Negotiating a successful return to work program.

This article has examined selected reasons why companies resist implementation of return to work programs. The reasons include many fears that companies can readily justify. Nearly all the fears can be eliminated when the occupational health nurse applies both nursing and management principles. As a specialized line manager in the company, with a specialty in people and systems management, the occupational health nurse is the most likely person to plan and implement a successful program. To design, implement, and manage the plan to a successful end, the occupational health nurse must enhance skills in language, salesmanship, and quantifying results. Success must be measured in both people and dollar terms to have relevance to the company, its bottom line, and its employees. People results, the harder of the two to measure, have value in helping to establish positive attitudes of program participants toward the company. People results also help prevent the development of disability syndrome by ill or injured employees by keeping them connected to work and productivity. People results also can be measured by the change in culture the return to work program is likely to produce among managers and employees. The resulting culture will reflect a sense of caring by the company about employees, and expectation that manipulation of the company by opportunists will be reduced, as scarce company resources will be conserved. The early return to work program is managed within employee capabilities in a therapeutic environment during the recovery process. In the long term, financial success of the return to work program can be measured by reduced costs per claim annually. Using the nursing, management, financial, and marketing principles discussed in this article, the occupational health nurse can improve chances of negotiating implementation of a successful early return to work program.