Occupational health (OH) nursing has taken me across continents, cultures, and care systems—but one constant remains: the profound impact our work has on people’s lives.

Today, I work as a Quality Improvement Nurse at Doctors Hospital in Grand Cayman, bringing over 25 years of experience in occupational health nursing. My journey has included military service, international leadership roles, and contributions to global nursing dialogue—but some of my most recent work is happening right here in the Caribbean.

A global perspective shaped by experience

My career has spanned the UK, Germany, Hong Kong, and now the Cayman Islands. Along the way, I’ve had the privilege of contributing to occupational health practice through publication, leadership, and advisory roles.

As a founding member of the RCN Public Health Forum and a long-standing member of its steering committee, I’ve remained committed to advancing public health nursing. My experiences—from military healthcare to global leadership programmes—have shaped how I approach workforce health: with adaptability, cultural awareness, and a strong focus on prevention.

Practicing in the Cayman Islands: A unique context

The Cayman Islands, with a population of around 85,000, present a unique healthcare landscape. The workforce is young, diverse, and multinational—but also faces distinct challenges:

• Variability in healthcare access due to insurance systems.
• High levels of chronic disease, including obesity and musculoskeletal disorders.
• Lifestyle-related health risks such as poor diet and inactivity.

In a small island setting where “everybody knows everybody,” confidentiality, trust, and cultural sensitivity are essential to effective OH practice.

Building occupational health services from the ground up

Working as the sole nurse with OH responsibilities in my organisation has meant developing services in a practical, responsive way.

Some key initiatives I’ve introduced include:

• ergonomic and workstation assessments adapted from UK tools
• safeguarding training in collaboration with local agencies
• sharps injury prevention and management programmes
• mask fit testing and infection prevention strategies
• staff flu vaccination campaigns.

Each initiative has required adaptation to local resources, workforce needs, and cultural context.

Tackling vaccine hesitancy: A case for trust and engagement

One of the most rewarding challenges I’ve faced was improving flu vaccine uptake among healthcare staff.

Initial uptake was low—under 10%—driven by misinformation, cultural beliefs, and a general perception of low personal risk. Through simple but targeted interventions—drop-in clinics, myth-busting campaigns, open conversations, and small incentives—we saw a significant shift.

Within a year, uptake increased nearly fourfold. More importantly, engagement improved across all staff groups, including those traditionally harder to reach.

This experience reinforced a key lesson: listening builds trust, and trust drives behaviour change.

Small changes, big impact: ergonomics in practice

Another impactful intervention involved supporting a clinician experiencing musculoskeletal symptoms due to poor workstation setup.

By adapting UK ergonomic assessment tools and working with management to implement practical changes—such as a sit-to-stand desk—we were able to significantly improve their comfort and ability to work.

This case highlights how early intervention and simple adjustments can prevent long-term health issues and improve productivity.

The reality of island healthcare

Practicing in a small island environment comes with unique pressures:

• limited regulatory frameworks in some industries
• minimal maternity leave and sick pay provisions
• workforce burnout in high-demand settings
• vulnerability to natural disasters and seasonal risks.

These realities shape occupational health priorities and demand flexible, context-driven solutions.

Lessons for practice

My work in the Caribbean has reinforced several key principles for occupational health nursing:

1. Context matters. Economic, legal, and cultural factors directly influence worker health. Effective OH practice must reflect these realities.

2. Know your workforce. Demographics and disease patterns should guide service design and priorities.

3. Address inequality. Occupational health can play a vital role in bridging gaps in access to care.

4. Be culturally aware. Understanding beliefs, values, and behaviours is essential for meaningful engagement.

5. Start small, think big. Even modest interventions can lead to significant improvements in health and wellbeing.

Looking ahead

Occupational health nursing is evolving—and so must we. Whether working in large healthcare systems or small island communities, our role remains vital in protecting and promoting the health of the workforce.

For me, the journey continues to be one of learning, adapting, and advocating—ensuring that wherever we practice, we deliver care that is not only effective, but equitable and culturally informed.