Are THEY ready? Preparing the work group for the return of an injured

employee

Alexina Baldini - Psychologist

16th September 2008

SIAV conference

OutlineOutline

• Preparation of the team and workplace – prior, during, after injury

• Workplace systems – micro, meso, macro

• Identify issues relevant to the particular work group – physical, behavioural, social, cognitive, emotional/psychological, existential

• Managing the issues for integration

Preparation prior to injuryPreparation prior to injury

• Policy• Procedures• Occupational Health and Safety

structures• Communication• Privacy• Confidentiality• Training/support of management and

peers

Preparation continuesPreparation continues

• During the injury period• Clear Critical Incident Response/support for all

involved• In the immediate hours following injury

• Psychological First Aid• Mental Health First Aid• Physical First Aid

• During the first few days and weeks• Meaningful contact• Updating and ‘keeping in mind’

• Over the months and years

Preparation – keeping the end Preparation – keeping the end in sightin sight

• What will the successful integration of the injured worker look like?

• How will work group members behave when that is achieved?

• What are the specific steps involved?• How will the work group celebrate

this achievement?• How will the support team record this

for history? Learning?

Perceptions of the barriers and Perceptions of the barriers and facilitators for RTWfacilitators for RTW

Health Services System

Workplace System

Injured worker system

Adapted from Friesen, Yassi & Cooper (2001) Return-to-work: Human interactions and organisational structures Work, 17, 11-22

Economic, Social, Legislative systems

Micro-systemMicro-system

• The injured employee• Attitude• Behaviours• Personal/Family• Empowerment• Demographics• Characteristics• Pre-injury work• Performance

Meso-systemsMeso-systems

• Workplace system• Union-management agreement/relationship• Workplace milieu• RTW program/policies/resources• Teamwork and communication• Organisational structure• “Buy-in” of all stakeholder groups• Personality factors• Trust and credibility• RTW team “sense of ownership”

Meso-systems (continued)Meso-systems (continued)

• Health Services System• Communication• Teamwork• Resources• Delays• Trust• Continual need for education

Macro-systemMacro-system

• Economic• Funding issues for health practitioners eg.

Impact of Medicare rebates on some professions

• Social• Workplace restructuring• Generational differences

• Legislative• Compensation parameters• Injured worker legislation

Identify issues for THIS work Identify issues for THIS work groupgroup

• Individualised assessment – not one size fits all• BUT – the principles help!• Look at broad areas: physical, behavioural, social

(observable) then those that you need to listen out for:

• Cognitive – what are they thinking?• Emotional – how are they feeling?• Psychological – how do those feelings

impact? • Existential – what ‘big picture’ messages

about the workplace are they taking away from what is happening or planned to happen?

PhysicalPhysical

• Seating arrangements• Work location• Parking• Access• Equipment• Hours of work• Rostering preferential treatment• Lighting• Noise

BehaviouralBehavioural

• Proximity

• Duration and intensity of contact

• Communication considerations

• Acceptance behaviours

• Inclusion behaviours

• Interdependence of work group members

• Goals of work group

SocialSocial

• Connections within the work group• Key supports within and outside the

group for the injured employee• History of connections between sub-

groups• Predicted impact the return of the

injured employee has on the overall group dynamics

• Desired group dynamic development

CognitiveCognitive

• Fears – helping people to express what is on their mind in a constructive non-judgmental manner

• Concerns - about future capacity to function

• Education around signs, symptoms and support strategies

• Ongoing training and development in enhancing work group performance

EmotionalEmotional

• Need for reassurance – particularly for middle management

• Approachability – that no aspect of the return to work process cannot be talked about/raised with key personnel

• Relationships – imperative to help all members of the work group feel that they belong and are valued

PsychologicalPsychological

• Rejection versus acceptance• Resentment versus embracing the

challenge of integrating the injured worker

• Blame of management/RTW personnel versus empowerment of team members

• Rumours versus clear communication of the needs of all

ExistentialExistential

• Importance of work in a person’s life

• Integral role of successful return to work initiatives to the overall workplace culture

• Professed values of the workplace versus values demonstrated in action

• Individual values including empathy and other-centredness

Two injured employeesTwo injured employees

• Both female nurses

• Both in mid 30’s

• Both mothers of young children

• Both soft tissue injuries – back/neck

• Both in workplace for more than five years

• Both well liked and respected

• Both skilled in their professional role

Two work groupsTwo work groups

• Quick access to expert health professionals

• Management effectively communicating with staff every day

• Open communication between work group members

• Strong achievement history of work group

• Clear identity as a collaborative group

• Quick access but frequent changes in health professionals

• Management ‘waiting to retire’

• Infrequent staff meetings – often cancelled or postponed

• Work group members needing to ‘watch their backs’

• Suspicion, ingroups and outgroups

IntegrationIntegration

• Initially returned to work after a week but needed to take more time off

• Returned part time after three weeks

• Gradual incremental time and complexity of tasks increased over two months

• Fully back three months later

• Team celebrated her full return

• Did not return to work until four months later

• Found she was “on the outer” and that it was difficult to find out information

• Struggled to feel that she was part of the team and vice versa

• Often cited her injury as the reason she could not do tasks

• Open resentment from team members

Promoting worker healthPromoting worker health

• Teamwork is vital – facets include:• Emotional Stability

• Adjustment• Self-esteem

• Extraversion• Dominance• Affiliation• Social perceptiveness• Expressivity

• Openness• Flexibility

Promoting worker health Promoting worker health (continued)(continued)

• Agreeableness• Trust• Cooperation

• Conscientiousness• Dependability• Dutifulness• Achievement

Driskell, Goodwin, Salas, O’Shea (2006) What makes a good team player? Personality and team effectiveness Group Dynamics: Theory, Research, and Practice, 10, 249-271

Managing the issuesManaging the issues

Preparation for integration from orientation of a new work group member – expecting successful outcomes and working towards them

• Valuing the RTW process – at every level of the organisation

• Individualised assessment of each situation • Communication – consistent and open• Coaching – of work group and worker• Positive relationships between stakeholders