Expert advice

Occupational health services are here to support staff – so why the stigma?

Find out what a referral for physical and mental well-being interventions really involves

As COVID-19 continues, nurses need well-being and health interventions now more than ever. Here’s what a referral to occupational health really involves

Picture: iStock

Employers are required by law to prevent physical and mental ill health in their staff members that may occur as a result of their business activities.

Occupational health has a key role in supporting the physical and mental well-being of nurses, but despite this, these services are often misunderstood and stigmatised.

How has COVID-19 affected nurses’ mental health and well-being?

Nurses have been on the front line of the COVID-19 response, often at the expense of their own physical and mental well-being.

This unprecedented struggle has affected nurses from all walks of life, clinical settings and career levels, and there is growing evidence of the psychosocial impact of the pandemic on healthcare workers.

Recent research points to a prevalence of common mental disorders in healthcare staff since the pandemic began, such as anxiety and depression, as well as post-traumatic stress disorder symptoms, most often affecting nurses, women and younger staff.

Many nurses have had to make difficult personal and professional decisions over the past 18 months – some of which may have challenged the core values of nursing and led to a rise in moral distress.

In light of these factors, a recent joint statement from the RCN and other royal colleges and healthcare organisations called for the physical and emotional well-being of staff to be given equal priority to that of patients, now and beyond the pandemic.

What is the purpose of occupational health services?

Employers have a legal duty of care to protect employees from any harm sustained while working, including a duty to identify potential hazards through a risk assessment and reduce any harm they may cause.

An occupational health referral may help identify workplace barriers, including health and well-being factors that may be influencing how an employee feels.

Occupational health can work collaboratively with the employee and manager, helping to support them with any adjustments identified.

Such interventions can have a positive effect on workplace culture, employee engagement and an individual’s sense of well-being at work.

What does a referral involve?

In the main, a referral to occupational health services follows sickness absence, although can occur for various reasons such as work-related stress (physical or mental), or making reasonable adjustments if you have a disability.

The referral process is a supportive tool that managers should use for both themselves and employees to help them return to or remain in their role after sickness or setbacks.

Occupational health nurses understand the importance of helping staff to maintain their attendance and enabling them to work to their full capabilities.

Advice is directed towards this ethos wherever possible and recommendations are based on individual assessment, considering the whole person and their role, workplace and environment.

The working environment can sometimes pose risks to staff, for example related to hazardous substances, ergonomic factors, manual handling and shift work. In such cases, occupational health can assess an individual’s health and the role they perform and the need for reasonable adjustments to be made.

Occupational health nurses adhere to a code of practice and follow legislation to ensure they uphold confidentiality and only ever make recommendations based on health and safety and employment laws.

A referral may follow a period of absence due to stress or illness related to work Picture: iStock

Why might some staff resist an occupational health referral?

There is a lack of awareness and understanding of the true role of occupational health services – often referred to as ‘occy health’. It can be seen as just a place to get a ‘medical check’, mandatory vaccinations or a ‘fitness-to-work check’.

There are various reasons why there is often reluctance to access services.

Some nurses might worry it will affect chances of career progression, while others might view occupational health plans as a punitive measure.

Most often, these concerns are due to how the service has been used previously by the organisation in which it sits.

A lack of communication and misunderstanding of the role of occupational health is often the main problem.

Why might a referral be a positive thing for me?

Occupational health nurses are specialist practitioners in the field, with the knowledge and skills to support all employees.

Often, an occupational health nurse is the first person an individual speaks to about their physical or mental health at work, and for more time than they would with a GP.

‘If you are struggling at work with your physical or mental well-being, do not suffer in silence’

They have an understanding of holistic health and provide objective advice and information to managers to enable them to support an individual team member’s health at work.

Managers are better able to support individuals when they understand how their health affects their work or how work affects their health.

Occupational health nurses also commonly provide support and advice for individuals, including signposting to self-help resources or early interventions such as psychological and musculoskeletal treatments.

Accessing the service and receiving independent objective advice helps create positive working environments. Now more than ever, this is an important service within organisations.

Musculoskeletal interventions may be necessary for some nurses Picture: iStock

Will an occupational health referral negatively affect me or my career progression?

No. A referral helps support individuals in achieving a better work-life balance.

An occupational health assessment can provide a deeper understanding of your health and well-being needs, producing workplace intervention recommendations that will enable you to fulfil your potential at work.

Interventions could include developing self-management techniques, as well as managerial support and workplace adjustments.

For interventions to be effective, both parties need to be engaged – manager and employee.

Regardless of where the referral comes from, occupational health practitioners will always conduct a confidential assessment and make specific recommendations, without disclosing medical information.

How to get an occupational health referral

The process for referrals varies between organisation. Sometimes, making a referral will be a joint decision, but in almost all circumstances occupational health nurses would direct the employee and manager to address the issues locally in the first instance.

If you have a health condition or feel your health is being affected by work, speak to your manager, who can refer you to the occupational health department if needed.

Managers may require occupational health support if they are unsure how to support the specific needs of an employee, are unsure what workplace adjustments are required, or need advice on managing attendance, for example in a phased return.

If you are struggling at work with your physical or mental well-being, do not suffer in silence. As nurses, we often put other people’s needs before our own, but if we do not look after ourselves, we may not be able to look after others.



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