Kate Franklin, our highly competent technician has written a short story about her day carrying out health surveillance. Bear in mind, her daily activities are not the same each day; her role also involves face fit testing, drug & alcohol testing and biological surveillance – Isocyanate testing, chromium testing and lead testing.
A day in the life of our occupational health technician, Kate… in her own words.
A Day in the life of an Occupational Health Technician
Being an Occupational Health Technician (OHT) can have its ups and down; just like any job. You can have a full clinic booked for a day and each person turns up at their allocated time. On other days, people will turn up as and when they want to. I have discovered during my time of being an OHT, that the people that have booked to see me, usually don’t want to attend their appointments; they think I am going to find something wrong with them that will make them lose their jobs. I have to reassure people that we are there to help but also that health surveillance is a legal requirement. If we find anything wrong, there is something that can be done about it. The plus side of being an OHT, for me, is the day to day interaction with people. I love meeting new people. I also love the part of my job where I feel a sense that I am helping this person if I do find something wrong.
So how does my day start? Usually a few days before:
Towards the end of each month, I confirm with my Manager, David Barber, my availability for the next month. David, for those who don’t know, is the owner of David Barber Occupational Health Limited. I keep him informed and up-to-date on what days I can work and when our weekly or monthly meetings are booked in, depending on how busy we are. Once clinic dates have been confirmed, clinic lists are put together by the clients’ HR department and are emailed to me.
The morning
The morning of the client session, before I have even left the house, I must calibrate the spirometry equipment to check that it is working correctly. This usually takes one attempt, although sometimes it can take up to three, and usually when I’m in a rush to leave the house!
Once the machine has passed the calibration test, I print out the certificate, sign it and then scan it for our company records. I have to carry out this procedure as it is part of the HSE protocol.
Upon arrival at today’s client location, I sign in and telephone HR. I’ve worked closely with this particular client for almost 12 months. We have established a close relationship and often chat about the weekend & family, before speaking about the clinic ahead. They advise me on anything that I need to know before I begin.
It’s then time to unload the equipment and set up the assessment room. Once all the equipment is assembled, I need to check that it’s all working. Initially, I start with the hearing test and test myself. Even to this day, I still find it difficult as I’m sure I can hear my own heartbeat when conducting the test.
I then go through the clinic list to check if this is the person’s first time seeing me or if they have been sent for a 6/12-month review. If they are to be seen for a 6-month review, it will be because they had a poor hearing test result, poor Spiro test result or high blood pressure. Hopefully, they would have been to see their GP after their last review, before we see them again.
My first appointment arrives
9 am and my first person arrives for their appointment. I always confirm their name and then introduce myself. They always assume that I am an Occupational Health Nurse! I confirm that I am an OHT but competent to carry out the health surveillance testing. I reassure them that if an Occupational Health Advisor or Practitioner is required, I can refer them to that person, depending on the outcome and results.
Firstly, the hearing test…
I explain to the patient the process of the appointment and we start off with a hearing test. Initially, I ask questions regarding their hearing and their ears, for example, are they prone to ear infections and do they suffer from tinnitus? I then explain the hearing test to them, for instance, press the buzzer every time you hear a beep. The test usually takes around 5 minutes, testing the left ear first and then onto the right ear.
At the end of the test, the individual takes off the headset, I input the numbers and calculate the results; I then give the result to the patient. Generally, people have a Category One hearing ability. That’s the best that your hearing can be for your age. You may also find that patients have a Category Two or Three hearing ability. This usually means that they have a mild hearing impairment. The test can also pick up Unilateral Hearing Loss (UHL). UHL is a type of hearing impairment where there is a difference of more than 40 dB(a) between the ears. With anyone who has UHL, we always send them a copy of their hearing results and refer them to their GP as this is not usually work-related.
Then, I check their general health
The second questionnaire that I must complete is regarding the patient’s general health. The questions include asking if they are asthmatic or diabetic; and if they are, are they taking their medication? I also check how tall the person is and how much they weigh, so that we can work out their BMI, or Body Mass Index. We also ask if they smoke and how many units of alcohol they tend to consume. There is nothing like promoting a bit of health and wellbeing during this part of the appointment.
During the second questionnaire, I also take the patient’s blood pressure after I have asked them first if they are on blood pressure tablets. Once we have a reading, I double-check the blood pressure reading chart that I keep on my desk and show the person where they are on the chart. I find that having a visual chart/picture, it is easier for the person to understand what their blood pressure reading means. If the reading is high, I take their blood pressure three times to get an average. With anyone who has high blood pressure, I always strongly advise them to visit their GP or go to the nearest Walk-in Centre at their next available opportunity. There are also restrictions put into place if the reading is high, for example; no more forklift truck driving, no working at heights and not working in confined spaces until they have clearance from their GP.
If the reading indicates that the person has pre-high blood pressure, it will be a case of promoting health and wellbeing. Are they a smoker? Could they cut down? Do they drink large quantities of alcohol? Do they exercise?
During the appointment, I also must complete the following questionnaires:
- Hand and Arm Vibration (HAVs) – This questionnaire is for people who use vibrating tools as part of their job. The good thing about this client is that their Health and Safety department carry out these checks on a regular basis already. I still need to double-check though that the patient does not suffer from white finger, numbness or any tingling. Should I find any of these symptoms, I will refer the patient onto an Occupational Health Advisor or Practitioner.
- Drivers Screening – This questionnaire is for people who drive a forklift truck, company car or has use of the car/van pools at work. The questionnaire confirms whether or not they have high blood pressure, any problems with their heart, have they had a stroke, are they on medication that has to be taken at restricted times. The Drivers Screening questionnaire is always followed up with a vision test. I always advise my patients to make sure that they go to an optician every two years to get their eyes checked. The type of vision test that I carry out is to check for distance. It is not the type of vision test that you have at, for example, Specsavers, where they check if the back of your eyes are fit and healthy.
- Night Shift Worker – The name of this questionnaire gives it away! The purpose of this questionnaire is to make sure that night shift workers are not suffering from frequent heartburn, indigestion or any other problems, this can be the case if the person is working continental shifts (days and nights), the changeover of shifts and subsequent change to sleeping and eating patterns can affect the person.
- Skin questionnaire – As with the HAVs questionnaire, our client does check that no one is suffering from any type of skin condition, like dermatitis. This usually occurs if the patient has come into contact with something on the machines or has an allergy to the latex gloves that they wear. If this is the case, a barrier cream is given to the employee or we refer them to their GP.
- Spirometry/Lung Function – This test is to check that there is nothing obstructing or restricting the lungs. At first, I ask the patient questions about their job, such as if they are exposed to dust or chemicals. Once the questions have been completed, the test is carried out. The patient must blow into a mouthpiece for as long and as hard as they can; they expel all the air out of their lungs through the mouthpiece. The patient must do this three times with a break in between – this is to check that the patient is feeling ok and to get an average for the results.
The results…
If any of the results from any of the questionnaires raise alarm bells, we always advise the person to visit their GP and we will review the patient in 6 months’ time. If all results are satisfactory, we will see the patient on an annual basis.
Once all the health surveillance assessments and questionnaires have been completed, all my notes are sent to David, who reviews the results and signs-off the Fit for Work certificate. I am not qualified to sign off these reports as it must be an OHA (Occupational Health Advisor) or OHP (Occupational Health Practitioner) that can confirm that this person is fit for work.
Once the certificates have been signed by my manager, they are automatically available for the clients’ HR department to access securely online and keep a copy for their company records. The client company can access these certificates via the secure online portal that we use for this purpose.
If you would like to know more about how we can help your business get in touch via our contact page or follow us on twitter @dbocchealth and Facebook /davidbarberoh