Tips for communication
Employers and Representatives
Open communication and collaboration are essential for a supportive return to work environment.
This section helps employers, HR professionals, and insurers learn how to engage employees diagnosed with cancer in respectful, solution-focused discussions about work abilities, accommodations, and reintegration planning.
Employers and Representatives Communication and Teamwork in Return-to-Work Ongoing collaboration between employers, employees, and partners is the foundation of a successful return.
Providing continuing support to employees when they return to work is one of the biggest factors in a successful return to work. Helping someone who has been diagnosed with cancer to successfully return to (or stay at) work typically involves ongoing dialogue with the employee, obtaining information from their healthcare provider and consulting with their disability insurance provider.
Getting clear information from the healthcare provider can be very beneficial in creating workplace supports that the employee with cancer may need. In turn, when employers provide information about the employee’s job demands, this can greatly help healthcare providers understand the workplace and provide clear recommendations to the employer.
Similarly, insurance providers can benefit from having a good understanding of the job demands and the employer’s expectations. In many cases, they can provide rehabilitation or workplace supports to foster a successful, sustainable return to work.
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Helpful Professionals to Support Return to Work
Medical team
Family doctor
Family doctors (also called general practitioners or GPs) play a key role in assessing, treating and addressing issues that may affect your ability to work. Family doctors know about your cancer and its treatments, but are also aware of other health conditions you may have that may contribute to your cancer recovery.
Medical oncologist
A medical oncologist is a doctor who specializes in caring for patients with cancer using chemotherapy, hormonal therapy, biological therapy and targeted therapy. Some oncologists specialize in one type of cancer, such as breast or lung. Medical oncologists prescribe cancer treatments and medications to treat their side effects. They may also be part of research on experimental cancer drugs. Right now, there is little research on the effect of certain cancer treatments on work abilities. With new treatments constantly being developed, medical oncologists often know the most about the effect of treatments on work ability.
Radiation oncologist
Radiation oncologists are doctors who specialize in radiation to treat cancer, to control the growth of cancer or to relieve symptoms such as pain. Radiation oncologists work closely with medical oncologists, surgeons, and other doctors to plan your treatment and manage any side effects that may occur due to radiation therapy. Radiation oncologists know about radiation effects through their clinical experience, and they are the best doctors to advise you on how radiation treatment can affect your work ability.
Surgical oncologist
Surgical oncologists (or cancer surgeons) are doctors who have additional training to diagnose, biopsy and surgically treat cancers of all types. They are specialized to remove cancerous lesions, tumours and organs and obtain tissue samples to make a diagnosis. They are experts in assessing the effect of cancer surgery on work ability. Major surgeries like amputations can significantly affect work ability. The same is true for other surgeries, such as colostomy or ileostomy (opening a small hole (stoma) from the abdomen to bring to the surface a loop of small intestine to let intestinal waste be collected in an external pouch). Brain or neurological surgery can also affect work ability as this type of surgery can affect physical and mental functioning.
Surgical oncologists are the best doctors to advise you on how long it will take to recover from surgery and how it may affect your work abilities. Cancer survivors may go on to have other treatments such as chemotherapy and radiation. In these cases, your oncology doctor or your family doctor may be better at assessing the cumulative effects of treatment on your ability to work.
Psychiatrist
A psychiatrist is a medical doctor with additional training in assessing and treating those with mental health challenges such as anxiety, depression, post-traumatic stress and psychosis. Psychiatrists can provide therapy, prescribe psychiatric medication and help figure out if psychological reactions are caused by medical problems, such as cancer and its treatment. They can also help determine the effects of psychological challenges on work ability. Neuropsychiatrists specialize in treating people whose psychological problems are caused by neurological changes. Many large cancer centres have access to psychiatrists and neuropsychiatrists.
Rehabilitation team
Occupational therapist
An occupational therapist, often abbreviated OT, assesses how an individual’s physical, cognitive and affective health impacts their ability to complete activities. Interventions may include restoration of skills or adaptation of the activity and environment to enable participation in activities. Occupational therapists can assess the job tasks, your functional abilities, and the work environment to make recommendations such as adaptations to job tasks or routine, use of aids or assistive technology and healthy ergonomics to promote maximum work engagement. Education to manage your symptoms, such as fatigue or memory impairment, may also promote successful return to work roles.
Vocational rehabilitation counsellor
Vocational rehabilitation counsellors help people with health conditions or disabilities address their employment concerns. They help cancer survivors get the rehabilitation services, medical and psychological services they need to stay productive at work or improve their function so they can return to work. They can assess work skills and abilities, provide career counselling and recommend suitable kinds of work. Vocational rehabilitation counsellors negotiate accommodations with employers and teach people how to search for new jobs if they want to make a change.
Neuropsychologist
A neuropsychologist is a psychologist trained in the assessment, treatment and prevention of behavioural and mental conditions. Neuropsychologists focus on how injuries or illness of the brain affect cognitive function, such as attention and memory. They can provide assessments, education, rehabilitation and counselling related to changes in thinking abilities. Seeking care from a neuropsychologist can be very helpful to those whose work tasks require cognitive abilities. Neuropsychologists can assess cognitive strengths and challenges that might impact work performance and provide guidance on ways to compensate to help maintain or enhance functioning at work.
Physiotherapist
Physiotherapists (also called PTs or physios) treat people who have been impaired due to injury or illness. They assess people’s ability to move and maximize their quality of life through prevention and rehabilitation. Physiotherapists can help you reduce your pain and stiffness, increase your endurance, strength and balance, and regain work ability. They can help you safely return to work by assessing the demands of your job, analyzing your work abilities, developing programs to get you ready to return to work, and deciding when you are ready.
Kinesiologist
Kinesiologists (sometimes abbreviated RKin or kin) are experts at assessing fitness and designing exercise programs. They have a deep understanding of body training and how the body responds to exercise. They help people increase their fitness to maximize their physical abilities and prepare them to return to work. A kinesiologist can design an exercise routine customized to your health needs and circumstances.
Workplace team
Human resources professional
Human resources representatives are required to: A) Manage claims and facilitate the Early and Safe Return To Work (ESRTW) process. B) Ensure that all required documentation is completed and filed. C) Contact the worker as soon as possible after the injury/illness or disability occurs. D) Communicate and cooperate with the worker throughout the period of their recovery or impairment. E) Work to provide suitable and available employment. F) Review physician reports and chiropractor/physiotherapist reports (Form 8/10 – WHSCC) when submitted by the employee. G) Develop ESRTW plans based on information provided by the physician, chiropractor/physiotherapist, occupational therapist or the Commission, in consultation with the supervisor. H) Communicate and distribute plan information to all appropriate parties. I) Monitor progress and compliance of employee participating in ease back and modified duties program. J) Periodically review the plan and revise as required. (Reference: Workplace Health, Safety & Compensation Commission of Newfoundland and Labrador)
Return to work coordinator
Return to work coordinators ease the return to work by communicating with employers, insurers and employees during their absence and when they are ready to go back to work. They identify any programs and insurance benefits available to the employee. They hasten the return to work process by answering questions, addressing concerns, and creating a return to work plan that supports the employee. They then track the plan’s progress to make sure it succeeds.
Occupational health nurse/advisor
Occupational health advisors are often nurses and work for your employer on staff or as consultants. They specialize in workplace health and can help you understand your legal rights. They can also help you decide if you are ready to return to work after treatment and recommend accommodations that will allow you to stay at work. For more information on this role see the Canadian Occupational Health Nurses Association Inc.
Union representative
Determine if a union group exists within your institution. If it does, a union representative can provide valuable advice on your plans to return to work, and on work accommodations. Duties of union officials include working with the employer to find reasonable work accommodation solutions for employees returning to work.
Insurance team
Case manager
A case manager is involved with the other insurance team members to monitor and make decisions regarding your claim. They gather information to assess your ability to work, track your progress, determine and refer to other professionals to aid in vocational rehabilitation and help to calculate insurance payments for a graduated return to work.
Vocational rehabilitation consultant
The vocational rehabilitation consultant specializes in vocational rehabilitation (see vocational rehabilitation counsellor) and can provide professional assessment, make recommendations to determine employability and rehabilitation services, and consult with your employer to aid in return to work. They are employed by the insurance provider and are therefore not acting as a counsellor, but can be very helpful in working with you to identify and overcome the barriers to work and developing a vocational rehabilitation plan to help you return to work.
Insurance consultant
The insurance consultant is often the person who sold the insurance policy (typically short- and long-term disability or critical incident insurance) to your employer or union. They are often very familiar with the terms of the insurance contract and can be helpful in interpreting, navigating or advocating if the insurance company is not meeting the terms of the contract.
Other helpful professionals and how they can help return to work
Healthcare team
Physiatrist
Physiatrists are rehabilitation physicians who have completed training to assess and manage long-term or permanent nerve, muscle and bone injuries or deficits (due to surgery, diseases or conditions) that affect how you move. Some have specialized training in cancer since cancer and/or its treatment can impact these components.
Pain and symptom management/palliative care doctors
Pain and symptom management/palliative care doctors focus on providing patients with relief from the symptoms, pain, physical stress and mental stress of a serious illness – whatever the diagnosis, including cancer. They are well positioned to understand how pain and palliative care can be managed to help in your return to work or to stay at work. They can offer symptom management to help you return to work after treatment or to continue to work for as long as possible during disease treatment. They also provide support throughout the course of the treatment for the disease and beyond for both patient and family/caregivers whether or not the disease is cured.
Nurse
Registered nurses (RNs) and licensed practical nurses (LPNs) work with cancer patients to answer questions, monitor for symptoms and side effects, and to provide support to patients and their families. Registered nurses may be specially trained to provide chemotherapy treatments and to support those patients undergoing radiotherapy. In addition, they can work in clinical trials. Registered nurses are often the first line of communication to the medical team and can help to address symptoms of cancer and treatment that might affect your work ability.
Nurse practitioner
A nurse practitioner (NP) is a registered nurse with additional training and education in physical assessment, diagnosis, and treatment. A NP can complete medical histories, perform physical examinations, order diagnostic tests and prescribe medications. NPs work with physicians and other members of the healthcare team to manage symptoms and treatment side effects. Like oncologists, nurse practitioners specializing in oncology through their clinical experience and training have extended knowledge about cancer treatment and side effects. This makes them qualified to provide guidance in symptom management to improve function at work.
Ophthalmologist
An ophthalmologist is a physician with specialized training in the anatomy and function of the eye and vision disorders. Some ophthalmologists (neuro-ophthalmologists) have specialized education and training in visual difficulties arising from the invasion of diseases such as cancer into the visual centres of the brain. Ophthalmologists can recommend vision aids (glasses), provide an assessment of the limits of vision and be helpful in coordinating referrals to vision services to improve function, such as the Canadian National Institute for the Blind or in the case of brain injury, to neuro-rehabilitation.
Otolaryngologist
An otolaryngologist is a physician specialized in the medical and surgical treatment of disorders of the ear, nose and throat, as well as related structures of the head and neck. With cancer diagnosis specifically affecting these regions, such as head and neck cancers, otolaryngologists can be helpful to discuss adaptive aids for hearing or speech to assist in your return to work planning.
Pharmacist
A pharmacist can provide guidance on the safe and effective use of medications. Pharmacists offer advice about drug selection, monitoring for side effects, avoiding drug interactions and assessing outcomes of therapy. They can be a helpful resource for learning how side effects or interaction with medications might impact your ability to function at work.
Rehabilitation team
Social worker/clinical counsellor
Oncology social workers/counsellors are trained and have relevant experience to support cancer patients and families as they adjust to the many changes and challenges that can occur as a result of having had a cancer experience. Social workers/counsellors can help with social, emotional, relationship and practical issues related to self-image, depression, family, work, finances, insurance, disability, distress and anxiety, and identify appropriate supports that can help. Returning to work following cancer is a vulnerable time for many; decision-making can feel ambiguous or uncertain. Social workers/counsellors can help you to talk about your experiences, reflect on and clarify your thoughts and help you gain perspective. They can also help you develop coping strategies to deal with challenging situations that may arise while learning to adjust to your new normal including coping with living with cancer. More specifically, they can assist with decisions regarding readiness to return to work, job loss, disability, mobility issues and vocational concerns. They can be a very helpful resource for you to find the services that could assist you with your financial and return to work needs.
Psychologist
A psychologist is trained to understand the impact of normal and abnormal brain functioning on cognitive, emotional and behavioural functions. A clinical psychologist may provide psychological support to a person who is struggling with a cancer diagnosis and can provide counselling to address psychological issues that could affect functioning at work.
Speech-language pathologist
Speech-language pathologists (also called SLPs or speech therapists) assess and manage communication and swallowing disorders. They help people communicate better by improving their pronunciation, word-finding, understanding, reading and writing, reasoning, problem-solving, memory and organizational skills. SLPs also help people with swallowing challenges by providing therapy or teaching strategies to allow them to eat safely without risk of choking or developing pneumonia.
Lymphedema therapist
There is a wide range of healthcare specialists that specialize in the treatment of lymphedema after cancer such as physical medicine doctors, nurses, physical therapists, occupational therapists and massage therapists. You may need to educate your employer on lymphedema as not all are aware that lymphedema can be a complication of cancer treatment. A lymphedema therapist can recommend wearing a compression sleeve or garment as a precaution. They can also help rehabilitate lymphedema symptoms and may provide guidance on lifting capacity, range of motion and specific movements to avoid further pain, negative symptoms, and injury.
Workplace team
Employee assistance counsellor
An employee assistance counsellor is a clinical counsellor, social worker or psychologist who can listen to your concerns about the workplace and your wellbeing. They can help you cope with stress, address interpersonal issues and, in some cases, explore career changes. Employment assistance counselling is typically funded through workplace extended healthcare plans. For more information, see the Disability Management and Accommodating Employees with Disabilities by Yukon Health Public Service Commission (PDF; page 13).
Disability management professional
A disability management professional can provide direct services to employees with disabilities. They can perform functions related to the administration of disability management services including the development of policies and procedures, as well as the promotion of return to work concepts through education and training. They can facilitate return to work with all stakeholders and assist with overcoming any barriers in the return to work process. Disability management is about looking at functional information and working with the employer to find suitable accommodation for the employees that fall within the functional abilities recommended by treatment providers. They can help to source assistive devices and work with outside providers to help ensure the employee is supported.
