Terry Driscoll, Mark Basich, and Rick Wiskstrom give us insight into "Work Therapy On-Site" in the workplace. Their major guideline is: "You don't have to get injured workers well in order to put them back to work. You put them back to work to get well." It all boils down to the job-specific treatment approach that combines therapeutic work will: increase worker functional capabilities; coach the worker in safe work methods to avoid reinjury, and progressive accommodation to reduce job demands through administrative or engineering controls.

Debra Jacobs presents an approach to resolving barriers to return an injured worker to work. This approach is effective and establishes return-to-work programs. Focusing on return-to-work programs that set the pace for a progressive plan of action for transition injured/ill workers through the continuum of modified duty during their recovery to full duty work as physical abilities allow. She points out that delayed medical care and rationing care is the most expensive medical care. The odds of a worker returning to work decreases by 50% by the 12th week of being off work. If a worker is not back to work in 6 months, then less than 58% will ever return to work. Her final comment on this subject is that each nurse must focus on the initial injury with urgency, appropriate treatment, educating all parties on "Disability Prevention" and "On Job Recovery."

Violet Clarke outlines the many hats a catastrophic nurse wears. She maps out a route that takes the patient to the feasibility of reentry into the world of work. Her article is a wonderful checklist to provide the patient the best care possible.

Frances Snowden, BS, RN, CRRN, CCM

Contributing Editor