What's it like being an independent practitioner?

Why choose occupational health (OH)?

I feel strongly that to be able to do a great job, be happy at work, and be the best we can be, our own physical and psychological wellbeing is paramount. I’m really passionate about what I do and the difference it can make to people’s lives. When you achieve results that both help the individual and their employer, it can be immensely rewarding and a great privilege. 
 

As an independent practitioner, what does your role involve?  

I work with organisations in all kinds of sectors, including education, health care, emergency services, manufacturing, hospitality and research. Every day is different, with opportunities for new learning all the time.

A typical day might involve liaising with managers around any problems they might be having in a work area or with an employee, then helping those individuals who are going through that process. I work closely with businesses advising on someone’s fitness for work and whether they need any reasonable adjustments to help them in their role. That might be followed up with regular health reviews.

In practice, I could find myself administering vaccinations, undertaking phlebotomy, promoting health education, consulting with employees and producing comprehensive outcome reports, facilitating and leading case conference meetings, and supporting a business’s health and wellbeing agenda.   

There are almost always solutions and people always have choices

You often find, after you’ve taken that initial call with an employee and started to peel back the layers, there can be all kinds of underlying factors affecting them. In occupational health we use our clinical judgement to understand how some issues might have an impact on someone at work and, in turn, how their work might impact on them, perhaps exacerbating their conditions.

OH can be very diverse and complex, but there are almost always solutions and people always have choices. We’re helping them navigate their own journey, providing support along the way. 

Why have you chosen to become independent?

It’s something I’d been thinking about for years. I’ve been employed in lots of different organisations and often there are constraints and a lack of resources. I’m not the kind of person who feels comfortable cutting corners, and compromising on standards of care, so a year ago I decided to make the leap. I also really wanted to raise the profile of occupational health and make a difference. There’s still a lack of understanding about the role and what we do, even within nursing and health care. Challenging this has been a real driving factor for me in setting up my business.   

What are those misconceptions? 

OH has evolved massively over the years I’ve been involved with it, but unfortunately some employers and employees still misconstrue what we’re about and some quite negative views remain. Even just a few weeks ago I did an assessment with someone who asked: “Is this so my employer can fire me?” I was really saddened. Others see it as a tick- box exercise. For example, I once had an HR manager tell me she could almost write OH reports herself because they were so predictable and more or less copied and pasted. When there are these kinds of bad experiences, it can really damage the reputation of OH. I want to break down these barriers by raising awareness, explaining our role, what we do, and how we do it.   

What are the benefits of being independent?

The attractions include being able to choose who I work with, when and how I work, and the type of work I do. For example, now I can commit to attending a whole day’s professional development event if I choose, and that wouldn’t have always been possible as an employee.  

What are the challenges of becoming independent? 

The compliance and legal side have been my steepest learning curve. For example, as an employee, there are usually already robust compliance measures in place when it comes to managing data protection; however, being independent means that this needs to be considered from scratch, and it’s important to get this right.  

At the outset, there’s a lot of work, which can mean working in the evenings and at weekends and there’s also financial insecurity. Nothing is guaranteed and if the work isn’t booked in, you don’t get paid. Of course, going it alone can feel daunting, but in addition to achieving immense job satisfaction from doing a job that I love, I’ve had so much positive feedback - and that’s really boosted my confidence.   

What are the vital elements of good OH practice?

Consent and confidentiality are crucial to the whole process and are non-negotiable to be able to create successful and effective working relationships. As an OH nurse, your commitment to the individual employee is central. They need to be able to come to you with confidence and share how they’re truly feeling, without fear of any repercussions or their personal information being leaked.

It’s equally important that all parties are aware that OH practitioners act in a neutral capacity, and as such, the information, advice and guidance that are provided are done so in an impartial, objective, and unbiased way. Managing perceptions and expectations in this regard is essential.  

Your commitment to the individual employee is central

It’s also vital to appreciate the moral, legal and ethical aspects of the OH role, which all go hand in hand. Employers have a duty of care to their staff, who need to feel valued and safe at work. Collaboration with other health care professionals is also key and, where required, I will always call on other expert practitioners to advise and guide.

• Read next: From coal mines to factories: how occupational health nursing has evolved with the times.

Can you share an example where you’ve really made a difference in someone’s life?

I helped an individual with long COVID successfully return to work. Initially he was adamant that he wanted to come back to work full-time, with no extra support or changes to his role. But when I spoke to him, I could hear the anxiety in his voice. Digging deeper, it became clear he felt he’d already lost some independence and was struggling and feeling anxious about what the future held. I knew I needed to tread carefully. He admitted that currently he could only manage a 30-minute phone call without feeling wiped out.   

Over time, I built up a rapport with him, listening to how he felt, but also reminding him not to pressure himself. Eventually, he told me he was really grateful I’d not supported him to go back to work at full capacity, as it would have been unsustainable and had a major effect on his health and wellbeing.   

We worked well together, achieving a fantastic outcome where he was slowly able to build up to his full hours and duties over several months. My feeling was had he gone back to full-time working too quickly, without flexibility, there would have been setbacks and he may even have decided to quit.