Co-workers play an important, but sometimes “invisible” role in RTW

If you’re trying to bring an injured worker back to work, you may want to talk to his or her co-workers. A new study suggests they may have some important insights about how best to help the injured worker get back to, and stay on, the job.

Published: April 22, 2010

Co-workers can play a positive role in the return-to-work (RTW) process, yet their efforts are sometimes ‘invisible’ to supervisors, notes doctoral candidate Åsa Tjulin. She spent time in 2009 at the Institute for Work & Health (IWH) as a student in the Work Disability Prevention CIHR Strategic Training Program (see below).

The role of co-workers becomes especially prominent, Tjulin says, once an injured worker comes back to work. That’s the point at which the day-to-day responsibility for ensuring that the worker’s return goes smoothly may shift from the supervisor to co-workers. A lot of effort is made by co-workers behind the scenes, and their efforts are not always noted by supervisors.

Tjulin designed and carried out a qualitative study involving three public-sector workplaces in Sweden. She analyzed the data with IWH Scientist Dr. Ellen MacEachen (her mentor in the training program). Open-ended interviews were conducted with seven returning workers, two or three of their co-workers, and the supervisor and/or human resources manager responsible for the return. The workers had been off work due to such conditions as musculoskeletal injuries, mental health disorders and cancer.

Although the study took place in Sweden, MacEachen says the findings may be applied elsewhere. Return to work tends to focus on relations between the worker and the supervisor or employer, she says. We suggest that the broader social environment – including co-worker relations – plays a critical role in return to work, regardless of jurisdiction or organizational differences.

Three phases in RTW

In this study, the researchers identified three distinct phases in the return-to-work process: off work, back to work and sustained work. Workplace challenges and social issues were identified in each phase.

  • Off work: The researchers noted that workplace social relations could become unbalanced during a worker’s absence. Normal roles changed, and a returning worker could be uncertain about how to engage with the supervisor and co-workers. Although the workplaces had policies around “early” contact, the supervisor, co-workers and the injured worker were not certain about how to “do” early contact.
  • Back to work: In each workplace, specific policies were in place to address an injured worker’s return. However, the researchers found that those facilitating the return to work had a process of their own, regardless of formal policies.
  • Sustained work: The researchers identified a gap in RTW policies around managing an injured worker’s abilities after returning to work. Co-workers played an important role in supporting and, to an extent, helping to organize the day-to-day tasks of the injured worker.

Although each phase is important, workplaces should pay particular attention to work sustainability, the researchers say. Workplaces need to consider the post-return phase. They should not think that everything is fine just because the injured worker has returned, says Tjulin. The entire work group is affected by a worker’s absence, and the return to work needs to be discussed and planned with all parties for optimal success.

The co-workers involved in this study largely described their interactions with returning injured workers in very supportive terms. They described the beginning of the RTW process, when the work colleague first falls ill, as “brotherly.” They talked about their “helping hand” approach in helping coordinate the return. And they talked of the “goodwill” relationship that develops once the injured worker returns to the workplace and co-workers take on the “social responsibility” to ensure the return goes well.

However, co-workers also noted that the “goodwill” relationship could not go on for an extended period of time.

The study’s findings were published online in the October 2009 issue of the Journal of Occupational Rehabilitation (e-pub ahead of print: DOI 10.1007/s10926-009-9209-9).

Training program focuses on work disability prevention

PhD student Åsa Tjulin is a trainee in the Work Disability Prevention CIHR Strategic Training Program, affiliated with the Dalla Lana School of Public Health at the University of Toronto. Funded by the Canadian Institutes of Health Research (CIHR), this program recently moved from the University of Sherbrooke to the University of Toronto.

This program helps new researchers develop and expand their knowledge and skills in work disability prevention. Led by more than 20 international mentors, the training program attracts researchers from diverse academic backgrounds including ergonomics, epidemiology, kinesiology, psychology, occupational therapy, public health, medicine and ethics.

Tjulin spent a winter placement at IWH. I was interested in growing as a researcher in my field and having access to an international network of researchers with different academic backgrounds and disability prevention interests, she says.

The Institute is one of five international research centres in which trainees can complete their placement for the program.

For more information about this program, visit