Man speak with Forked Tongue

Years ago I checked the health of applicant Fork Lift Truck drivers at the factory where I was an occupational health nurse.

The factory worked 24/7 with rotating 12-hour shifts in a factory that produced and packaged ready to feed baby milk in cartons. Cartons were automatically wrapped by machine and the cartons came off the end of the line and then packed into larger heavier boxes.

The milk had a long shelf life so although the product was popular it sold quickly. The stock was stacked in a cooled warehousing complex where fork lift trucks fetched and carried the boxes constantly – reordering, stacking and piling the wrapped palletised boxes.

The pay was good and successful applicants were fully trained before starting work.  Unemployment was high in the area so jobs were hard to come by for young men, so, there were always a lot of applicants; sometimes 40 people applied for just one vacancy.

Medical Standards for our Fork Lift Truck Drivers

Fork lift truck driving is not covered by the requirements of the ordinary (Class 1) driving licence, as many company warehouses are not on the public highway. Bu,t in view of their potential to cause harm to themselves, others and most likely the warehouse walls, we followed HSE guidance at the time which was to medically check them all. The checks included blood pressure, hearing, etc. The guidance is now withdrawn, but at the time specified that workers should be medically fit to operate the fork truck which included being able to escape in an emergency.

There was also the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations which means that any failure, collapse or overturning of lifting machinery, excavator, pile driving frame or mobile powered access platform must be reported to the proper authorities as it could have been a serious accident.

The Health Checking Process

The medical started with the job applicant filling in a health questionnaire which asked questions about potential problems with driving the fork lift truck or responding to emergency situations. At the end of the form, the applicant driver would sign a declaration saying all the information is correct.

And, as PL put it, ‘A bit like being in a courtroom.’

I would then go through his (never any woman lift truck drivers applied on this site) answers. If I thought a health problem would affect driving or I had concerns I could write to the GP or specialist, ask for a workplace test or say they failed the test on safety grounds. Obviously, it would be really serious for the applicant if I failed someone without consideration of all the facts.

Finding Health Problems for Drivers of Fork Lift Trucks

PL was 18 with a stack of blonde, sticky up hair arranged in tousled layers.  He sat, arms folded as I inspected his answers.  They were fine on all parts of the medical form – no health issues declared and nothing to investigate further. So I moved on to do the health checks which were:

Next were the health checks:

  • Eyesight test for near and distance vision (one eye at a time) with and without glasses
  • Urine test to check for diabetes
  • Testing hearing for alarms and shouts
  • Blood pressure
  • Balance and coordination test
  • Making sure musculo-skeletal parts were working for driving e.g. neck movements to look around when driving forward and reversing, back movements for twisting and being able to squat
  • Full movement of hands and arms for manual handling and using the controls of truck
  • Rotation of the ankles and feet for brake and accelerator use, plus there was a lot of walking involved in the job.

Fitness for Work

All went well till he had to rotate his ankles and feet. PL struggled to bend his foot any way at all blaming it on the new ankle boots he was wearing. I asked him to try again and to take his boots and socks off.

I didn’t realise that this is just what PL was dreading for, as the bare feet emerged from the boots, I saw the problem. It wasn’t the boots at all. He had two distorted feet with silver scars crisscrossing the upper foot and ankle. Looking up from the naked feet my eyes found PL’s and his face slowly turned a brilliant hot red.

‘I’m sorry nurse but my ankles are fixed like that. I’ve had loads of operations on them since being a kid. They work OK but I thought I wouldn’t get the job if I told you.’ he said

My eyes switched back to the sorry feet that rested between us.

I felt for the would be driver but glad I had investigated things a bit further. Now I was in a quandary. What to do? The good fairy was feeling sorry for him especially as I had caught him out (and I am a nurse after all). On the other shoulder, the puritanical fairy shouted in my ear to send him packing. The company had a high regard for honesty and integrity.

I was conscious that he had not only lied to me about his boots and ankles, he also hadn’t mentioned operations and specialist care during our discussions.  No wonder he was red.

An Occupational Health Nurse Dilemma

I talked to him about the ankle operations and learnt the full story. Now that I had found him out he was more than happy to give me a blow-by-blow account of the ankle saga, infections, plaster splints and crutches. He had been in and out of hospital as a child. One part of me listened, but another part thinking about what to do with him. I talked about the options available and asked if I could talk to the hiring manager about his health problems. Usually, occupational health professionals don’t discuss medical details because of confidentiality rules (and Data Protection Act). We have to obtain a patients consent before sharing personal health information. I guess PL was expecting the worse so any hope of getting a job welcomed.

I spoke to the warehouse manager who had already interviewed the boy; it really helped that he really shone in the interview.

‘PL has restricted movements in his feet’ I told the manager, ‘And you will need to do an on site lift truck test with him.’

The manager looked at me expecting me to say more. I pointed out that there may be an issue with using brakes or the accelerator pedal. He would also be on his feet all day. A practical job assessment would be the only way we could measure whether he could do the job or not. Due to these factors, he might also need longer probation. The manager hesitated and then called PL through,

‘OK son, follow me.’ PL followed sheepishly behind the Manager, looking nervously at me as he left.

Result of Test

Later that day I learnt PL passed the test easily and the manager and the boy were happy.

I never saw PL again as the factory transferred to Ireland and all the staff either relocated or redundant. But I often wonder how PL would get on at his next job interview and medical. Would he tell the truth about his health or decide to hide the disability?

Should I have told the manager about the deceit, written to the GP for verification of the facts or even failed him? Well, I weighed the situation up, deciding to give PL the benefit of the doubt. Occupational health professionals deal not only with medical matters but social and personal matters too. People often tell us things we know are not true but understand the fear behind the declarations. By using the medical checks with the manager’s assessment I believe we made the right decision.

Would I do the same again? Probably.

Good, Bad and Smugly
Behind the Scenes at Occupational Health

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This extract is taken from “The Good the Bad and the Smugly: Behind the Scenes at Occupational Health” available on the Amazon store

Forktruck Medicals – what do they involve?

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