Diane Romano-Woodward is president elect of the Association of Occupational Health Nurse Practitioners UK (AOHNP), director of OH provider Sunny Blue Sky Ltd and a former Occupational Health Nurse of the Year. In this article she details what she has learned from her experiences in the OH profession.
How did you get into OH?
My interest in health and safety at work started when I became a Royal College of Nursing safety representative. I was working in operating theatres at the time. I interacted with the staff from the hospital’s OH service when supporting individual members, and also took part in initiatives to improve health. I preferred the health and safety aspect of my activities so decided to specialise in OH, and became a bank nurse in the OH department.
There was no money back then for training in the NHS, so I applied for, and received, a Birmingham Hospital Saturday Fund scholarship to do the Master of Medical Science in Occupational Health course at the University of Birmingham. This course was designed to prepare physicians for associate membership of the Faculty of Occupational Medicine, so the students were a small multidisciplinary group of physicians, nurses and public health educators from all around the globe.
Who were your influences?
I was motivated to improve workers’ health by Trevor Clay, who was the general secretary of the Royal College of Nursing, and John Goodlad, who was the labour relations officer and a keen supporter of safety representatives and health and safety generally. Both men died before their time.
Professor Malcolm Harrington was inspirational at university, and my tutor Kerry Gardiner, an occupational hygienist, gave me a different perspective.
Gail Cotton, who was active in the Association of Occupational Health Nurse Practitioners (AOHNP) and who studied for an MBA, gave me an insight into it in business and organisations.
What other influences have been important?
My father instilled in me a sense of public service and “giving back” to the community. He also encouraged us to do our best at everything we did. I would also not have achieved all that I have without the support of my husband, John; we have been a team for more than 40 years. As in any team, over time the dynamics change, and the energy of individuals alters, but we have always achieved our common goals.
I came into nursing in the 1970s with a science degree, which was very unusual then. I still approach problems with scientific rigour, and it has been a good grounding in participating in evidence reviews.
My times on the board of the AOHNP have been fruitful in learning the fundamentals of running an organisation, communicating with others and contributing to OH practice. Offering study days is now part of my business; I learned to do this while helping to organise the AOHNP annual general meeting and best practice forum days.
I like to read about personal development. Jim Rohn’s philosophy appeals: “You must take personal responsibility. You cannot change the circumstances, the seasons, or the wind but you can change yourself.” As I am American in origin, I like the directness of Larry Winget in Shut Up, Stop Whining and Get a Life. However it is worth revisiting the classics such as Dale Carnegie’s How to Win Friends and Influence People and Think and Grow Rich by Napoleon Hill. Energising me to take the steps to set up my business were two books: these were Michael Heppell’s How to be Brilliant and Robin Sieger’s Natural Born Winners.
Darren Hardy’s Success magazine is essential reading; it does not define success only in terms of money but in terms of quality of life and relationships. It is aimed at the small business entrepreneur, which is where most independent OH practitioners sit, and contains a monthly CD or MP3 download if you read the digital version. I have spent many a happy hour driving on the motorway learning business and life skills this way. For more recent contributions, look at From Good to Amazing by Michael Serwa and pretty well anything by Tony Robbins, John C Maxwell, Shawn Achor and Seth Godin.
What are your priorities and goals in your current role?
The business I created about five years ago, Sunny Blue Sky Ltd, seems to be running smoothly. I work as a jobbing OH adviser, offering my expertise to those who need it, and, thankfully, I am never without work when I want it.
My energies outside of work will be focused on AOHNP as, if the members give me a mandate at the annual general meeting, I will serve them as president for the next two years. I have a bold goal, to double the membership in that time.
To do this we need to make AOHNP more attractive to the many OH nurses, technicians and advisers out there. We need to focus on a communications strategy, improving how we inform current and future members and fellow OH professionals. We can continue to strengthen our links with OH physicians as they reconsider their position in view of the outcome of the vote on the single organisation. Our website could be made more user friendly and comprehensive and we need to continue to strengthen our use of social media sites such as Facebook, Twitter and LinkedIn.
Improvement could be made in the way we respond to requests for information on professional issues from inside and outside of OH, and in streamlining the joining process.
Most importantly, we need to ask the current members and those who might become members in future what direction they think the AONHP should be taking.
In order to accomplish these things, we may need to revisit the structure of the board and harness the incredible energy of OH practitioners in roles that draw on their expertise. Everything is up for discussion, but we might persuade people to become sector leaders, so that if a member has a query regarding a specific industry, there would be a clear link to an experienced probationer.
Recent social media postings have given me the idea that we might approach the Nursing and Midwifery Council (NMC) to reopen the opportunity for Migration by Portfolio to part three of the register. The AOHNP might be able to help connect people to do assessments of practice, and this might also be useful for NMC revalidation in the future.
1976: BSc Biology (Hons) University of London
1981: Registered nurse
1985: Further Education Teachers’ Certificate
1996: Master of Medical Science (Occupational Health), University of Birmingham. Dissertation: Investigation of hand dermatitis and associated factors on operating theatre personnel and ward nurse at Leicester Royal Infirmary
2009: Specialist Community Public Health Nurse-OH (Migration by portfolio)
Royal College of Nursing: 1984-1990; Leicester Branch. Public relations officer, secretary, vice-chair, district safety representative.
Voluntary Medical Services Medal: British Red Cross 2003.
British Occupational Health Research Foundation (BOHRF): Working group-developing guidelines on occupational asthma 2004.
BOHRF: Working group-developing guidelines on occupational dermatitis 2010.
Health and Safety Executive: Working group occupational dermatitis standards of care.
Occupational Health Nurse of the Year 2012: Occupational Health journal
RCN: “Tools of the Trade” Guidance on Examination Glove Use, contributor 2012
Contemporary Occupational Health “Nursing: A Guide for Practitioners” 2013, Routledge. Chapter contributor – epidemiology and research.
Association of Occupational Health Nurse Practitioner (UK): Professional development director 2013 and also 2003-2006, treasurer 1999-2002.
1994-96: Nurse advisor in occupational health, Leicester Royal Infirmary- Healthcare
1997-99: Senior occupational health advisor, workplace health management-gas industry
1999-2002: Occupational health advisor, Merck Ltd, chemical industry sales, warehousing
2002-03: Interact Health Management-healthcare and railway industry
2004-6: AXA-PPP OH remote case manager, banking industry and Environment Agency
2006-08: Occupational health adviser, HMP&YOI Glen Parva prison service
2004-08: Occupational health adviser, University of Birmingham
Ongoing: director, Sunny Blue Sky Ltd, independent practitioner working with the police, healthcare, local government and the printing industry
I think we should do some fun things, too. There has been recent interest on Facebook in a mini-cruise with some OH lectures and site visits, and it might be possible to organise this through the AOHNP.
What motivates you today?
I want to pass on to new practitioners the knowledge and experience I have gained from 20 years of practice. My preferred route is by writing articles and responding to queries in JISCMail and on the UK Occupational Health Practitioners Facebook page. I am working towards becoming confident in public speaking, and have joined the National Speakers Association to achieve this. I firmly believe we should never stop learning and improving our skills. It helps in so many aspects of life.
What advice would you offer to those new to OH or early in their careers?
First, welcome to a specialty which is exciting and challenging. People rarely fall into occupational health; they arrive with some determination and effort. We are glad to have you with us.
When I talk with experienced practitioners, we do have real concerns about some colleagues who need to “learn to walk before they learn to run”. In my opinion, those who are newly qualified need to get experience in many industries, public sector and private, and learn how organisations work. They need to work alongside senior experienced practitioners as their mentors for a period of consolidation of several years, before they set up as independent practitioners.
From some of the questions posted in the public domain, such as those on JISCMail, it is obvious that they are not aware of what little underpinning knowledge they have; “they don’t even know what they don’t know”. They are putting themselves at risk of litigation and prosecution by the Health and Safety Executive if they give poor advice (for example on the Control of Substances Hazardous to Health Regulations and health surveillance). They may not be aware that, as well as giving OH advice, they will have the demands of starting up a small business, which brings its own challenges. I realise that I may not make myself popular by saying this, but I hope it will be accepted in the intended spirit of helpfulness. Reflect on your competence: “It isn’t what the book costs. It’s what it will cost you if you don’t read it.” (Jim Rohn).
I would also advise nurses new to OH to get training in business skills. We all work in the context of industry or business and if OH practitioners are going to be able to influence strategy and policy, we have to know what motivates employers and how we contribute to the “bottom line”, ie the profits of the business. This is, in general, by reducing costs, whether they are sickness absence costs, improving productivity in individuals, avoiding the attention of the enforcing authorities and thus preventing punitive fines and reducing insurance and compensation claims.
It is really important to understand sales. We are all selling something, whether it is ourselves at job interviews, persuading a board to invest money in the expansion of an OH service, or influencing an individual to buy into improving their health by lifestyle changes.
Make sure that you are presentable and business like in appearance and in conduct. Have a look at your Facebook page and social media activities (as others will when finding out about you) and make sure that it does not manifest qualities prospective employers or customers would not be attracted to. Get a professional business photograph taken, which can be used when writing articles and in the public domain. Yes, you need to write articles to share good practice.
Finally, become an activist for the cause of OH. Join your local group and a national organisation. If we all pull together we can make a difference. As US cultural anthropologist Margaret Mead said: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”