What Is an Occupational Health Nurse?

Occupational health nursing offers healthcare professionals the opportunity to practice in workplace settings of all kinds. Rather than just traditional health care settings like an office, hospital, or rehab facility, occupational health nurses can also find positions in occupational health departments in manufacturing plants, government offices, corporations, construction sites, academic institutions, and more.

They treat acute injuries, as well as work within the institution to promote healthy practices, maintain training programs, and advocate for employee safety. Working as an occupational health nurse provides opportunities to practice in a wide variety of settings and with a wide variety of patients and workplaces.

What Is the Job of an Occupational Health Nurse?

An occupational health nurse is a registered nurse specializing in workplace health. An occupational health nurse can be employed in any workplace where an occupational health department is responsible for the safety and well-being of employees, in a hospital or physician’s office, or even in urgent care facilities. Employers of occupational health nurses can include factories, government institutions, the military, construction sites, and large corporations, as well as traditional medical settings.

In corporate or manufacturing companies, nurses work in occupational health departments dedicated to developing appropriate safety protocols, monitoring compliance, and responding to employee health concerns. Occupational health nurses play a key role in that ecosystem. Primary areas of responsibility include:

1. Preventive care. This can include general wellness programs, workplace-specific monitoring, or chronic disease management.
2. Safety training. For workplaces with heavy machinery, equipment, chemicals, and other hazards, occupational health nurses are tasked with aiding in the development and delivery of appropriate training programs to employees and regular refresher courses on the dangers in that specific workplace.
3. Health promotion. Through an occupational health department, an employer may offer smoking cessation programs, weight loss programs, stress management tips, or team building and communication best practices. Some programs may be designed specifically for the workplace, such as safe driving, proper use of personal protective equipment (PPE), or how to dispose of hazardous materials.
4. Medical care in the case of injury. Occupational health nurses are among the first responders to any medical incident in the workplace. As such, they may need to provide first aid, triage employees to higher levels of care, and evaluate injuries and situations. They may decide when additional medical or environmental support is necessary.
5. Case management. For both employees with ongoing health conditions and those who were hurt on the job, occupational health nurses follow their treatment plans, collaborate with other health professionals, and coordinate testing or services.
6. Compliance. Occupational health is heavily regulated, and industries where there are environmental risks to employees require monitoring, administration, training, and compliance.  Occupational health nurses need to be familiar with coding, billing, regulations, and documentation to keep the business compliant with all federal, state, and/or local regulations, such as Occupational Safety and Health Administration (OSHA) or Department of Transportation (DOT) regulations. As any applicable regulations change, occupational health departments are responsible for understanding the updates and keeping the business compliant.
7. Health and emergency planning. Whether planning for fire, chemical spills, equipment malfunctions, or natural disasters, occupational health is an important part of contingency planning.
8. Documentation and record keeping. As licensed medical professionals, occupational health nurses are subject to the same documentation requirements as other nurses. They will need to be able to demonstrate that all applicable employees have completed safety training, had preventative exams, and are physically capable of performing their work tasks. If an injury occurs, the incident and treatment plan for affected employees need to be fully documented.

What Role Do Nurses Play in the Specialty?

Occupational health nurses act as the liaison between employees and the organization or business when it comes to decisions about safety, health care, and well-being. In order to do this, they must understand workplace regulations, monitor hazards, provide safety training, and intervene in the case of injury. A primary responsibility is preventive care and preparing both the physical environment and each employee to work safely. That includes:

• Analyzing the environment for risks such as physical, biological, or chemical dangers
• Screening employees for hearing or vision impairments, physical capabilities, drug use, and other risk factors
• Designing wellness programs for employees, including programs directly related to job tasks such as safely using equipment and materials, proper PPE use, and awareness of the surrounding environment, as well as general wellness programs related to common concerns like smoking cessation, weight loss, and stress management 
• Ensuring all OSHA regulations are followed
• Tracking employee health metrics
• Developing training plans to improve workplace health and safety, including adopting new safety measures and ensuring all employees have safety equipment
• Keeping records of violations, injuries, training, and assessments

Occupational health nurses are also on the first line of defense when an incident occurs in the workplace. When something goes wrong, they can be responsible for:

• Helping to secure the physical environment
• Providing emergency treatment to employees
• Documenting the incident and the treatment and future prevention plan
• Reporting to management or regulators
• Evaluating return-to-work orders

How Do They Fit into the Workplace Ecosystem?

Occupational health nurses play an essential role in managing workplace health and safety. They need to thoroughly understand all the regulations and standards concerning equipment testing, safety training and certification, and incident reporting and management.

They are responsible for ensuring all necessary employees have been trained on safety protocols and procedures, and that all safety violations are documented and addressed. In the event of a workplace incident, they liaise with management, medical providers, first responders, or regulatory bodies to minimize damage and prevent similar incidents in the future. They may even be involved with legal parties by providing documentation or with insurance companies in the case of workers’ compensation or disability claims.

In order to achieve all of these goals, occupational health nurses need to develop deep relationships with company management and employees, if they’re employed by a company. They may even advocate on behalf of employees to the company for better working conditions, improved equipment, or additional training. Regardless of employment setting, they need to understand how jobs are done, what the risk factors are, what concerns employees have, and which procedures will best protect workers. They need to stay current on healthcare trends and how these affect those they work with every day.

They will also use all the nursing skills required in other settings. They may be responsible for administering immunizations or medications, triaging patients in an emergency, and assessing patients for health risks and suitability for their role.

How to Become an Occupational Health Nurse

Like nurses in other specialty areas, occupational health nurses must have at least a bachelor’s degree, with many employers preferring master’s degrees. If you’re considering becoming an occupational health nurse, choose one of the many accredited programs available through reputable colleges and universities.

You will have to be licensed in the state where you plan to practice. Candidates must take and pass the National Council Licensure Exam (NCLX-RN) to become a registered nurse. You can take this exam for any state you plan to practice in.

Experience in the field looks great on applications. Areas to focus on that will help you stand out for occupational health jobs include:

• Emergency or critical care
• Public or community health
• Case management
• Ambulatory care
• Business administration
• Surgery

After initial examinations and licensures, nurses who want to work in occupational health settings can pursue additional certifications. The American Board of Occupational Health Nurses offers two types of certifications. The Certified Occupational Health Nurse (COHN) exam focuses on clinical practice and credentials nurses in the categories of clinician, coordinator, advisor, or case manager. The Certified Occupational Health Nurse- Specialist (COHN-S) focuses on the administrative side of the workplace with credentials for clinicians, managers, educators, consultants, and case managers. Nurses may only be licensed in one area.

What Types of Patients Do Occupational Health Nurses See?

Occupational health nurses are concerned with any health-related issues for all kinds of employees. Typical patients may include:

• Employees with acute injuries. If someone is hurt at work from a fall, spill, accident, laceration, or altercation, the occupational health nurse is typically the first to respond and provide treatment.
• Employees with overuse injuries. In office settings, common complaints include back pain and carpal tunnel syndrome. In manual labor or manufacturing settings, nurses often treat joint pain or health concerns related to repeated chemical exposure. Depending on the care setting (whether employed in-house for a company or externally at a hospital, physician’s office, or urgent care facility), the types of overuse injuries can vary widely.
• Prospective employees. For jobs with physical requirements, occupational health nurses can screen applicants. They will determine if the applicant can safely perform the job functions and make recommendations to hiring committees.
• Returning employees. Any employee who has been on temporary medical leave may require an evaluation before returning to normal duties.
• Employees with chronic health conditions. Occupational health nurses provide great support to employees with existing health conditions or who want to make positive changes to their health status. They can create treatment plans and provide daily support.
• Trainees. Part of new employee training will include safety regulations, correct use of equipment, and other hazard-prevention practices. Occupational health nurses can deliver this training, document it, and track when training should be updated.
• Management teams. Occupational health nurses report to management organizations to assess risk, report on incidents, and track employee health. They advocate for changes that will improve the working lives of employees.

Occupational Health Nurses: An Essential Part of Maintaining a Healthy Work Environment

Occupational health nurses play an important role in workplace health. Any employee can benefit from the expertise these nurses bring to the environment. In high-risk settings such as hospitals, manufacturing plants, and construction sites, they ensure all employees are trained and protected. In office settings, they provide an additional layer of support for normal health challenges.

As experts in regulatory requirements, they also protect corporations by maintaining the documentation necessary to ensure safety standards and best practices. They serve as the bridge between employees and management to create a safer work environment. For nurses who are interested in settings outside of traditional healthcare, occupational health is a great avenue.