Occupational Health Nurse

Department:	Health Services	Effective Date:	February 2007
Grade:	USG 12	Reports to:	Medical Director of Health Services

General Accountability

This position reports to the Medical Director of Health Services. She/he is accountable for occupational health programming and services and promoting workplace health and wellness within the guidelines and requirements of relevant Occupational Health and Safety legislation... She/he consults with experts on and off campus to provide the breadth and depth of programming necessary for a wide spectrum of Occupational Disease Prevention, Health Promotion and Education appropriate to the very diverse workforce of CUPE, staff and faculty at the University of Waterloo. She/he frequently co-ordinates multi-disciplinary activities employing the knowledge, skill and experience of professionals from Human Resources, Safety, Services for Persons with Disabilities, Mental Health, Infection Control and Public Health.

The occupational health nurse’s clinical role includes clinical nursing, first aid emergency care, ongoing medical treatments, crisis intervention, counselling and support to employees on individual health issues with referrals to appropriate external and internal resources. The occupational health nurse is supported in these functions by the clinical nurse and physician team within Health Services. The occupational health nurse works with employee health care providers and Human Resources to facilitate early and safe returns to work following absence due to illness or injury. The occupational health nurse develops pre-participation protocols, monitoring for potential workplace health exposures and provides health education and promotion for CUPE, staff and faculty of the university community.

The University Occupational Health Nurse will abide by the requirements of the Regulated Health professions Act and treats as strictly confidential, any information learned about individuals through interviews, medical tests, examinations, or reports from other health professionals. Adherence to medical confidentiality is good occupational health practice and essential for effectiveness of the programme. Adherence to confidentiality establishes the foundation for employee’s trust and confidence in the department.

It is understood that the occupational health nurse practices in accordance with the College of Nurses of Ontario Standards of Nursing Practice and Guidelines for Ethical Behaviour, the Regulated Health Disciplines Act, 1991, and the Ontario Occupational Health Nurses Association Standards of Practice for Occupational Health Nursing and any other legislation applicable to her/his individual setting

Professional Accountability:

The consumer is the central focus of the professional service nurses provide, and as a partner in the decision making process, ultimately makes her/his own decisions.
The goal of professional nursing service is the best possible health outcome for the consumer, with no unnecessary exposure to risk of harm.
Improvement is a necessary component of practice and the public interest is best served when nurses constantly improve their application of knowledge, skill and judgement.
Reflective practice- continually assessing one's practice to identify learning needs and opportunities for constant growth and improvement- is essential to competence improvement.
Ongoing feedback from peers, co-workers and consumers is essential to maintaining competence.
Quality practice settings contribute to the provision of competent professional nursing service.

The occupational health nurse is a registered nurse with additional knowledge and skill in:

Environmental and health assessment
Identification and primary treatment of workplace injury and illness
Case management, worker rehabilitation and return to work programs
Health and Safety education
Interpretation of and compliance with legislation pertaining to the workplace

Nature and Scope

The Occupational Health Nurse is responsible for the following:

Participates in the Employee Assistance Program (EAP) as a contact person, making appropriate referrals and also is a member of the Committee, involved in program planning and implementation for CUPE, staff/faculty on campus.
Participates in the Joint Health and Safety Committee as a resource member and is part of the laboratory safety audit team with special expertise in infection control.
Works cooperatively with the Safety Office to develop and manage Occupational Health maintenance programs such as screening and monitoring of health conditions (i.e. needle stick injuries, chemical exposure) and to minimize the risks associated with potential workplace hazards
Develops and presents programs promoting employee health/wellness in the workplace
Collaborates with Office for Persons with Disabilities and Parking services to provide confidential assessment and facilitation of special needs parking on campus for CUPE, staff/faculty who have medical requirements
Works with Human Resources in the management of sick leave and safe return to work programs.
Works with Human Rights and Conflict Management in resolution of workplace stress resulting in health related issues
Works co-operatively with the Union, Staff and Faculty Associations when appropriate
Works with one/all departments across campus for health promotion, increased awareness regarding workplace hygiene, and education regarding specific health topics relevant to the workplace group

Statistical Data

Full time ongoing staff -- 1701
Part time ongoing staff -- 135
Casual staff – 1562
Full-time/part-time union employees -- 351
Full-time faculty -- 892
Adjunct faculty – 606
Post docs – 154
Grad students -- 3028

Specific Accountabilities

Assists the WSIB Coordinator with evaluation of medical requirements for workplace accommodations
Creates and maintains a confidential and accurate data base, for example sick leave management, health monitoring
develops Occupational Health Policies and Procedures such as Food Safety for Student Vendors, protocol for management of needlestick injuries
Maintains occupational health website, creates pamphlets and media releases to keep employees informed about services.
Disseminates health education information through written and verbal presentations in response to on campus employee health issues (for example: West Nile Virus, SARS)
Produces reports as required
Coordinates training and deployment of Automatic External Defibrillators (AED)
Is a Member of the Critical Incident Stress Debriefing Team (CISD)
Assists the various Departments on campus with resources in order to comply with occupational health legislation for specific roles (for example: health assessment and certification for Diving Program, audiometric testing for noisy environments, visual testing for laser use, pulmonary function testing for smokers and asthmatics)
Resource person for Food Safety on campus
First Aid Training for Summer Camp Counsellors
First Aid Training for TA’s and new lab assistants
Supervises Workplace Wellness Student for EAP events
Performs other duties as requested

Specialized/Unique Occupational Health Tasks

1. Workplace Surveillance and Health Risk Identification:

The Occupational Health Nurse in collaboration with the members of the Safety Office conducts workplace surveillance, a term used to describe activities which determine whether groups of workers may be suffering actual or potential work related injury or illness. Occupational Health Nurse conducts workplace surveillance utilizing methods to detect, appraise, identify and manage health hazards and exposures to physical and chemical hazards at work.

Comprehensive interventions or programs to control all actual and potential health risks to employees and provide the worker with education of potential health risks and strategies to prevent injury and illness
Intervention measures designed to prevent occurrences, monitor exposure and eliminate the problems
Early detection of workplace hazards
Health education for employees to reduce the likelihood of injury/illness
Documentation of health and safety potential risks for each job activity
Utilize statistics to indicate trends and target health risks

2. Health Surveillance:

As part of health surveillance, the Occupational Health Nurse conducts activities which determine whether groups of workers may be suffering an occupational illness as a result of exposure to a particular hazard or group of hazards. Health surveillance is always based on environmental assessments with exposures evaluated and documented. Examples of health risk assessment and medical surveillance include immunization for employees who are exposed to infectious biological agents. This includes those who come into contact with: animals, human blood or body fluids, certain bacteria and viruses used in research, communicable diseases etc

Reduction of workplace injuries/illnesses due to early detection of workplace hazards
Reduction of financial costs associated with exposure to workplace hazards
Increased knowledge of the workplace environment by the worker and employer
Develop statistics to identify significant trends in occupational illness or injuries

3. Health Promotion and Protection:

The Occupational Health nurse is responsible for employee health promotion and protection. This programming focuses on the prevention of illness/injury by promotion of health and well-being using strategies directed towards modifying the behaviour of individuals/groups and encouraging them to accept responsibility, in matters which affect their health and over which they have control, towards achieving a healthy lifestyle. Anticipatory interventions include strategies for protection from agents causing disease and /or hazards in the work environment and /or university community.

Enhancement of employee well-being by gaining knowledge of risk factors in the workplace
Movement toward a state of optimal health by obtaining management commitment and policies to support development and provision of individual employee and work group programs
Reduction of health risks by programs targeted to meet goals determined by needs assessment of individual workplace.
Familiarity with community resources and skill in utilizing community resources such as posters, pamphlets, brochures, fact sheets, newsletters, health programs where applicable
Individual knowledge of risk factors and preventative measures as a foundation for development and provision of health building programs such as smoking cessation, nutrition, hypertension, fitness, which in turn will provide a reduction of financial costs to both the employer and the health care system
Reduction of financial, psychological cost to the individual by timely referrals to the Employee Assistance Program when applicable

4. Primary Care:

Primary care is the set of nursing actions that are provided to manage illness or functional challenges in the workplace. The goal is to prevent complications, promote recovery and facilitate rehabilitation of both occupational and non-occupational illness and injury. Primary care is based on the nursing process, on a theoretical base consistent with occupational health nursing practice, on knowledge of the health/illness continuum and on norms and deviations of the continuum.

Appropriate treatment, referral and follow-up so that an early return to work process, where indicated, can be initiated
Reporting and recording: confidentiality ensured by utilizing the nursing process
After obtaining an informed consent, investigating and addressing factors which influence progress to optimal functioning
Promoting worker responsibility for self care which includes: health education in treatment (where appropriate), collaboration with other health disciplines (where indicated), maintain competence in emergency/primary care

5. Counselling:

Counselling is the process of helping employees to clarify problems and make informed decisions and choices while giving positive reinforcement. It provides strategic interventions and appropriate referrals to deal with a crisis situation and time for the employee to reflect on impending decisions and evaluate actions taken. Counselling is a broad area that ranges from simple encouragement of clients who are motivated to make positive changes to health behaviour to providing direct care for clients in a crisis situation. The type of counselling offered is determined by the level of additional preparation and expertise of the nurse.

Safety of client and others in the situation is ensured
Confidentiality is ensured
Legal obligation to report criminal or dangerous situations (e.g. child abuse, harm to self or others)
Client returns to optimal functioning
Appropriate referral and follow-up are made
Collaborate with internal and external resources
Use contracting and mutual goal setting to promote client’s responsibility for self care
Pursue continuous improvement of counselling ability through education

6. Rehabilitation/Case Management:

Rehabilitation/Case Management is the process/provision of services necessary to restore an individual to the fullest physical, mental, emotional, social, vocational and economical independence of which they are capable. Rehabilitation cases may be either work or non-work related. Rehabilitation includes preventative processes whereby the Occupational Health Nurse implements knowledge gained from research studies/epidemiological studies within the workplace and work culture.

Return of individual to maximum ability to function in physical, mental, emotional, social, vocational and economical areas by utilizing community resources, referral agencies
Increased individual self-esteem and morale, especially with the modified return to work program when applicable
Participates in facilitated meetings following the RTW Principles when workplace stress/issues are prime reason for absence.
Reduced WSIB assessments and insurance premiums
WSIB penalty avoidance
Improved corporate culture and morale (good corporate citizens)
Well established modified work programs by co-ordinating the return to work to the pre-illness level of the individual through positive communication with all parties involved
Maintain/document statistics to support programs

Working Conditions

Fast paced position with need for quick interventions especially when an employee is absent from the workplace
Consumers may suffer from minor or more complex health issues. Mental health issues are often involved in the diagnosis
Illness/absence may be complicated by workplace issues with management or co-workers. It may also be a medical illness complicated by performance issues
Programming deadlines
Demand for thoroughness and accuracy, able to withstand legal scrutiny
High accountability to represent both the employee’s medical condition and the need for a well employee to return to the workplace as quickly as is healthy and safe
Work with management, faculty, staff, CUPE in difficult situations in a timely manner. Often some degree of conflict or competing goals must be resolved
Extended hours are frequent with RTW meetings, interviews, testing etc.
Accountability to multi disciplinary team members requires knowledge and confidence when called upon

Stress levels are often high due to the nature of the job and the possible prospect of litigation, arbitration, grievances, dismissals and human rights issues
Determining, and directing clients to the best resources available to help them
Multi tasking is reality
Due to confidential nature of the position, very few resources available for support