Inside view would make the difference

We have been surprised to see very little published discussion regarding the
future of OH nursing within the public health agenda. The Making a Difference
document, therefore, came as something of a surprise in its context and tenor.
It was rather difficult to find anything "new" in an occupational
health sense, within it and on the whole we found it patronising to OH nurses.

Department of Health assistant chief nursing officer Gill Stephens states
that the document is a useful resource for OH nurses in starting to play their
part to improve health within the wider public health programme. But OH nurses
are already well ahead both in promoting health in the workplace and
influencing life outside work.

This is evident when, as tutors, we regularly assess students’ workplace
practice and have the opportunity to observe the innovative practices of their
OH nursing colleagues.

She also states that the OH nurse will need to take the lead in assessing
and responding to health needs in the workplace. This has always been the basis
of OH nursing.

This document contained several "examples in practice" which were
all everyday OH issues for the average OH nurse. It is difficult to believe
that any OH nurse would not be familiar with the essential applications of the
Disability Discrimination Act and the Working Time regulations.

As with all other trained nurses, OH nurses have a duty to keep themselves
professionally updated and abreast of current knowledge. In our experience they
have always taken this obligation seriously.

Liaison with social workers and community nurses is, of course, to be
encouraged and we are sure that many OH nurses already do this to some degree.
Many years of experience within nursing generally indicates to us that social
workers, community nurses, health visitors and OH nurses, are already so
overburdened that they struggle to cope with existing pressures, without
attempting to take on additional ones.

We are not informed as to whether employers in the NHS and industry are
backing this proposal document: has a needs assessment been undertaken for this
group of stakeholders? Will they be willing to allow their OH nurses time to
teach voluntary groups, and primary care workers first aid?

Some of the functions proposed within the paper are already within the remit
of the other professional groups, mentioned before. The fact that such
professionals are overworked and under resourced does not mean that OH nurses
should take on their roles.

Liaison for the greater good is commendable and well worth the effort, but
absorption into the public health function and the inevitable dilution of
expertise among all professional groups would appear to be a backward step.
This document makes no reference to evidence-based practice or research, which
would support this way forward.

We are encouraged to learn that some consultation is taking place on this
document, but would like to be assured that the selection of those invited was
by a random method.

We have discussed this document with a large number of OH nurses within our
dual educational and professional roles, who also found it patronising and
worrying in terms of future OH nursing practice. We would like to be reassured
that further democratic consultation will take place before a definitive
document is published.

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