FOHNEU speaks out for occupational health nursing

The Federation of Occupational Health Nurses within the EU (FOHNEU) was set up to provide a voice for occupational health nurses in Europe. Katie Oakley examines the impact of the organisation.

The FOHNEU claims to represent the largest group of OH professionals (45,000) in Europe. Its mission statement and aims are “to consolidate and represent the voice of occupational health nursing within the EU in order to promote the health, safety and wellbeing of the European workforce”.

The Royal College of Nursing (RCN) was instrumental in the initiative – using a European Commission grant to help fund an OH nurse symposium in England in 1993. This led to the establishment of the FOHNEU, which is now active in all European institutions that relate to nursing or OH. The fifth FOHNEU international congress will take place in Spain in 2012.

But the RCN no longer subscribes to the FOHNEU. Why not? And what is the likelihood of future UK involvement? This article summarises the FOHNEU’s role and achie­vements, and explores possible reasons behind UK OH nurses’ apparent apathy towards networking in Europe.

FOHNEU mission statement

To consolidate and represent the voice of occupational health nursing within the EU in order to promote the health, safety and wellbeing of the European workforce.

The inaugural symposium in 1993 and the rationale for the formation of a European organisation were greeted enthusiastically (Mcgraham, 2002): “The decision taken by those present was that there was a need for an organisation representing all OHNs within the EU and FOHNEU was born. They believed that no single country had the best health and safety system or the most effective methods of controlling or reducing the toll of occupational ill health. Through partnership and support for each other real progress could be made to ensure that Europe’s workplaces are healthier and safer. The challenges – but potentially opportunities and benefits – are tremendous if Europe’s occupational health nurses, the largest group of health and safety practitioners in close daily contact with workers, can work together for the common good.”

Subscription info

Membership of the FOHNEU is open to national OHN associations within the EU – with observer status available to non-EU countries. Funding is by sponsorship and subscription (on a sliding scale of €50 to €1,000 per annum based on national association membership numbers).

There are 15 (out of the 27 EU member states) subscribing members of the FOHNEU. Board members are allocated different project areas covering political development, education and research, sponsorship and fundraising, congress and ad hoc work. English is the lingua franca of the FOHNEU. But English is not the first language of most members and, with a range of cultures, economies and infrastructures within Europe, meeting face-to-face at twice-yearly board meetings aims to assist mutual understanding and communication.

International contacts

The FOHNEU is the voice of occupational health nursing at European level and is in contact with:

  • the European Parliament;
  • the European Commission (EC);
  • the European Foundation for the Improvement of Living and Working Conditions (Dublin);
  • the European Agency for Safety and Health at Work (EU-OSHA) (Bilbao);
  • the European Federation of Nurses Associations (EFN); and
  • the European Specialist Nurses Organisation (ESNO).

Julie Staun, FOHNEU president and Danish representative, says: “Links have become closer between EU-OSHA and FOHNEU since 2007, when we were invited to become an official partner in the agency’s Healthy Workplaces Campaign. The agency also hosted one of our board meetings.”

Moreover, she continues: “FOHNEU is recognised by the EC and EFN as one of the most dynamic and effective groups of specialist nurses. We make sure our voice is heard by responding to consultative documents – for example on pensions reform – and by speaking and networking at conferences around the globe.”

Twinning project

Alongside EU enlargement, the FOHNEU has also grown, with a recent board meeting in Slovenia attended by 17 representatives. Observers from Slovenia, Turkey and Croatia were also present thanks to the FOHNEU’s twinning project. This project aims to attract more members and observers by identifying occupational health nurses in other countries and contacting them. The “we go to them” initiative has proved successful in marketing and expanding the FOHNEU.

quotemarksWe make sure our voice is heard by responding to consultative documents and by speaking and networking at conferences around the globe.”

Julie Staun,

Susan Pierrot, French representative, explains her link with Romania: “This started the ‘we go to them’ idea for the first contacts. We held a board meeting in Bucharest, and France pays Romania’s FOHNEU subscription in addition to our own. The French association will continue to support the Romanians as they develop OH nursing.”

Henriett Hirdi, of Hungary, is also enthusiastic about twinning. She was contacted by her national nurses association following an approach to them by the FOHNEU. “Exactly one year later, we organised a meeting in Budapest,” explains Hirdi.

“I’ve now been elected vice-president and been to Brussels to receive our partner certificate at the Safe Maintenance Conference. And we’ve had a breakthrough with a new twin country – the Czech Republic. I’m working to secure an OHN representative there and will be presenting at the 30th Jubilee Congress of Occupational Medicine in Prague this October.”

In Malta, the profile of OH nursing was raised at a board meeting in 2009 at the invitation of the Maltese Union of Midwives and Nurses (MUMN). Staun says: “MUMN president Paul Pace held a news conference stating that OH provision was lacking in the healthcare sector and that contracting infectious diseases, back and neck injuries, and psychological trauma are common obstacles for healthcare workers, yet they get little information promoting good health and preventing sickness.”

Staun appeared on Maltese TV promoting the importance of access to competent OH professionals, and in 2010 the Maltese health minister created two OHN posts in state hospitals.

Defining OH nursing

“Occupational health nursing aims at securing the health, safety and wellbeing of the workforce. This is achieved through assessing, monitoring and promoting the health status of the workers, and developing strategies to improve the working conditions and the total environment.” (FOHNEU definition, 2010.)

But why the need for a definition? “We wanted to emphasise preventive work and health promotion and the unique role of the nurse as part of the OH team,” says Staun. “Representative Marguerita Raistro told us they’d succeeded in changing the dictionary definition of ‘nurse’ in Portugal. This inspired us to define the OHN and, after prolonged discussions, we agreed a consensus definition.”

Clearly, this definition complements FOHNEU’s 1996 adoption of the Hanasaari model of OH nursing (designed at an earlier workshop of European OH nurses facilitated by innovative OH nurse, the late Ruth Alston).

OHN education

The FOHNEU launched its Core Curriculum (FOHNEU, 1997) at the International Commission on Occupational Health (ICOH) Congress. It is a baseline document to be adapted at national level, aimed at a consistent approach across Europe. The goal is equality of access to OH nurse education. The curriculum was developed using EC funding.

The MMedSci (occupational health nursing) online course was launched at the FOHNEU’s 2007 congress. The FOHNEU was initiator and partner in this programme, which is based on its Core Curriculum (Sourtzi, Atwell et al, 2006).

Harmonising Occupational Health Nursing in the European Union (HOHNEU) is a master’s degree coordinated by Sheffield University, but applications are not currently being considered.

A spokesperson for the university said: “Due to a decrease in application levels, the university has decided to suspend the HOHNEU course this year. The course will remain suspended until further notice.” Staun hopes that there is a future for this degree. “It will take time to become established,” she says. “It needs a really good marketing strategy across Europe.”

The FOHNEU also conducts questionnaire surveys across Europe on the status, training and working practice of OHNs (FOHNEU 2005, 2009). Staun, along with Greek representative Professor Panayota Sourtzi, University of Athens, Department of Public Health, will present the findings of the latest survey at the fifth international FOHNEU congress in 2012.

The international voice of EU occupational health nursing

In addition to organising its own international congresses (Belgium 1997, France 2000, Finland 2003, UK 2007 and Spain 2012), the FOHNEU worked closely with ICOH and provided assistance for the WHO publication on OH nursing (Whitaker and Baranski, 2001).

Aims of the FOHNEU

  • To contribute to the health, safety and wellbeing of the European working population;
  • To raise the profile of occupational health nursing within the EU;
  • To promote OH training, education and standards of professional qualifications;
  • To encourage research into practice, education and management with publication of the results; and
  • To maintain a dialogue with EU organisations responsible for health and safety, public health and EU nursing authorities.

“I think the concept of OHNs across EU member states coming together to share in the development of the profession is a really important and valuable goal,” says Stuart Whitaker, director of the Centre for Occupational Health and Wellbeing and a longstanding member of ICOH. “However, when I look at FOHNEU and particularly the UK’s relationship with our European colleagues in FOHNEU, it seems that this important goal has not been realised.”

Whitaker thinks reasons for this include: “Politics between the different groups and between individuals involved, and lack of a clear focus on producing things that make a real difference to OH nurses in practice.” However, he adds: “I do believe that the UK should be present and play an active part alongside our colleagues and friends in Europe; we can also benefit from contacts across the rest of the world.”

Relationship with the UK

So why has the RCN ended its membership of the FOHNEU?

“The RCN has a dedicated International Department and is a member of ICN [International Council of Nurses],” says Jan Maw, RCN public health adviser.

“However, the outgoing committee of the old Society of Occupational Health Nursing recommended to the RCN that they would not be renewing their subscription as a member to FOHNEU, but that if there was an opportunity to work with FOHNEU on any task and to finish projects or promotion of activities, then the committee would be more than happy to consider them.”

The FOHNEU’s president says that she would like to have the formal link with UK OH renewed. “We really miss the UK but we need people to belong to the organisation and be properly involved in the hard work to be done between, and at, meetings,” she adds. “Yes, it’s a long haul and, as with occupational health as a field, sometimes the results may be difficult to measure in the short term but the long-term benefits are immense.”

Sharing ideas

“We work efficiently using emails and Skype and, when we do meet, the sessions are focused with much networking taking place in the evening. This helps develop communication and bonds and professional relationships that develop over the years,” says Staun.

FOHNEU presidents and board members have had a clear vision from the outset. Convinced of the benefits of meeting colleagues from other counties and sharing ideas and practice, their aim has been to contribute to improving the health and wellbeing of the European workforce.

A lofty aim perhaps, yet, despite the obstacles, in fewer than 20 years the organisation has grown from six to 15 member countries and has been successful in obtaining grants for its projects. UK OH nurses who want to assess the benefits of the federation can attend the conference in Spain next year and get involved.

Katie Oakley is a freelance writer specialising in public health.

References and further reading

FOHNEU (1997; revised 2002). Core Curriculum for Occupational Health Nurses. (accessed 10_05_2011).

FOHNEU Education Group (2005). “Occupational health nursing: education and practice in the EU countries”. (accessed 10_05_2011).

FOHNEU (2009). “Benchmark survey on occupational health nursing within EU member states”.

Mcgraham C (2002). “European perspectives in occupational health nursing”. Occupational Health Nursing (2nd edn). Chichester: John Wiley and Sons Ltd.

Sourtzi P, Atwell C, Claesson A, Rasteiro M and Aguirre G (2006). Eurohvision. Occupational Health 58(11)11-12.

Whitaker S and Baranski B (eds) (2001). “The role of the occupational health nurse in workplace health management”. Copenhagen: World Health Organisation.

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