Career Guide - ABOHN

Career Guide

Occupational Health Nursing

Profession

The Career Guide is a publication of

201 E. Ogden Ave. ? Suite 114 ? Hinsdale, IL 60521

630-789-5799 ?

Synopsis of Occupational Health History in the U.S. and U.K (2000 BC ? 2013 AD)

470-410 BC Hippocrates

1494-1555 AD Georgius Agricola

1540 AD "Law of Deodand"

1713-1788 AD Percival Pott

1869-1970 AD Alice Hamilton

1895 AD Ada Mayo Stewart

1911 AD Worker Compensation Legislation

BC

2000 BC Code of Hammurabi

1400

1600

1493-1591 AD Paraclesus

1800

1900

1898 AD Phillipa Flowerday

1950

2000

1970 AD Occupational Health and Safety Act

23-79 AD Pliny the Elder

1633-1714 AD Bernardino Ramazzini

1820- 1910 AD Florence Nightingale

1912 AD ? 39 1918 AD ? 1,213 1930 AD ? 3,189 1939 AD ? 6,255 1945 AD ? 12,939

2013 AD Approx. 22,000

Nurses Employed in Industry

Figure 1: Timeline of events that shaped Occupational Health & Safety ? for additional information see Appendix A

The Career Guide

to Occupational Health Nursing

The Career Guide is a publication of

American Board for Occupational Health Nurses, Inc. 201 E. Ogden Ave., Suite 114 Hinsdale, Il 60521 630-789-5799

Copyright by ABOHN. All rights reserved. May not be reproduced without written permission from ABOHN.

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Table of Contents

What is Occupational Health?..................................................................................... Page 3 Occupational Health Nursing ? A Specialty Practice................................................... Page 4 Occupational Health Nursing Categories of Competency........................................... Page 5 What Occupational Health Nurses Do........................................................................ Page 6 Where Occupational Health Nurses Work................................................................... Page 8 Occupational Health Nursing Pay............................................................................... Page 9 The Future for Occupational Health Nursing............................................................. Page 10 Opportunities in Occupational Health Nursing..........................................................Page 11 How to Become an Occupational Health Nurse........................................................ Page 21 Professional Societies.............................................................................................. Page 22 Occupational Health Nursing Credentialing Agency..................................................Page 23 Resources................................................................................................................. Page 24 Contributors............................................................................................................. Page 25 Appendix A: A Noble History.................................................................................... Page 26 Appendix B: Glossary................................................................................................ Page 28

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What is Occupational Health?

In general, the term ? occupational health ? refers to caring for and protecting the workforce you serve. This broad definition integrates traditional occupational safety and health protection efforts with health promotion and other workplace activities to prevent illness and injury, regardless of cause, so that all workers have opportunities to achieve optimal levels of health and well-being.

The occupational health nursing field has a long history but started an evolutionary change in the 1970's when the United States Congress passed the Occupational Safety and Health Act of 1970 (OSH Act). The law requires employers to provide their employees with working conditions that are free of known hazards. The Act created the Occupational Safety and Health Administration (OSHA), which sets and enforces protective workplace safety and health standards.

After passage of the OSH Act, the scope of the field significantly changed as new and improved local, state and federal regulations passed which protect both the employee and the employer.

Economics play an important role in health care. Per the latest information from the Council of Foreign Relations (Johnson, Toni. "Healthcare Costs and U.S. Competitiveness." Mar 2010. Council on Foreign Relations. Jan 2014.),

the United States spends an estimated $2 trillion annually on healthcare expenses.

Occupational health and protecting the workforce are an important part of these costs.

Changes in the median age of the workforce, changes in laws and regulations and changes in health costs all have a great impact on the bottomline decisions of executives.

Occupational health initiatives can be found in a multitude of environments and industries. Businesses from mining and construction to finance and real estate all have an occupational health element. Integrating workplace wellness and occupational health and safety supports a holistic approach to health.

The occupational health professional can be the guiding force to keep workers healthy, maintain company compliance with regulations, curb medical costs and assess the environmental factors that affect the workplace and the community which it serves.

Whether your goal is to work for a Fortune 100 company or use your skills as a consultant, the occupational health industry offers a range of opportunities. The information found on the next few pages will explain the occupational health nursing (OHN) profession and what is needed to become a competent, capable voice for worker health in the 21st century.

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Occupational Health Nursing ? A Specialty Practice

OSHA classifies Occupational Health Nurses (OHN)s "as registered nurses who independently observe and assess the worker's health status with respect to job tasks and hazards. Using their specialized experience and education, these registered nurses recognize and prevent health effects from hazardous exposures and treat workers' injuries and illnesses."

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Employee Health

Advocate

Business Industry Expert

OHN

Environment & Community

Leader

Figure 2: Occupational Health Nursing Roles

Many industries and work environments require occupational health initiatives. Nurses that care for the worker population in hospital settings are usually known as Employee Health Nurses. This title is interchangeable with the Occupational Health Nurse.

The American Association of Occupational Health Nurses (AAOHN), the professional society devoted to occupational health nursing practice, further defines occupational health nursing as follows: "Occupational and specialty practice that provides for and delivers health and safety programs and services to workers, worker populations and community groups. The practice focuses on promotion and restoration of health, prevention of illness and injury, and protection from work-related and environmental hazards. Occupational and environmental health nurses (OHNs) have a combined knowledge of healthcare and business expertise to balance the requirement for a safe environment with a "healthy" bottom line. (

mission/aaohn-fact-sheet.html)

A state license as a registered nurse (RN) assumes competency in general nursing practice. The occupational health nursing designation constitutes a broader understanding in the specialty of worker care.

Table 1 (next page) lists nine categories of competencies which AAOHN defines as required for effective occupational health nursing practice:

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Occupational Health Nursing Categories of Competency

Clinical Practice

Document the nursing process in care management via assessment, diagnoses and treatments consistent with appropriate standards and laws.

Work Force, Workplace, and the Environment

Coordinate client health screening and surveillance programs and services and monitor the work environment to protect the health and safety of workers.

Health and Safety Education and Training

Implement occupational and environmental health and safety education and training.

Case Management

Identify the need for case management intervention and be able to conduct a thorough and objective assessment of the client's current status and case management needs.

Regulator/Legislative

Bring awareness of current legislative activities that may impact nursing practices, workers, workplaces and the environment.

Management, Business and Leadership

Responsible for coordinating cost-effective occupational health services and programs and continuous monitoring for the best quality, most cost effective vendor products and services.

Health Promotion and Disease Prevention

Assess the health needs of workers and worker populations.

Research

Identify and share resources and applications that help support relevant evidence-based practices.

Professionalism

Maintain scientific, regulatory and business knowledge appropriate to the nursing profession.

Table 1: Retrieved from

AAOHN has adopted Dr. Patricia Benner's (R.N., Ph.D., FAAN) stages of clinical competency for an occupational health nurse. The information listed above is for the most basic level, or Competent occupational health nurse. The other levels, Proficient and Expert, have additional scopes of responsibility, education and years in practice. The American Board for Occupational Health Nurses (ABOHN) certifies occupational health nurses at the proficient level of practice, using Dr. Benner's framework, which was published in 1984, for addressing nurses at various stages of professional growth.

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What Occupational Health Nurses Do

The Occupational Health Nursing industry has been cultivated in the United States since the 1890's. Ada Mayo Stewart, one of the first known occupational health nurse in the U.S., was employed by the Vermont Marble Company in 1895. Her job as clinician was to provide the care for work related injuries. Her practice also included health education for the employees and their families. Ms. Stewart was probably the first Case Manager as we know it today.

Nowadays, occupational health nursing is a varied and specialized nursing practice in which occupational health nurses (OHNs) use their wide base of knowledge and skills to care for individuals in the workplace. No two practices are alike.

According to AAOHN, occupational health nurses collaborate with workers, employers, members of the occupational health and safety team, and other professionals to identify health and safety needs. The occupational health nurse is the center of coordinated care for individual employee needs and has the responsibility for delivering comprehensive and qualified service and programs that meet or exceed OSHA requirements and reduce medical benefits from a company's bottom line. The major roles and responsibilities associated with occupational health nursing practice include:

Clinician ? Clinical and Primary Care

Educator/Coordinator ? Training ? Disease Prevention

Manager/Advisor ? Research ? Health Promotion

Consultant ? Workforce Issues ? Workplace Issues ? Environmental Issues

Case Manager ? Regulatory responsibilities ? L egislative management

Each role is used while performing basic occupational health activities. These workplace activities include health and wellness, case management, ergonomics, workplace safety, infection control, disaster preparedness and others such as travel health. Within these broad categories, a recent survey conducted by ABOHN (American Board for Occupational Health Nurses, Inc.) found that practicing occupational health nurses have recognized the following top ten tasks, shown in Table 2, associated with their practice:

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