For nurses who enjoy both nursing and business, occupational health nursing is a career that combines both interests. While the majority of nurses work in medical care facilities or settings, occupational health nurses work in an office setting and care for employees of a company.
According to Betty Sanisidro, DNP, MSN, COHN-S, APHN-BC and the executive director of the American Board for Occupational Health Nurses, occupational health nursing is one of the nursing industry’s undiscovered secrets.
Nursing, says Sanisidro, was a calling she recognized from an early age. “When I was young, every time someone was hurt, I was the first to go to the rescue,” she says. After considering a premed path, Sanisidro says nursing offered her something she knew would be essential to her own career satisfaction–high patient contact.
“But I had no idea occupational health nursing was even an option,” she says. She was disillusioned by her current nursing role and didn’t feel like she was able to make the impact she wanted or expected. When a professional contact mentioned a job at a large corporation and noted that Sanisidro’s nursing background and bilingual skills were ideal for the role, she applied. With her strong medical base and her understanding of workplace safety and preventative care, Sanisidro says she realized the role would allow her to flourish, and she accepted the role when it was offered.
With that introduction to occupational health nursing, Sanisidro never looked back and appreciates the variety of her work and the relationships with the people she cares for. “You never know what will walk in the door,” she says. “I have to stay on top of my game. I felt like I hit the Disneyland of occupations.”
The job also offers opportunities for nurses to gain essential business skills they might not have in traditional medical settings. As a liaison to the leadership, occupational health nurses are relied on to give concise presentations and gather and report on data. For those reasons, Sanisidro says advanced degrees will benefit nurses. Even if an advanced degree isn’t required, she encourages nurses to pursue them. Certification in occupational health nursing is also valuable, and certification for this niche is for entry-level skills, so new nurses are able to take the exam. “The most important attributes in an occupational health setting are those that can’t necessarily be taught,” Sanisidro says. “It’s having that desire, care, and compassion. You can’t teach that.”
Unlike many medical centers, save for long-term care options, employees are generally with a company for a long time. And nurses gain deep knowledge of the business aspects of a company so they become experts at about compliance and keep detailed records about visits. Although occupational health nurses have specific daily, weekly, and monthly tasks to track, the day-to-day work is unpredictable. “There’s no typical week,” she says. “And that’s the exciting part of it.”
As a nurse within a corporate setting, occupational health nurses’ duties are broad. They can be counted on to give hearing conservation testing, eye exams, and preventative programs including biometric testing, health coaching, and nutritional counseling. There will be biosafety questionnaires and follow up exams. Nurses in this role can also see emergencies like a cardiac event, seizures, or anaphylaxis or less traumatic problems of something in an eye, a rolled ankle, an abrasion, or checking an unusual mole or suspicious skin lesion.
Occupational health nursing is sometimes confused with occupational therapy, which is distinctly different. But many people aren’t familiar with occupational health nursing–even many nurses. “It’s not a specialty reviewed in most nursing programs,” says Sanisidro. “But once nurses find the niche, they stay for a long time.”
Another difference that many occupational health nurses find is that there is funding in the specialty. Corporations that have occupational nursing staff are making a purposeful, direct investment in the employees’ health and well-being. “We may not generate revenue, but we can demonstrate what was utilized this month and if visits were for personal medical or occupational reasons,” she says. “You have to get comfortable with public speaking, PowerPoint presentations, and speaking the lingo of business, because businesses listen to dollar signs.” Occupational health nurses are also advocates for employees, so they are comfortable alerting the company to a workplace safety issue or a strange odor before it becomes a larger problem.
Employees, in turn, appreciate the convenience of health care in the workplace with someone they recognize and trust. “You develop a rapport and trust with them,” says Sanisidro. “They can just pop in and say hello.”
If occupational health nursing interests you, Sanisidro recommends reaching out to an occupational nurse for a conversation, shadowing a nurse to see what the role is like, or even picking up some per diem jobs through an agency to get a feel for the position. “If they love helping others and are caring and compassionate nurses,” she says, “everything else can be taught.”
One of the best things about nursing is that there is a rewarding job for everyone. While some professionals prefer to care for patients inside a hospital, others do their work while spending time outdoors, educating people or traveling the globe. No matter your personality or your working style, you can start an exciting career as soon as you get your registered nurse (RN) license. The following unique nursing jobs may require casual jogger scrub pants or a stylish, formal lab coat. Whatever you wear or how you like to contribute to others, one of these fresh and interesting roles is sure to suit you.
1. Forensic Nurse
If you have an investigative mind and like to advocate for your patients, forensic nursing may be right for you. These experienced RNs help to treat patients who are survivors of assault or abuse. They also collect evidence and may be asked to testify in some court cases. While it takes some training to become a forensic nurse, the field is growing. Nurses can also expect to earn between $59,000 and $89,000 per year.
Forensic nursing is always a rewarding challenge. Professionals with critical thinking skills, compassion and an understanding of the criminal justice system are encouraged to apply. While you will develop relationships with survivors, families and law enforcement, you will also make a difference in helping victims through a traumatic experience. Forensic nurses may work in hospitals, community centers and even in medical examiner offices.
Some of the biggest benefits of becoming a professional in the forensics field include a more flexible shift schedule, additional RN skills and a good salary. To become a forensic nurse, you will need at least an RN license and a BSN. Some roles will require you to obtain a certification as a sexual assault nurse examiner (SANE). There is even a SANE-P designation for caring for child and adolescent patients. Even if it is not a requirement at your current job, the SANE certification from the International Association of Forensic Nurses is invaluable to your career.
2. Occupational Nurse
Also referred to as employee health nurses, occupational nurses have a unique role outside of the hospital room. These experienced RNs work in factories, chemical plants and companies of all sizes to recognize and prevent damaging effects from hazardous exposures in the workplace. They may also be hired to treat workers’ illnesses and injuries and partner with other professionals at their company to analyze company medical benefits. Some work for private organizations, while others are hired by the government as contractors or consultants.
As an occupational nurse, you can expect to earn a higher annual salary with the more experience you have. According to PayScale, most nurses can be expected to bring in an average of $71,883 per year, while some of the highest-paid employee health nurses in the country make around $96,000. Some nurses can earn overtime pay, while others are on a fixed salary. Check with the organizations and employers in your area for specifics.
To become a nurse in this interesting field, you will need an RN license and at least two years of nursing experience. Some careers will require you to become certified as an occupational health nurse before you apply, while others will let you earn your certification in the first year on the job. The COHN or COHN-S exams take a few hours to complete. You must also submit an exam fee and recertify your license every five years. If you are committed to the effort it takes to make a difference as an occupational nurse, you will benefit the companies and employees that you work with.
3. Cruise Ship/Resort Nurse
A cruise ship nurse, resort nurse or yacht nurse gets to care for patients, all while working in relaxing or picturesque environments. Some are employed as registered nurses (RNs) in an onboard walk-in clinic, while others are authorized to provide higher-level care in a state-of-the-art medical facility. A resort nurse’s duties vary and may include everything from treating cuts and scrapes to prescribing medication.
While the nurse should have years of experience managing emergencies and triage, some common daily responsibilities include providing first aid and educating guests on how to care for medical conditions. They may also be in charge of education courses and care for onboard employees. Experienced nurses at sea could be hired to provide the company with expert information on how to deal with medical data and healthcare services.
If you would like to travel the world as a cruise ship or resort nurse, you will need an active RN license. Professionals with bachelor’s degrees or master’s degrees are even more attractive applicants for worldwide resorts, cruise lines and luxury yacht companies. Start by browsing jobs in the city or home port of your choice. Be sure to apply for your passport as you begin the interviewing process. You may be headed to a gorgeous international location before you know it.
4. Nurse Informaticist
Nursing informatics is a field of study that combines the fields of information science, communication and computer science. By gathering and analyzing data, nurse informaticists help hospitals and clinic administrators improve the flow of communication and information within their facilities. Other job responsibilities include interpreting and communicating data that will help to increase a clinic’s efficiency, promote excellent patient care and cut unnecessary costs.
To become a nurse informaticist, you will need an RN license, experience with patients and a BSN. Experienced RNs may find a job if they have an additional bachelor’s degree in healthcare or information technology. To be successful in this role, you should be analytical, with robust technical skills and an interest in solving problems. If you are willing to study and earn additional degrees or certifications, nursing informatics is sure to interest you and challenge you throughout your career.
This recent survey of nurse informaticists revealed that over half of them have a postgraduate degree. With all of the experience and specialty skills that nurse informaticists have, it is no surprise that they make a good living. According to the salary professionals at ZipRecruiter, this type of nurse makes an average of over $102,000 per year. While you will love what you do, you will also know you are contributing to the improvement of your hospital and the enhancement of patient care. This is what makes being a nurse informaticist so rewarding.
5. Travel Nurse
Well, travel nursing can’t really be described as “unusual” now, but have you thought about it? Do you thrive on fresh experiences? Going to new places and meeting new people? Does the idea of being an ad hoc nurse while “living out of a suitcase” sound… sort of exciting? If this sounds like you, travel nursing is both a fulfilling and lucrative career. The traveling nurse is in high demand, so you will need to be a well-qualified RN with years of experience caring for patients or have a Bachelor of Science in Nursing (BSN). If this sounds like you, it is time to bolster your resume and explore a new location.
You will need a minimum of 12-18 months of bedside experience in an advanced care clinic or hospital, as well as a willingness to fill staffing shortages in facilities that need you. You should also be comfortable with living in a different location every few months. Since some healthcare specialties are in more demand than others, recruiters may need you faster if you are experienced in high-demand nursing roles such as dialysis or emergency room (ER) care.
While flexibility is key, you will be able to spend your off-time exploring somewhere new. You may also be able to schedule your time in your old hometown or a favorite vacation spot. Another benefit is compensation. Travel nursing salaries are competitive and often include housing credits or travel stipends. Talk to a travel nursing recruiter about which openings are available in your area. It is also possible to search online for travel nursing jobs that are open in larger hospital systems.
Discover an Exciting Nursing Career
Once you get your RN license and gain valuable skills, there will be a variety of job roles available to you. This list of unique jobs will help you to think about which career in the nursing field will suit you. If necessary, you can also begin to obtain the necessary education and certification to land your dream job. The field of nursing is ever-changing, which means you will always have an exciting career, along with a meaningful purpose.
It’s my first day on the job as an occupational health nurse at one of the largest automobile factories in America. The Tesla Fremont factory encloses 5.5 million square feet and has around 15,000 workers on site at any one time. At the moment I’m hired, the factory is in overdrive to meet quotas and workers are pulling five twelve-hour shifts per week.
I’m overwhelmed by the factory floor. Spinning robots, automobile bodies on overhead assembly lines, herds of forklifts, and an incredible noise assaults my senses. The floors are covered with painted walkways, traffic safety barriers, and bollards to separate vehicles and pedestrians. Every 20 feet or so there is a sign on the floor stating “HEADS UP, PHONES DOWN” to encourage safety in this dangerous environment.
I’m working for a subcontractor. Tang and Company is a provider of occupational health services for 40 years serving such disparate industries as petroleum production, electrical generation, construction, and automobile manufacturing. They provide drug testing, respiratory mask fitting, employee health surveillance, safety education, and first aid services with the goal of keeping workers healthy and productive.
Most of my career has been in emergency room and ambulatory care. I feel well prepared for the clinical part of this job. I’m not so well prepared for some of the other functions. Fortunately, my employer has a well designed training program. I’m interested in the population health aspect. Mitigating the dangers in the workplace requires data. What are the injuries? How are they happening? What can be done to prevent them in the future? The benefits to the employees are obvious. Nobody wants to be injured on the job. The benefits to the employer include increased compliance with regulatory bodies and rules such as OSHA, FMLA, ADA, DOT, HIPAA, etc. The employer also enjoys decreased costs associated with insurance, lost production, potential fines, and the staggering expense of caring for the injured worker. In 2017, the cost of workplace injuries was $161.5 billion. This includes lost wages and productivity, medical cost, and administrative cost.
During my training period I’m instructed on how to perform routine workplace tests such as drug and alcohol testing, respiratory mask fitting, spirometry, and hearing tests. I work
Fast Facts about Occupational Health
Occupational health nurses work in a variety of settings to keep workers healthy and safe.
The typical occupational health nurse would be baccalaureate prepared and may have an advanced degree.
This nurse might enter the field with experience in community health, emergency room, critical care, or ambulatory medicine.
The American Board for Occupational Health Nurses, Inc. offers the following certifications for this specialty of nursing: Certified Occupational Health Nurse (COHN) and Certified Occupational Health Nurse-Specialist (COHN-S).
There are certifications available for ADN-prepared nurses, BSN-prepared nurses, and advanced practice nurses wishing to enter the field.
closely with EMTs, Physician Assistants, LVNs, and ancillary personnel working to keep the clinic running. The EMTs are trained to respond to workplace incidents on the factory floor. They are ready at a moment’s notice to respond to medical emergencies in the vast reaches of the factory. Typical responses I’ve seen so far are falls, cuts, and even a heart attack. They respond with a shoulder carried first aid pack, oxygen, and an AED.
Medical care beyond first aid is provided by physician assistants on site or through a video conferencing system. The range of services is pretty broad. Management of repetitive motion injuries, evaluation and treatment of traumatic injuries, and referrals for non-occupational conditions are typical. The clinic is well stocked with equipment and supplies, an EKG machine, nebulizer machines, various notions and potions for symptomatic relief of sprains, headaches, and bruises. The goal is to keep the factory moving with healthy workers.
Each day is a new and interesting experience. My nursing skills are being used productively and I’m learning about this expanding and well-paying field of nursing.
Welcome to the world of occupational therapy (OT). You are about to learn about a profession that can truly make a difference in a person’s life.
As a practitioner in OT you can improve the lives of people, from newborns to the elderly, by providing them with the knowledge, skills and abilities to achieve independence and enjoy life to its fullest.
“I truly enjoy my profession because of its uniqueness,” says Kashala Erby, OTR/L, who works for Sundance Rehabilitation’s Montgomery Village Health Care Center in Gaithersberg, M.D.
“I think the fundamental knowledge that we learn, coupled with clinical reasoning and creativity, makes us a distinct profession,” Erby continues. “I value occupational therapy as a means to influence, restore and rehabilitate.”
A Career in OT: Challenging, Rewarding
Occupational therapy, or “OT” as it is often referred, is a health care profession that uses occupational, or “purposeful,” activity to help those individuals whose tasks of daily living are impaired by developmental delay, physical injury, medical or psychiatric illness, a behavior problem, or a psychological disability. Practitioners in OT evaluate function through an analysis of human performance, relationships and situations. They also engage clients in experiential learning and problem solving activities. Specialties within the field include, but are not limited to: gerontology, pediatrics, developmental disabilities, mental health, prosthetics training, spinal cord rehabilitation, school-based practice and hand therapy.
OTs need to be both people-focused and science-oriented. They must be creative, innovative and well trained in the functions of the mind and body.
Good communication skills are also a hot commodity in the OT field. Brushing up on such skills will greatly benefit all prospective or current OT employees. Emily Groth, who is in the process of completing her master’s degree in OT and serves as the South Carolina representative to the American Occupational Therapy Association (AOTA) Representative Assembly, agrees that communication skills come in handy in occupation therapy, especially for OTs working with children.
“I greatly enjoy interacting with the families and teachers [of my young patients] in order to determine the best placement for them in the school system,” Groth says.
There is no question that occupational therapy is challenging work, however, there are plenty of rewards that come from making a dramatic impact in patient’s lives.
“I really enjoy finding the modification to an environment or activity that will allow a child to be as successful as possible,” Groth adds.
If occupational therapy is an area of allied health that you’re interested in pursuing, you’ll be please to know that this is a great time to enter the field. As the number of middle-aged and elderly individuals increases, the demand for therapeutic services, including occupational therapy, also multiplies. Currently, job growth within nearly all health care disciplines are projected to increase at a much faster rate than other field, but the job outlook for practitioners in OT in particular is expected to increase by 21-35%, according to the U. S. Department of Labor, Bureau of Labor Statistics.
Salaries for practitioners in OT are also on the rise; according to the ADVANCE 2003 Salary Survey, full-time practitioners in OT salaries show an average increase of $9,000 in the past four years. The new national annual average salary for OTs is $51,352, which takes into account professionals in all work settings and with all degrees of experience and education. Occupational therapy assistants, based on all settings and levels of experience, show an average annual salary of $35,635 in the past year $8,000 higher than the average in 1999.
An OT Overview
Occupational therapy is a career for individuals who care about people and have a desire to learn, achieve, and contribute their best to society and the profession. OT’s ultimate goal is to help their clients lead independent, productive and satisfying lives.
“Occupational therapy allows me to interact on a deeply personal level with people from every walk of life and with all levels of ability,” Groth says. “I am able to assist them regain independence in activities of daily life that are easy to take for granted, such as dressing, bathing, eating, and participating in play and leisure activities.”
Practitioners in OT may implement physical exercises to increase the strength and dexterity of their patients, or paper-and-pencil exercises may be chosen to improve visual acuity and the ability to discern patterns. A client with short-term memory loss, for instance, might be encouraged to make lists to aid in recall. One with coordination problems might be assigned exercises to improve hand-eye coordination. Practitioners in OT also use computer programs to help clients improve decision-making, abstract reasoning, problem-solving and perceptual skills, as well as memory, sequencing and coordination, all of which are important for independent living.
For those with permanent functional disability, such as a spinal cord injury, cerebral palsy or muscular dystrophy, therapists instruct in the use of adaptive equipment, such as wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop and teach clients with severe limitations to operate computer aided adaptive equipment that helps them to communicate and control other aspects of their environment.
Some occupational therapists, called industrial therapists, treat individuals whose ability to function in a work environment has been impaired. They arrange employment, plan work activities and evaluate the client’s progress.
Practitioners in OT may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, OTs evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and in general, help children participate as fully as possible in school programs and activities.
Groth, who works with children aged three to 18 with various levels of ability ranging from severe autism and orthopedic handicaps to mild coordination disorders and difficulty with handwriting, says, “Educating the child, the family and the educational team on how to improve fine and visual motor skills, self-care and sensory processing skills is the biggest component of my job.
“The children I work with bring me incredible joy and often teach me things about life that I’ve never considered before,” she adds. “The first time they can form their name independently or fasten the button on their pants or play with a special toy all by themselves is a very cherished moment.”
Practitioners in OT in mental health settings treat individuals who are mentally ill, mentally retarded or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to cope with daily life. Activities include time-management skills, budgeting, shopping, homemaking and use of public transportation. They may also work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders or stress-related disorders.
Recording a client’s activities and progress is an important part of any practitioner’s job. Accurate records are essential for evaluating clients billing and reporting to physicians and others.
Practitioners in OT are employed in a wide range of workplaces hospitals, schools, nursing homes and home health care programs and they serve as employees of public or private institutions or as private practitioners.
Groth has worked in acute, sub-acute and outpatient hospital settings, as well as in an assisted living facility for the elderly. “The diversity of practice areas insures that one will never be bored or lose interest [in the field],” she asserts. “No matter what the setting is, the goal of the therapist is to help restore [their patients] to their highest level of independence.”
Choose Your Role
Along with registered occupational therapists, OT assistants and aides are in increasing demand to assist a ever-growing elderly population. Insurance carriers are also encouraging more occupation therapy to be delegated to OT assistants and aides because it helps reduce the cost of therapy.
In the field of OT, education determines at what level one will work. Those who complete an associate’s degree or certificate program work under the direction of a registered occupational therapist as occupational therapist assistants. Occupational therapist aides however, receive most of their training on the job. Since aides are not licensed, they have more limitations on what they can do in comparison to the range of tasks an occupational therapist assistant is required to do.
However, both OT assistants and aides generally provide rehabilitative services to persons with mental, physical, emotional or developmental impairments. Their ultimate goal is to improve clients’ quality of life by helping them compensate for limitations. For example, a therapist assistant will help an injured worker reenter the workforce through improved motor skill development or may assist a client with learning disabilities increase his or her independence.
Occupational therapist assistants record their client’s progress with rehabilitative activities and exercises outlined in a treatment plan and report back to a registered OT. They make sure clients are performing the exercises and activities properly and provide encouragement. The aide prepares materials, assembles equipment used during treatment, and is responsible for a range of clerical tasks. Duties can include scheduling appointments, answering the telephone, restocking or ordering depleted supplies, and filling out insurance forms.
Those entering at the assistant or aide level of OT should also be aware of the physical endurance that is necessary on the job. Assistants and aides will need some strength in order to lift patients, and they may be required to kneel, stoop or stand for long periods of time. For most, however, this is a minor concern and is overshadowed by the thrill of watching patients succeed and improve through proper care and encouragement.
Occupational therapist assistant candidates interested in improving their admission chances should make sure they have mastered high school algebra, chemistry, biology, English, computer skills and have completed volunteer hours in the field. Training to be an OT assistant includes an introduction to health care, basic medical terminology, anatomy and physiology. During the second year of school, course work will involve mental health, gerontology and pediatrics. Students will also complete 16 weeks of supervised fieldwork. Upon successful completion of academic coursework, assistants must pass a national certification examination in order to receive the title of certified occupational therapist assistant.
Becoming an OTR
Presently a bachelor’s degree is sufficient as a minimum education requirement for entry into the OT profession as an occupational therapist registered (OTR). Starting in January 2007, however, all new occupational therapists registered will be required to complete a master’s degree. In both cases, however, candidates must also pass a national certification examination in order to become an OTR and then receive licensure in the state where they will practice.
Occupational therapy course work includes physical, biological and behavioral sciences and the application of occupational therapy theory and skills. Completion of six months of supervised fieldwork is also required.
Volunteering in a variety of OT areas during one’s education is a critical step in deciding where one would like to work in the field. When students understand what role they want as a therapist, it can make their OT education experience more focused and enjoyable. Kashala Erby, who was a grad student intern and practice associate at the American Occupational Therapy Association, advises practitioners in OT to find a mentor in the field, volunteer in various practice areas, and get involved with the AOTA as a student member.
Erby also brings up the issue of lack of diversity in the occupational therapy field. She believes that the profession needs to embrace and encourage more minorities to enter OT. “While this is a female dominated profession,” Erby says, “as a minority woman in [OT], I face some of the same challenges I would have to face in any other profession.”
The ADVANCE 2003 Salary Survey shows that women greatly outnumber men in the profession. However, men report higher average salaries. The male survey respondents reported average salaries of $55,216 for occupational therapy and $37,425 for occupational therapy assistants; women reported an average salary of $48,763 for OTs and $32,927 for OT assistants.
Paving the Way to a Career in OT
Of course not everyone who ends up in OT initially starts out pursuing the field. When Emily Groth graduated from high school, she aspired to become a pediatric physical therapist. “I went to the University of Central Florida and enrolled in the appropriate prerequisites, however, I soon realized that it wasn’t a perfect fit for me,” she explains.
“My school guidance counselor gave me a test [to determine a more appropriate field]. Occupational therapy was in my top ten fields, and after I job-shadowed an occupational therapist at work, I knew it was for me.
“Engaged with people on such a personal level, the ability to truly help them regain independence, and the diversity of the practice areas drew me into this field,” Groth says.
As she asserts, the diversity of work environments is a plus for many in the OT field. According to the ADVANCE 2003 Salary Survey, most OTs reported that they are employed in schools or in skilled nursing facilities, but therapists can work in hospitals, offices, clinics, home health agencies, nursing homes, community mental health centers, adult daycare programs, job training services and residential care facilities. As an occupation therapist, your career options are truly never-ending.
Those who will succeed in OT are individuals who have patience and strong interpersonal skills to inspire trust and respect in their clients. Practitioners in OT have ingenuity and imagination in adapting activities to individual needs, a strong commitment to serve people, and an interest in social and biological sciences. And, according to Groth, no matter what area you choose, a career in occupational therapy is “so valuable to society.”
Are you looking for an empowering, high-paying career alternative that offers exceptional opportunities for advancement and leadership development? Do you want to make a difference in your community, help the nation’s workplaces become more productive and help ensure that all working Americans are able to do their jobs in a safe and healthy environment? Then consider becoming an occupational health nurse.
Unlike traditional hospital nursing jobs, occupational health nurses are able to go out in the field and provide care to a company’s employees right where they work. But this specialty involves much more than just treating workers who are injured on the job. Occupational health nurses are also responsible for developing employee health promotion programs, preventing workplace hazards and helping employers control the cost of health insurance benefits and workers compensation claims.
According to the American Association of Occupational Health Nurses (AAOHN), this specialty was first defined in the late 1800s when a nurse named Betty Moulder provided care to Pennsylvania coal miners and their families. Today, occupational health nurses work all over the country, in settings ranging from private corporations to government agencies and academic institutions. The scope of their responsibilities can encompass such varied functions as case management, employee counseling and crisis intervention, legal and regulatory compliance and even emergency preparedness and disaster management.
“Occupational health nurses do everything from treating employees’ injuries–whether they’re incurred on the job or off–to conducting pre-employment [health] screenings and providing disability management,” says Tamara Blow, MSA, RN, COHN-S/CM, CBM, manager of occupational health services at Philip Morris USA in Richmond, Virginia. “We do it all.”
Culture and Community
Minority nurses who work in occupational health often find that this career offers a rewarding opportunity to serve their communities. For example, it can involve improving health and safety conditions for medically underserved workers.
“I’m originally from Jamaica but my parents moved to rural Clewiston, Fla., when I was 12 years old. My father worked for the sugar companies–he originally began as a sugar cane worker in the fields,” says Ann Marie Robinson, RN, a graduate student who is pursuing a dual master’s degree in nursing and public health at the University of South Florida in Tampa. “As I was growing up, I realized there were health inequities for people who had different cultural backgrounds or a different economic status. I noticed that [the sugar cane workers] didn’t seem to have the information they needed to protect their health–things like how to use sun protection or how to take certain safety precautions when working with chemicals. Those disparities influenced me to become a nurse, and they are my motivation for going into occupational health nursing.” Upon graduation, Robinson plans to return to Clewiston to help the area’s working population.
For nurses like Blow who work for large national corporations, the company itself is a community–and the employees who make up these “corporate communities” are becoming increasingly diverse. Because her job is considered part of her company’s human resources department, Blow says it’s critical for her to be sensitive to the cultural needs of all employees. “As [an African American], I often have to correspond with people who come from different cultures than my own. I have to be able to communicate with them and I have to be able to listen to their needs.”
There are many times when her perspective as a person of color helps her solve difficult workplace situations, Blow adds. “A [minority] employee recently met with me to discuss certain medical problems [the employee] was experiencing,” she says. “This employee blamed their medical situation on workplace stress. I was able to create a win-win solution that allowed this person to get the assistance they needed while mitigating any further actions [such as legal disputes]. This person was referred to me because I have been identified as a problem solver who is able to listen to others and come up with a solution.”
As America’s corporate landscape continues to become more culturally inclusive and globally oriented, “multicultural approaches to care are important,” says AAOHN President Susan Randolph, MSN, RN, COHN-S, FAAOHN. “[That is why] it is important to recruit and train [occupational health] nurses across different racial and ethnic groups.” This outreach includes recruiting more nurses who speak multiple languages, Randolph continues. “If [a company] has a staff that is bilingual, the occupational health nurse must be able to communicate with them and provide care.”
Opportunity and Autonomy
Another reason for nurses of color to look into this specialty is that it offers unique opportunities for career growth, leadership development and professional fulfillment, says Marre Barnette, RN, who is completing her master’s degree in occupational health nursing at the University of Cincinnati in Ohio.
A scholarship opportunity at the university introduced Barnette to the study of occupational health, but it soon became a passion for her. “As I spent time in the educational program, I became much more interested in this field,” she says. “I learned that occupational health involves more than putting a bandage on someone’s cut at a factory. It also involves finding ways to make workers comfortable, determining what is feasible [in terms of employee health programs] and identifying job tasks that need to be changed for safety reasons.”
Barnette even uses some of the ergonomic principles she has studied to counsel friends and family members who own small businesses. “I have applied what I have learned in my everyday practices,” she says. “Occupational health nursing has opened up a whole new world for me.”
In addition to building technical skills in areas like accident prevention, environmental health and compliance with Occupational Safety and Health Administration (OSHA) regulations, many nurses find that working in occupational health also helps them build crucial leadership skills, such as negotiation and independent decision-making.
“This specialty represents a different paradigm from traditional nursing, where you are working in a hospital, a doctor tells you what is wrong [with the patient] and you follow protocol,” Blow explains. Instead, the nurse may have to assess the patient and determine the next course of action. “You utilize your critical thinking and assessment skills to go beyond technical evaluation. It is a benefit that you do not usually have in a hospital setting.”
Blow encourages self-motivated, independent and career-driven minority nurses to explore this field. “If you are a person who loves autonomy and you are a futuristic and strategic thinker, consider occupational health nursing,” she advises. “It gives nurses the chance to look at a patient from a holistic perspective, not just a clinical view.”
Issues and Trends
There are a number of social and economic issues that impact the field of occupational health. For example, the skyrocketing rise in health care costs is a major source of concern for both employers and employees.
“There has been an increased interest in occupational health nursing because of the increase in the costs related to workers compensation,” says Donna Gates, EdD, RN, FAAN, professor of nursing and Jane E. Procter Endowed Chair at the University of Cincinnati. “Occupational health nurses help lower these costs by working with company safety directors to navigate [employee task] systems, eliminate possible exposures [that could cause worker accidents] and reduce overall injuries.”
“Nurses are tasked with implementing programs that improve employee health but are also a wise use of a company’s health care dollars,” adds Randolph. By managing those funds wisely, occupational health nurses make a significant impact on their employers’ bottom lines.
For More Information American Association of Occupational Health Nurses (AAOHN)
www.aaohn.org National Institute for Occupational Safety and Health (NIOSH)
www.cdc.gov/niosh
Includes links to the universities (and their affiliated nursing schools) that have NIOSH-funded Education and Research Centers (click on “Grants & Funding”).
“We can keep workers healthy and we can justify to a company why it is important to keep us employed,” says Blow. Sometimes nurses will need to justify the existence of specific company health initiatives. “If an employer asks why a particular health program should be kept, a nurse can (hopefully) say, ‘I saved you X amount of thousands of dollars by implementing this program.’ As a result, senior management may look at our successes and say, ‘Wow!’ At the same time, employees trust us because we are helping them stay healthy.”
An escalating health care price tag is not the only issue that is creating strong demand for occupational health nurses. As the baby boomer generation moves into its 50s and 60s, another concern is learning how to keep an aging workforce healthy.
“As we age, we need to redefine how we do certain jobs,” Randolph explains. “We also need to look at chronic diseases [which may become more prevalent with an older population] and understand how those diseases affect an employee’s ability to work.”
Education and Advancement
Blow advises nurses interested in occupational health to pursue higher education and learn to develop the skills that will help them advance their careers. “Technically, you do not have to have your BSN in order to become an occupational health nurse,” she says. “But I tell nursing students to strive to get their BSN. If you want to know the clinical aspect of occupational health, go out and learn all you can. Become an RN and develop strong assessment skills. Remember, occupational health nursing is different from working in a hospital, where a doctor tells you what to do.”
Opportunities for advancement in occupational health nursing have as much to do with leadership and networking skills as with clinical and technical abilities, Blow adds. “[Those administrative skills] may be even more important. I was able to advance in my career because I had many situations where I functioned as an internal consultant to my employer.”
The federal government takes an active role in funding occupational health education. Several university programs are funded in part by the National Institute for Occupational Safety and Health (NIOSH), a federal agency that is responsible for conducting research on work-related injuries and illnesses and for finding solutions that can be adapted into today’s work environments. NIOSH is part of the Centers for Disease Control and Prevention (CDC), which is located within the U.S. Department of Health and Human Services.
NIOSH currently funds 16 university-based Education and Research Centers (ERCs). Some of this funding goes to those universities’ schools of nursing. The University of South Florida and the University of Cincinnati both house NIOSH-funded ERCs.
“Our program director, Dr. Sue Davis, maintains the funding for our program,” says Gates. “As part of her duties, she develops the [occupational health] nursing curriculum, provides nursing student advisement, conducts project research and oversees recruitment.”
Once a nurse has finished the appropriate schooling, job prospects are good. “There are always positions in occupational health nursing,” says Randolph. “Wherever there are workers, there can be positions .” And the jobs pay well, she adds. “AAOHN’s 2006 Compensation and Benefits Study found that the average annual salary for occupational health nurses was almost $67,000 a year.” In contrast, the national average salary for RNs in general, according to the Bureau of Labor Statistics, is $56,8801 a year.
Occupational health nurses who have bachelor’s degrees are more likely to find work in a clinical setting. However, those who go on to obtain their master’s degrees have more options. They can work for federal agencies like NIOSH, state and local health agencies, research centers, corporate employers and even in academia.
Both Randolph and Blow encourage nurses who are researching their options in this field to make use of the resources available from AAOHN. “This organization is geared to promoting occupational health and advancing our profession,” says Blow. The association offers such services as continuing education opportunities, online job postings, a mentoring program, publications, professional development scholarships and research grants.
Another benefit of AAOHN membership is that it can provide minority nurses with leadership opportunities that can help them in their careers. “I am on AAOHN’s national board of directors,” says Blow. “First, I became president of my local chapter. Then I became the representative for the state of Virginia. Then I went on to the national board. In that sense, AAOHN has helped me develop both my technical and networking capabilities.”
