Managing return to work after a heart attack
Managing return to work after a heart attack
Understand, don't fear restrictions
Managing return to work for an employee who has had a heart attack not only involves determining worker's abilities and restrictions, but also can involve educating the worker about what precautions he or she should take, as well as what he or she should not be afraid of.
According to the Dallas-based American Heart Association (AHA), most people who can perform routine activities requiring ordinary effort without being bothered by heart symptoms should be able to return to their previous jobs after recovering from a heart attack.
Because 45% of heart attacks occur in people younger than 65 and most people survive heart attacks, managing return to work after a heart attack is not an uncommon task for occupational health nurses. The vast majority of people who are not troubled by symptoms during normal activities requiring ordinary effort should be able to return to their previous jobs unless there are specific fitness requirements, according to AHA.
Job descriptions since the passage of the Americans with Disabilities Act (ADA) have become quite broad, but when working on a return-to-work plan for an employee who has suffered a heart attack, specifics are important, says Maureen Thompson, RN, COHN-S/CM, manager of employee health services for Toyota Financial Services in Maryland.
"The ADA makes job descriptions broad, but you need to get a detailed one for the physician," so that he or she can have an accurate picture of the physical demands the employee's job carries.
"Then, the occupational health nurse should meet with the employee's supervisor and the employee to go over the restrictions to make sure they both understand them," she says.
It's important that an employee understand what the restrictions are and what they are not. AHA recognizes that many people recovering from heart attacks are sometimes afraid that the rigors of everyday life might cause new heart symptoms, but fears of dying, of new pain, or of being unable to work are normal and should diminish with time and adherence to restrictions and a healthy lifestyle.
"You do have to make sure the employee understands the restrictions and that he or she must adhere to them, and that if they don't they'll have problems all over again," Thompson points out.
Rehab, monitoring contribute to re-entry
Before releasing a heart attack patient to return to work, the physician will evaluate his or her fitness and the heart's ability to respond to exercise. If the level of response is within acceptable limits, cardiac rehabilitation might be recommended.
Rehabilitation can aid in re-entry to work by addressing the patient's risk factors, treating symptoms, restoring physical fitness, relieving anxieties about the heart attack, and providing counseling to the patient and support to the family.
The occupational health nurse can not only help the employee understand the restrictions on his or her return to work, but also can help supervisors and co-workers understand the facts about heart attacks through general education.
"The occupational health nurse might also estimate the frequency of visits to the medical center, making sure that someone is medically watching the employee so that the physician can have an ongoing pattern to monitor," Thompson adds.
[For more information, contact:
- American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231-4596. "How Will I Recover From My Heart Attack?" available at http://www.americanheart.org/presenter.jhtml?identifier=3007458.
- Maureen Thompson, RN, COHN-S/CM, manager, employee health services, Toyota Financial Services. Phone: (410) 415-4420. E-mail: [email protected]].
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