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.

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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.”

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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.”

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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) National Institute for Occupational Safety and Health (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.

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“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.

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“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.”

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