunity in the future. The direction of OH nursing in the RCN should have been driven by the elected representatives. They share the responsibility. More importantly, they have the mandate from members. They have power. RCN employees, up to and including the chief executive, are accountable to the membership.

This, then, is the opportunity. Rather than bemoan a restructuring, OH nurses have been given an opportunity to hold the RCN leadership to account without any perceived barriers – to stand for election, to vote, to represent, to make sure the full weight of the RCN is behind occupational health.

OH nursing needs a more powerful voice – not the voice of one person, but the voice of the organisation with the largest membership of registered health practitioners in the UK.

Richard Preece is a consultant occupational health physician.

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