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Getting injured worker back on job requires team effort

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Returning an injured employee to work after a work-related injury can be a tough and sometimes sticky situation. The employee can have conflicting emotions upon transition into uncharted territory if a light-duty position is opted for. This can also cause conflicting feelings among coworkers who might view the light-duty position as preferential treatment.

Once in a light-duty position, there is the transition to ease the employee back to full-duty work, which can again cause animosity and, at times, increase the chances of reinjury to the employee.

To help with this transitional period, an employer needs to understand the employee's type of injury and expected time frame for recovery. Ask the attending physician about the expected recovery time for the employee's particular injury and research the avenues to be taken.

The National Safety Council offers a book titled "Accident Facts." This book provides statistical information about work-related accidents, cost and time lost, claim cost by nature of injury and trends in incident rates. The National Safety Council can be reached at

on the World Wide Web.

Often a nurse case manager has literature available to help the employer and employee. Education leads to enlightenment and thus, less conflict, as well as encouragement of individual and group growth, resulting in cohesiveness.

It is important to keep in mind that everyone does not recover at the same rate, and healing processes may be impaired due to disease processes, lifestyle, drug use, smoking, dietary habits, stress factors and numerous other circumstances.

If the attending physician does not give the employer the answers to help him understand the employee's injury and expected plan of treatment, then it may be necessary to switch to a physician with whom the employer can develop a rapport and discuss a goal-oriented outcome.

The action plan and expected outcome goal should be a team effort discussed between the employer, employee, physician, insurance adjuster and nurse case manager (if the latter two are involved).

Regular conferences with all involved in employee health care are recommended. Have the injured employee at the conferences to give a feeling of control over the situation, and thus reinforce empowerment.

Ask the injured worker if he is satisfied with the health care received. If not, why not? What can be done to improve the situation? What steps in the action plan need to be altered to improve the employee's health care and satisfaction?

The injured employee knows his body better than anyone else, and each person handles pain differently. Therefore, it is important to keep in mind that you need to believe the injured employee, and acknowledge and address the situation immediately. Discuss the employee's concerns with the health care team and document changes to ensure optimal outcomes.

How the employee is treated once he returns to work is also important in obtaining a desirable outcome. The employee must know that his employer cares about him as a valuable person and an asset to the company. Being involved in the injured employee's health care lets the employee know that the employer cares about him as a human being.

As a nurse case manager working closely with the injured worker, too often I hear complaints of "My employer doesn't care." I find that the employer, when I call to voice such concerns, is very often concerned and wanting to become actively involved. All it takes is communication to all parties involved to make sure everyone is headed in the same direction.

Use your nurse case manager as your resource person. Nurse case managers can bridge the gaps when an injured workers' unmet needs fall through the cracks of the health care system. A nurse case manager is an advocate, responding to crisis, troubleshooting, identifying opportunities, and acting as an agent of change.

Nurse case managers move freely through the structured layers of the process to facilitate the care of the injured worker. If you feel the need for a nurse case manager, and one is not provided, talk to the insurer regarding its policies on the appointment of one.

Last, but not least, re-evaluate your safety program and continuous quality improvement process. This should be re-evaluated immediately after the injury, however, upon his return to work, show the injured worker what you've done as a company to lessen the chances that his type of injury will not occur again.

Ask the injured worker to be involved with the continuous quality improvement process and safety program, and reinforce the fact that their input is valuable.

This is a collaborative process and communication is paramount.

(Annette England is a registered nurse case manager and president of Kelnett Inc., a professional case management company in Crane.)

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