Case Study: Senior Occupational Health Nurse - Sue

What do you do?

I'm a service manager for occupational health in the NHS, and my responsibilities include the recruitment and retention of staff, and general staff issues.

We currently employ 40 staff, including nurses, clerical staff and four doctors, and it's my responsibility to deal with the day-to-day operational issues involving that group of people.

[Sue manages the occupational health of people within the NHS. This work is broadly similar to looking after occupational health in a company or industry. Differences include issues such as the importance of immunisation for staff working with patients, the need to ensure strict infection controls, and a higher level of support for mental health issues such as stress than exists in some other areas of work.]

What is your background?

Originally I wanted to be a policewoman, but unfortunately they found that I was short-sighted, so I wasn't able to enter the police force.

I wanted to do another career that involved helping people and contact with people, so I chose to do nursing. And, to enter occupational heath, you have to do your general nursing qualification in your adult branch [now, some course providers only accept people who have registered through the adult/general branch; for other courses, any branch might be acceptable] and then specialise after that.

I started off with my qualification in general nursing, went into occupational health very early on, in the early '80s, when it was called 'works nursing' or 'industrial nursing', and I thoroughly loved it.

Due to personal circumstances, I needed to get a job back in the NHS to secure a mortgage, to buy a house, so I came back into the NHS and worked on a coronary care unit for seven years, and then I hurt my back moving patients, so I could no longer do patient care nursing.

I had to look for an alternative career within nursing that didn't involve moving patients, and so that's why I went back and chose occupational health again.

What characteristics do you need to be successful in your job?

I think you need to be very patient because you have to deal with a wide range of people, with a wide range of problems, some of them quite personal. So, you need to be a good listener.

You need to be very patient because quite a few people take quite a long time to get to the point of why they've come to see you.

You need to be extremely well organised, because you only have a set amount of time to see each person, so it's difficult - if you're overrunning, you don't want to keep the next person waiting.

And, I think you need to be able to relate to people in all levels of an organisation, from the chief executive level down right down to the domestic level, and be able to talk to them on their level, and put the information across in a way they can understand.

What other jobs could you do using the skills from this job?

Well, I could go back into general adult nursing at any time, if I was physically fit enough to be able to do that.

And, also, I could go and be a practice nurse in a GP's surgery, giving generalised care to the patients, because a lot of the skills are transferable - vaccinations are very similar and a lot of the interaction with members of staff is the same as interaction with members of the public.

You could do both careers if you wanted to. A lot of occupational health nurses work in both - they work part-time in occupational health and part-time as a practice nurse, so they're keeping both sets of skills up.

You could take the qualifications you need to be a service manager into any senior level nursing post.

What changes will there be in the future?

I think that the whole workforce pattern will change, and because we deal with workforces, that's going to influence the kind of care that we give.

Because: people are going to be working longer, they're going to be older, they're going to have more health problems that will then impact on the duties of the jobs that they do.

So, they're going to have to find more flexible ways, hours, duties or different kinds of jobs to keep people in employment for as long as they want to work.

And also, because technology's advanced so much in medicine, people that would be seriously disabled, or would have died years ago, are now having various types of implant technology that mean that they can continue working.

And that always presents a challenge because you've got to think of different jobs that those people could do without any detrimental effect to their health.

Medicine's one of the most advancing fields, people are on different medications now, so the older population plus the multiple health problems that people have make the whole idea of working totally different.

What are the biggest challenges in your job?

One of the challenging aspects of being an occupational health nurse is because legislation changes quite frequently, chemicals change quite frequently, new things are always coming out for you to expand and challenge your thinking and your roles.

As a manager, there's always a challenge in looking after 40 people, because you've always got somebody off sick, somebody's who's got compassionate leave, somebody's who's got bereavement problems or carer's leave, so to try to actually keep the service fully staffed is a continuous challenge.

Are there many opportunities to enter this career?

It's actually a very difficult field to enter because you tend to find that most people, once they've entered a career in occupational health, don't want to leave it.

And, because we're flexible about the hours that people can work and the duties that they can do, it does give people the incentive to keep carrying on, year on year; I don't get many people leaving my service.

Once you've qualified as a nurse, if you really do want to do occupational health, the best thing that I can advise is that you contact somebody who's working in occupational health and go and shadow them for a day.

Or better still, if it's in the NHS, try to get a bank contract, so you can actually go and bank for a few days a week in an occupational health department, and actually see if you really like it, because most nurses either love it or hate it.

I've taken on some staff in the past who've stuck it for three months and it's really not been what they wanted to do because they've left a patient environment and they miss the patients and want to go back to that.

I went to work on an agency, 20 years ago, to first get my experience in occupational health, so you can always enrol in a bank or an agency, to see if it's actually for you, because it may not be.

What do you like about your job?

I like working in a team, because there are members of clerical staff, nursing staff and medical staff, and we all have to work together for the patient's best interest.

And, every day is different; you just do not know what's coming through the door, until the person arrives and tells you the reason why they've come down.

And often the reason that they've actually given to the clerical staff is not the reason why they've come at all, because they don't want to say the real reason, because they're worried that their colleagues will find out why they're accessing the occupational health services.

So, it's just the variety, because no one day is ever the same.

What do you dislike about your job?

Because of the legalities of the field in which I work, there's an awful lot of paperwork, and sometimes I query whether I trained to be a secretary or whether I've trained to be a nurse.

We're in days now where you have to write everything in triplicate, so there's quite a lot of paperwork. At the senior level that I am, there's an awful lot of paperwork - at the junior levels, it's more clinical and less administration.

At my level, it's more administration and less clinical, and that can be a bugbear to me because quite often I think, in the NHS, we're creating paperwork for paperwork's sake, and that's my biggest dislike of my job.

What are your ambitions?

I'd like to get the service fully staffed and I'd like to be able to lead it into the next level of service delivery to take account of an older work force with more disabilities coming through - and I'd like to retire at 58.

What advice would you give to someone interested in your career?

Because it's such a specialised field, I would advise anybody to do what I did, and that's to find out more about it by, for example, by accessing various websites to do with occupational health - most NHS occupational health departments have a website that tells you who the key people are to speak to, or look at the NHS Careers website.

I'd recommend that you go and have a chat with somebody, try to shadow somebody for a day to see what they do, or, if you are already a qualified nurse, do some bank or agency work, just to see what you actually think to it.

A day in the life

8:30 am - 9:00 am

Meet with my team. Look at my schedule diary to see which patients [NHS staff] are in there and what the team already knows about each one.

I meet with the occupational physician to go through the cases I'll deal with later during clinic time. We exchange information, eg, brief histories of the patients.

I also check my email and any telephone messages.

9:00 am - 12:00 pmClinic time. I see a number of patients, for example:

  • people referred by their managers because they've been off work sick
  • people injured at work
  • staff who want to talk about their physical or mental health.

During clinic time, I could be, for example:

  • giving vaccinations
  • taking blood samples
  • forming an opinion to give to managers
  • referring patients, eg, to physiotherapy or manual handling training.

Between seeing patients, I deal with clinical and managerial phone calls.

12:00 pm - 1:00 pm

Dealing with morning post. Looking at blood test results. Considering any clinical actions that need to be taken. Returning phone calls and checking my emails again.

1:00 pm - 1:30 pm

Lunch.

1:30 pm - 4:00 pmMeetings, for example:

  • case conferences, discussing particular patients
  • health and safety issues, eg, infection control
  • incident meetings, eg, when a patient is diagnosed with TB
  • discussing how to support staff, eg, dealing with deaths on wards.

4:00 pm - 4:30 pm

Making any urgent phone calls, writing up notes, checking emails once again.

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