health nursing is there one? Anne Harriss Reader in Educational - - PowerPoint PPT Presentation

The future of occupational health nursing – is there one?

Anne Harriss Reader in Educational Development Course Director Occupational Health and Workplace Health Management programmes LONDON SOUTH BANK UNIVERSITY harrispa@lsbu.ac.uk Tel 0207 815 6735 http://prospectus.lsbu.ac.uk/courses/course.php?UCASCode=unknown&CourseID=9472

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Occupational Health - A new way of working ?

Or “This (2005) validation will be the death of us” – Critically discuss

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My experience of developing a multi- pathway SCPHN programme in 2005 felt like this…..

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Areas to explore – opportunities and threats

• Public health and OHN practice.
• Contribution to the Work, Health and

Wellbeing strategy

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Work should be good for our health and wellbeing

Gordon Waddell, A Kim Burton (2006) Is Work Good for Your Health and Well-being?

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Opportunities and threats.

Identify a threat and/or an opportunity to the future

• f OH Nursing

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Occupational health – the world of work

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This country once had the highest per-capita income in the world –now nearly bankrupt – but were at the Olympics Anibare Bay

• http://www.lonelypla

net.com/nauru/image s/phosphate-bulk- nauru$6361- 4#content

• http://www.bbc.co.uk

/news/world-asia- pacific-15433616

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NO FORWARD THINKING- Nauru as it is now – phosphates nearly gone heading for bankruptcy -

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It has the highest rates of obesity in the world 80% of

the population have diabetes – not “flexing their muscles” & overkill (from a western processed diet)

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Potential threats to OH nursing can also be opportunities

• OH technicians – incorporate them into the

team to do the non-strategic work

• Case Managers – caution – EFFECTIVE triage!!!
• Workplace OTs and Physio’s – use their skills
• NHS plus and NHS Health at Work – support

for SMEs

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Potential threats to OH nursing can also be opportunities

• RCN SOHN – no longer exists now RCN Public

Health Forum AOHNP saw the opportunity to take the OHN lead

• NMC validation (SCPHN) or another body

more in tune with OH practice SOM/FOM

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Influences on OHN practice

– Government and organisational policy – OHN education

• influenced by validating and regulating bodies ie NMC and HEIs
• Standards for SCPHN programmes
• Are we preparing OHNs who have the skills which employers want

and need?

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Lets practice what we preach:

• Innovatively
• Competently
• Confidently
• Effectively

Add value by contributing to the success of our employing

• rganisations

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OH practice is delivered in the workplace and its focus is public health

Taking a leaf out of Ronseal’s book:

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The clue is in our title: and….

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Do we want to be a vestigial appendage of health visiting?

.

• .

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The Health, Work and Wellbeing strategy

Aims to:

– Improve the health and productivity of the (working age) population – Help those with health problems remain in productive employment in order that: – Prevent people falling into a benefit trap

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Rationale behind the strategy

Economic - for person and society

Need more people in work to support our society because of an ageing population

Work should be good for us - benefits (must)

• utweigh the adverse effects on health

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The figures stacked up leading to strategy

• 175 million working days lost in 2006 due to

sickness absence (CBI)

• 30 million days lost as the result of work-

related ill health or injury

• 1.4 million older people not working due to

ill-health

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Keeping or getting people back into employment

• Government target of 80% employment
• Need to:

– increase the number of people in work – Have more people at work for more of the time – reduce sickness absence

• The role of an OH service in employee health

management is pivotal.

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Promoting workplace health, safety and welfare

• Being out of/away from work impacts on:

– Social exclusion – Health inequalities – De-skilling

• 80% of those out of work for 6/12 will be away from

work for 5 years or more

• After 2 years claiming incapacity benefit: claimant more

likely to die, or retire, rather than return to work

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The Government intends to:

• Improve public health -

reduce health inequalities and social exclusion

• Improve the health &

wellbeing of the working population

• Keep people at work

and keep them there for more of the time

• Support people with

chronic health problems

• r disabilities to stay in

work

• Reduce poverty and

sustain the economy

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Evolving OH provision - crystal ball gazing

• Referral routes - GP, Employer, Jobcentre plus
• Professionals involved: OHPs, OHNs,

Employment advisers, OTs, Physios, CBT practitioners etc

• Funding - ?? - Employers / Trusts,

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Carving a niche

• What are the opportunities?
• What are the threats?

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The challenges

• Return to work recovery strategies - could we

do better - if so how?

• Inter-disciplinary working - who with?
• Addressing OHN education and CPD needs?

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OH education must meet the needs

• f practitioners
• Are all SCPHN

courses equal?

• What should be

included in OHN courses and how should they be delivered The London South Bank University approach:

• SCPHN & non-

SCPHN pathways

• 6 units other than a

research unit the remaining 5 OHN specific

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SCPHN (OH) educational programmes

• Supporting practice - the structure required by the

NMC:

– Core and pathway specific elements – Cross boundary learning outcomes (usually with HV & SN)

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Course content – NMC driven

• The interpretation of NMC standards by some

HEIs may be putting OHN’s at a disadvantage.

• Multi-disciplinary same classroom learning

may not effectively meet the needs of OHNs

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Remember the 2005 experience?

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Well the elephant had now become visible at LSBU (appropriately located @the Elephant and Castle)

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South Bank University team – foresaw the threats and opportunities & challenged the status quo

• We presented the challenges and persuaded
• ur head of department to change the

pattern.

• Persuaded the SCPHN team that NMC
• utcomes should be used like tiles of a mosaic

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From this to this

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What we developed

A spiral curriculum OH focused degree rooted in public health Welcome inter- disciplinary learning with OTs and Physio’s rather than HVs/SNs

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BSc (Hons) Health Visiting & School Nursing (SCPHN) BSc (Hons) Occupational Health Nursing (SCPHN)

Evaluating Research for Advance Practice Evaluating Research for Advanced Practice

Shared concepts and

• utcomes

Accountability and responsibility Legal and ethical frameworks Respect for individuals, groups and communities Reflection Problem solving abilities Complex decision making Risk assessment Risk management Clinical governance Change management Service Improvement Clinical leadership Project management Evidence based practice

Fitting the tiles into the mosaic

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Thumbs up - chocks away, fly high!

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Stirring up a hornet’s nest?

• I frequently lift my head above the parapet–

usually it works sometimes I come close to getting into slightly hot water

– Pressure exerted by non-OH colleagues re course content – Jumbo sized problem! – The first rap on the knuckles from our past Dean – Waiting for the second from our current Dean – Proposed a challenge to Prof Eileen Ellis:

Chief Nurse Guys and St Thomas Hospital and Director

• f Infection Control

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Me – when approaching retirement? (Hoping I will still have the drive, cut and thrust)

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In conclusion

• OHNs have always practiced public health
• Soldiers were cared for by the first public

health nurse – Florence Nightingale

• Forsee threats – but spin them into
• pportunities
• Stand by what we believe be brave & put
• urselves in the firing line to move things

forward

• Otherwise we could go the way of ……

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…….. the dodo, we know of it’s existence in

theory - but nothing left of it in practice.

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