- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Tuesday, January 01, 2008

Happy New Year + enquiry: Occupational Health and Hodges' model

Whether the 1st of January is with you or yet to arrive as I post this I would like to wish you a very happy and peaceful New Year.

I've received an enquiry from Pippa Crouch copied below - a great start to 2008.

There's another post to follow today on University of Toronto's Health and Human Rights Conference later this month and WorldCOMP'08. In the meantime....

Pippa: I'd be very pleased to help you. If you've some specific questions about the HUMANISTIC-MECHANISTIC dimensions in the OH context ask away and I'll try to answer them. Once your study is sorted we can move on from there. (I have a graphic template for an A3 poster - used in 2005 - I can share with you.... If your OH contacts/Univ. would like me to link to the conference let me know.) Thanks for your interest and the insights/references below, really enjoyed reading it.

Sent: Saturday, 29 December, 2007 7:27:12 PM
Subject: thank you - OH and Hodges' model

Just wanted to say a quick thank you for your web site.

I am writing a paper for my Occupational Health degree and have to apply a model. As it stands there are no models specific to OH which are of any use. They are either theoretical or 'amended' from traditional nursing.

I stumbled across your website and thought I would give the career model a paragraph or two, but have become completely converted and will now be using it as the model on which to base my critical incident.

After spending weeks shifting through all the dross that apparently is supposed to make our lives as nurses easier, it is nice to finally find a model that I can actually use in practice. I will (after submission of course) be posting the link on our University website.

Many thanks

Pippa Crouch (convertee)

Date: Sat, 29 Dec 2007 21:56:11 +0000
Subject: Re: OH and Hodges' model
Hello Pippa

Thanks so much for your message - a real fillip with the start of a new year beckoning.

I'm really pleased to hear that the model is useful. As you may be finding the model will grow with you as you learn and encounter new OH and other experiences.

If you have any queries get in touch and let me know how you get along. I'd be delighted to provide some feedback on your study. If you wish and would like to provide a little background about yourself, such as where you are studying and practising I would very much like to post your message on the blog?

As you have noticed on the blog one of the ideas for the new site is an open source book that people can contribute to. A contribution on OH would be a great idea. If you are already published or would like to try I'd be delighted for us to knock some ideas around regards the possibility of collaborating. (Maybe other OH practitioners will get in touch and provide assistance and opportunities?) Your studies are the priority at present of course.

Any way all the best with your studies and for the new year holiday.


Sent: Monday, 31 December, 2007 7:56:31 PM
Subject: RE: OH and Hodges' model
Hey Peter

Please feel free to publish any of my emails on the blog.

As you know now, my name is Pippa Crouch and I'm an OH nurse advisor at East Grinstead Hospital. I'm fairly new to OH, but I have a sound background in oncology and A&E. I have recently experienced a very steep learning curve from spending two years as a practice nurse in OH to becoming an OH nurse advisor virtually overnight. Couple that with now running my own department for a small NHS trust (of around 1000 employees), this transition has been alarming to say the least!

I suppose what I have found the hardest is the ethical position that being an OH nurse puts you in. You are still the patient's advocate, but you have a wider responsibility to the employer and community as a whole. This I suppose is what part 3 of the register prepares you for.

I have never been pro models and usually I think they are a waste of time and energy. Nursing is an instinct; if you are unable to talk to patient’s and decipher their needs then you are in the wrong profession.

That said, whilst looking back on my nursing career, there is a distinct basis from which the questioning occurs, whilst in oncology there was Orem's self care model in the background and A&E - a very loose base of Roper, Tierney and Logan.

I suppose why I am struggling now is because there is no universal model for OH. Wright (1990) likened OH nursing to a building with fours pillars from which to distribute the weight equally. Each pillar is a simile for practice, education, research and management and each has to be equal else the building will fall.

Adisesh (2003) designed the OH Paradigm which incorporates how work can enhance health giving it a more balanced view as opposed to always causing detrimental effects.

In OH there are many models, yet there does not appear to be a universally accepted model to date. This presumably is due to the diversity and ambiguity of the OH role. Alston (1990) devised the Hanassari model which has allowed OHNs to reflect on their role, yet there is little indication that it has actually been applied in practice (McBain, 2006; Chang, 1994).

When I started my role, I found myself suddenly expected to be able to take patient histories and identify needs. I relied heavily on my experience in A&E for this, what I wanted was a model and an assessment tool that was actually applicable to the working environment.

I stumbled across Hodges' model purely by chance and at first gave it little thought. Then lying in bed that night I began to see how all the pieces fitted together. I realised how I could use my A&E assessment tool but take it further and how to use it as a health promotion tool as well. If I am honest then I am only learning the basics of it at present but feel it will grow with me and I can tailor it to my needs.

The only area I feel I would like more guidance is the humanistic to mechanistic section. I lack some clarity and was hoping you could offer some help?

To be honest I doubt I will be able to attend (2 very small children..), but I have been asked to write something for the OH review. I am thinking that with your guidance I may be able to use the HC model for it? I have been approached by the University to present a poster at this year’s OH conference.

Let me know what you think, and please feel free to edit any of this for the blog.

Wishing you all a happy New Year.


Adisesh, A. (2003). Occupational Health Practice. In Snashall D, Patel D (eds) ABC of Occupational and Environmental Medicine. London, BMJ Publishing.
Alston, R. (1990). 'A critical examination of roles and attitudes of occupational health nurses, their relationship with safety personnel and managers and implications for education and training initiatives'. MA Thesis. Thames Polytechnic, London.
Chang, P-J. (1994). 'Factors Influencing Occupational Health Nursing Practice'. A two-part PhD thesis. Kings College London, University of London.
Hodges, B. (1997). Hodges' Health Career Model http://www.p-jones.demon.co.uk/hcm.htm (Accessed online 29/12/07 Online: 1998-2015).
Wright, S.G. (1990). Building and Using a Model for Nursing 2nd edition, Edward Arnold, UK.