Your Employee Health Nurse Is Leaving: The Handover That Keeps the Program Running

The resignation letter gives you two weeks. The obligations it leaves behind run for the duration of that employee's employment plus thirty years.

The short answer

Almost nothing in an employee health program fails loudly when the person running it leaves. The exposure case that needed a six-month draw, the fit test that expires in March, the confidential list that matches case numbers to names on the 300 Log — none of those raise an alarm. They simply stop happening. A handover is worth doing in one pass, in deadline order: what has a clock running today, what has an annual clock, and what has no clock at all and disappears anyway.

What actually walks out the door

It is rarely the records. Records are usually somewhere findable, even when "somewhere" is a shared drive nobody has opened in a year.

What leaves is the state of the program. Which cases are open. Who is overdue and has been chased twice. Which manager always returns the form late and needs a phone call rather than an email. Which of the three people called Robert Smith is the one on restricted duty. That knowledge has no file, and it is the reason a program that looked fine in January is visibly behind by April.

So the goal of a handover is not to transfer documents. It is to convert one person's memory into something with a date on it.

First: anything with a clock running right now

These have legal deadlines that do not pause because somebody resigned. Work through them before anything else, because they are the only items where a two-week gap creates a violation rather than a backlog.

• Open exposure cases. A bloodborne pathogen exposure is not an event, it is a file that stays active for four to six months. Under 29 CFR 1910.1030(f) the employer owes the evaluation, the follow-up and the written opinion. List every open case with the date of exposure and the next draw due. This is the single most damaging thing to lose.
• Form 301s not yet completed. Due within seven calendar days of learning of a recordable injury. Anything logged in the last week needs finishing now, not after the replacement starts.
• Sharps log entries that are incomplete. California gives you fourteen working days; federal OSHA sets no deadline but still requires the log. The entries that stall are always the ones waiting on the injured employee's own opinion of what would have prevented it, and that conversation gets harder the longer it waits.
• Any serious injury inside its reporting window. Eight hours for a fatality, twenty-four for an in-patient hospitalization, amputation or loss of an eye — and eight hours for a hospitalization if you are in California. If one is live, it is not a handover item. It is a today item.

Second: the annual clocks

These fail quietly and are usually what the next person discovers in month three.

• Respirator fit tests. Annual, and the record has to name the make, model, style and size — not "N95". Get the expiry list, sorted by date. If it does not exist as a list, that is the first thing to build.
• The medical evaluation behind those fit tests. It gates the test, it is confidential, and it is filed separately. Know where.
• TB program. Since the 2019 CDC and NTCA recommendations there is no routine annual testing for U.S. healthcare personnel, but baseline screening at hire continues, as does annual education and annual symptom screening for anyone with untreated latent infection. Find out which of those the program actually does, because plenty still run an annual PPD out of habit.
• Immunization and declination status. Particularly hepatitis B, which is the one vaccine federal law actually requires you to offer, with a declination form the standard prescribes.
• The 300A. Posted February 1 to April 30, certified by a company executive. If the departure is in autumn, the person leaving is the only one who knows what is still unresolved on the log.
• Electronic submission. Due March 2. Read the next section before you assume this one is fine.

Third: the things with no clock that vanish anyway

This is the part most handovers skip, and it is where the expensive surprises live.

The privacy-case list

Six categories of case go on the 300 Log without the employee's name — needlesticks among them. You write "privacy case" in the name column and keep a separate, confidential list matching case numbers to people.

That list exists nowhere else. It is not in the log, by design. It is frequently in one locked drawer or one password-protected file, and when the person who made it leaves, an auditable record becomes an anonymous one permanently. Find it first. Confirm somebody else can open it.

Logins that do not transfer

OSHA's Injury Tracking Application requires a Login.gov account tied to a work email. Nobody inherits it automatically. If the person who filed last March has gone, you find out on March 1, which is the worst possible day to find out.

The same applies to the state reporting portal if you are under a state plan, the immunization registry, the lab portal for titer results, and whatever system holds the audiograms. Write down every one, with who else has access. "The nurse had it" is not access.

Active restrictions and open leave

Who is on modified duty, what the restriction is, when it was meant to end, and which of those are already past their review date. Restricted days are counted and capped on the log, so an unwatched restriction is both a duty-of-care problem and a recordkeeping one.

The relationships

The occupational medicine clinic you actually use, the one you stopped using and why, the lab rep who can chase a result, the manager in environmental services who does not read email. None of this is written down anywhere. Ask for it out loud, in a room, and take notes.

Five things to get before the last day

1. A list of open exposure cases with next action and date.
2. The privacy-case list, and a second person who can open it.
3. Fit test and screening expiry dates, sorted, however rough.
4. Every login and portal, with a second holder named for each.
5. An honest answer to: what is behind right now?

That last one needs asking plainly and without consequence attached. Every program is behind on something. A departing colleague who believes the answer will be held against them will give you a tidier list and a worse handover.

The edge case: the program that was already behind

Sometimes the resignation is the disclosure. The person leaving has been carrying a backlog nobody above them knew about, and the handover is where it surfaces.

The instinct is to treat that as a performance problem. It is usually a capacity problem — employee health is frequently one person who is also the infection preventionist and also the workers' compensation coordinator. What matters in the two weeks you have is an accurate map, not an accounting. You can decide later how it happened.

One thing not to do: do not clear the backlog by destroying anything. Employee exposure records run thirty years, medical records the duration of employment plus thirty, and the OSHA forms five years after the year they cover. A tidy-up during a transition is how decades of required records disappear in an afternoon.

If you are the one arriving

Do the four clock items in week one. Build the expiry list in week two, even a bad one in a spreadsheet, because you cannot plan against a program whose due dates you cannot see. Then ask for the previous person's phone number and permission to use it once.

Most of what you need in the first month is not in any file. It is one conversation, and it is available for about six weeks after somebody leaves and then it is not.