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The Ultimate Guide to the Occupational Health Nursing Specialty

What Is Occupational Health Nursing? The Ultimate Guide

When most people hear of nursing, they conjure up images of chaotic emergency rooms (ERs) or perfectly controlled operating rooms (ORs), but they rarely picture offices or factories. To be fair, only about 1 percent of nurses work in occupational health nursing, but perhaps one of those few spots is meant for you.

Are you a new nurse exploring career options? Are you an experienced nurse looking for a change of pace? Either way, you are in the right place. This ultimate guide to occupational health nursing covers everything you need to know about this often-overlooked nursing specialty. After reading, if occupational health doesn’t seem right for you, continue exploring other nursing specialties. We guarantee the perfect nursing job for you is out there!

Table of Contents

What Does Occupational Health Mean in Medical Terms?

occupational health nurse

Occupational health is an area of healthcare that focuses on wellness and health promotion, prevention of injuries and illnesses, and protection of workers from workplace

hazards. Healthcare professionals working in occupational health include doctors, physician’s assistants, advanced practice registered nurses (APRNs), registered nurses (RNs), licensed practical nurses (LPNs), and medical assistants.

In particular, occupational health nurses take preventive measures to ensure the health and safety of workers in diverse settings but especially in settings that use machinery, heavy equipment, or toxins.

Occupational nurses work closely with employers and management to ensure that health and safety standards are met for the well-being of employees. Although they collaborate with employers, occupational nurses must advocate for employees’ rights, ensuring safety measures and access to preventative health. Through the work of occupational nurses, employee productivity, health, and safety increase while absenteeism, disability claims, and on-the-job injury claims decrease. 

What Does OH Stand For?

The abbreviation OH stands for occupational health. Similarly, OHN stands for occupational health nurse. The World Health Organization’s definition of occupational health is “an area of work in public health to promote and maintain highest degree of physical, mental and social well-being of workers in all occupations.” This nursing specialty is also referred to as employee health or industrial medicine.   

What Is an Occupational Health Unit in a Hospital?

Occupational health units or departments may be found in corporate, industrial, governmental, academic, and healthcare settings. Health care is one of the sectors that most requires occupational health, in particular hospitals. In 2019, US hospitals reported 221,400 work-related injuries and illnesses—5.5 for every one hundred full-time employees. This rate is almost double that of the private industry sector in general. Furthermore, this rate only continues to increase. In 2020, the healthcare and social assistance industry reported a 40 percent increase in injury and illness cases. This situation affects hospitals and other healthcare facilities, as well as employees, since over half of these cases resulted in at least one day away from work. 

According to the World Health Organization (WHO), the following are the most common occupational hazards in the healthcare sector:

  • Occupational infections, including Hepatitis B, HIV/AIDS, and respiratory infections
  • Unsafe patient handling, such as lifting or transferring patients without using proper techniques
  • Exposure to dangerous chemicals, such as disinfecting agents and toxic drugs
  • Exposure to radiation, such as x-rays and lasers
  • Occupational stress, burnout, and fatigue due to working long hours and lack of support, among other factors
  • Violence and harassment, such as physical or verbal threats and assaults
  • Risks in ambient work environments, such as noise and very high or low temperatures
  • Occupational injuries, such as slips, falls, or electric shocks 
  • Environmental health hazards, such as inadequate sanitation and hygiene

What Is the Role of a Nurse in Occupational Health?

occupational health

According to the Association of Occupational Health Professionals in Healthcare (AOHP), regardless of work setting, occupational health nurses fulfill six roles or functional areas: 

  • Administrator/Manager: An occupational health nurse may manage a unit or department, be part of a unit or department, or manage an entire system. As a manager, an OHN must balance meeting the organization’s objectives and advocating for employees. Within this role, an OHN may write job descriptions and develop performance standards and evaluation tools; they also may schedule staff and services, recruit staff, and set professional development goals. 
  • Clinician: Occupational nurses working as clinicians may perform health assessments, including fitness for duty, pre-placements, and return to work evaluations. They may also identify and manage occupational exposures and monitor infection prevention and control requirements regarding immunizations.
  • Case manager: This OHN role involves coordinating and managing disability issues, work-related injuries and illnesses, workers’ compensation, and family and medical leave. 
  • Educator: As educators, OHNs must provide health and safety education, including creating presentations appropriate for their audience’s age and educational background.
  • Consultant: An OHN can share their expertise and guide policy formation to reduce injuries and increase safety and well-being overall.
  • Researcher: Research can provide evidence for improving program development and the cost and quality of services.

What Does an Occupational Health Nurse Do?

The responsibilities of an occupational nurse may vary depending on the work setting. That said, here are some common duties of an occupational health nurse

  • Conducting screenings for new employees and annual employee health screenings, including health history, immunization updates, and brief physical assessments
  • Referring employees with identifiable limitations or health risks to appropriate resources
  • Offering health promotion incentives and educational materials
  • Collaborating with Human Resources to ensure the completion of all health screenings
  • Conducting surveillance and follow-up of employee exposures to communicable diseases, such as COVID-19
  • Planning, implementing, and conducting annual Flu Vaccine Programs
  • Plannning and implementing other vaccine programs as directed by APIC, OSHA, CDC, and other regulatory agencies, including Tetanus and MMR
  • Conducting tuberculosis (TB) screenings for all new employees, all other employees, and volunteers, as well as follow-up skin testing for all employee TB exposures
  • Identifying safety and health issues based on trending employee illnesses and injuries
  • Planning, implementing, and conducting annual TB and blood-borne pathogen training for employees in required departments
  • Providing education as needed regarding hand washing and isolation practices
  • Striving to manage situations in a reduced-risk manner
  • Demonstrating awareness of adherence to legal requirements regarding employee health and safety
  • Maintaining employee health records
  • Maintaining summaries and written reports required for employee illness and injury reporting
  • Assisting with the compilation of data by providing concise data and tracking all exposures
  • Conducting new employee orientation in Infection Control and Employee Health as needed
  • Providing initial assessments of employee injuries and managing worker’s compensation

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How to Become an Occupational Nurse and How Long Does It Take?

RNs may find employment in occupational health with two-year associate’s degrees in nursing (ADNs); however, many employers prefer hiring RNs with four-year bachelor’s of science in nursing (BSN) degrees. In fact, an employer may hire a nurse under the condition that they complete a BSN upon employment. In addition, employers may require up to two years of nursing experience. 

Based on data from the American Association of Occupational Health Nurses, Inc.

(AAOHN), the following percentages represent the educational background of nurses working in occupational health:

  • Less than a bachelor’s degree: 29%
  • Bachelor’s of science in nursing: 35%
  • At least a master’s degree: 30%

According to an occupational nurse in charge of hiring other OHNs, although employers may want to hire a nurse with previous experience in occupational health, this is not very realistic.

“For me in my job, it's really difficult to find nurses with occhealth experience. Even though recruiting always puts it as a requirement for job listings I end up interviewing people that have none and I'm perfectly fine with that. Most nurses have no work comp or OSHA record-keeping experience, so I assume that whoever is hired will need to be trained. What I'm looking for is a nurse that can work independently and has great assessment skills. We don't have a provider there full time, so I need to trust that the nurses I hire can make accurate assessments and know when to refer out for special treatment.” Redditu/ChRo1989

Occupational Health Nurse Certification?

occupational health

The American Board for Occupational Health Nurses Inc. (ABOHN) offers two certification options for occupational health nurses.

The Certified Occupational Health Nurse (COHN) focuses on clinician practice. The roles associated with this credential are clinician, coordinator, advisor, and case manager.

Nurses interested in pursuing this credential must meet the following eligibility criteria:

  • Current, active RN license
  • 3,000 hours in occupational health nursing in the past five years

The Certified Occupational Health Nurse-Specialist (COHN-S) focuses on administration. The roles associated with this credential are clinician, manager, educator, consultant, and case manager.

Eligibility requirements for this credential include the following:

  • Current, active RN license
  • 3,000 hours in occupational health nursing in the past five years
  • Bachelor’s degree or higher

According to data from the AAOHN, approximately 26 percent of occupational health nurses hold a COHN-S credential, and roughly 14 percent have the COHN certification. 

In addition to specific occupational health certifications, the following are other common certifications held by OH nurses:

  • Basic Life Support (BLS) or other CPR certification: 81%
  • Audiometry: 50%
  • Spirometry: 42%

How Much Does an Occupational Health Nurse Make?

According to a survey conducted by AAOHN in 2018, the average salary for occupational nurses that year was $86,972, indicating a 6 percent increase from 2013. This average is significantly higher than the national average which was $82,750 in 2021—three years after the AAOHN survey.

Furthermore, the average salary varied significantly based on certifications and work experience. Occupational nurses with COHN certifications earned $83,755 annually, whereas nurses with COHN-S certifications earned $95,146.

Regarding work experience, the average starting salary for occupational health nurses was $71,952. Respondents with two years or less in their positions earned, on average, $82,801 annually, whereas respondents with three to fifteen years in their positions earned $88,108. Respondents who had been in their positions for more than fifteen years earned $92,302 annually.

What Is Occupational Health Nursing Like?

Peggy Anderson, RN, COHN/CM, and member of the Association of Occupational Health Professionals in Healthcare, shares their experiences working as part of an industrial medicine program, which offered occupational medicine for hundreds of businesses and municipalities. 

“I remember one trucking business where I would sit weekly in the cafeteria as part of a wellness program, checking blood pressures, and offering counseling and educational material based on the needs of the employees. Some other memorable assignments involved providing monthly new hire tuberculosis and bloodborne pathogen training for county employees, performing tuberculosis exposure testing and follow up at the county jails, and administering flu shots at 4 am at a car manufacturing facility while automobiles on the assembly line circled overhead. My assignments took me to many unusual and interesting places, and I covered thousands of miles.”

An occupational nurse on Reddit also shared what OH nursing is like for them and why they chose this specialty. 

“I am busy all day every day. My day goes fast, its just not exciting stuff. Not a lot of fun stories to relay when i get home. I don’t find it stressful. I was offered an L & D position at the same time for the same pay and benefits. I decided no nights, weekends, or holidays was an ok trade for the lack of excitement.”

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Is Occupational Health Nursing Hard?

A study by Angela Ballard at Gardner-Webb University found that although most occupational nurses were satisfied with their jobs and perceived low levels of workplace stress, their lowest satisfaction scores were related to pay and promotion opportunities. 

Why Choose Occupational Health Nursing?

occupational health

Let’s talk benefits. The 2018 AAOHN survey found the following data regarding the prevalence and type of employee benefits for nurses working in occupational health:

  • Dental insurance: 91%
  • Medical insurance: 90%
  • Life insurance: 85%
  • Vision insurance: 82%
  • Prescription drug coverage: 80%
  • Accidental death and dismemberment insurance: 74%
  • Health savings account: 74%
  • Short-term disability insurance: 71%
  • Employee assistance programs: 71%
  • Medical flexible spending accounts: 66%
  • Long-term disability coverage: 66%
  • Free parking: 64%
  • Flexible spending accounts: 60%
  • Employee discounts: 59%
  • Tuition reimbursement: 56%
  • Fitness facilities/wellness programs: 54%

In addition, the occupational health nurses participating in the survey reported an average of six paid sick days, sixteen paid vacation days, eight paid holidays, fourteen paid time off days, and two paid days for professional development—totaling an average of forty-six paid days off work!  

“I am a former ED APRN who now works in Occupational Health for a large health system. I love it! The hours are great M-F, 8-5, no weekends/holiday's. A normal flow of patients, not the insane chaos of the ED. For me it was a good move! 😊” Redditu/Jen120ha

What Makes a Good Occupational Nurse: Tips for New Nurses?

In addition to the knowledge and abilities developed in nursing school, new nurses interested in pursuing a career in occupational health should strive to develop the following indispensable soft skills:

  • Leadership skills: Since occupational health nurses fulfill administrative roles, leadership skills are indispensable. They must be able to delegate tasks and inspire confidence in the people they work with or care for.
  • Critical thinking skills: OHNs must be able to identify problems in organizations’ health and safety strategies and offer appropriate solutions. 
  • Interpersonal and communication skills: Regardless of their role, occupational health nurses must always communicate and interact well with others. They must be good listeners to correctly diagnose patients’ conditions and make appropriate referrals; they must be good teachers in order to educate staff regarding health and safety measures; they must be clear and effective communicators to present findings and propose changes to management. Furthermore, they must always communicate and interact with respect, empathy, and tact to contribute to positive work environments. 

Final Thoughts on Occupational Health Nursing

One common concern among nurses considering less traditional nursing roles is whether they will be able to return or transition to other areas of nursing down the road. Although this concern is valid, nurses must weigh the pros and cons of remaining in more traditional but highly stressful areas of nursing. Are you having a hard time achieving work-life balance? Are you experiencing burnout? If you no longer feel satisfied working bedside or if you feel that emergency room care does not fit your personality traits, perhaps changing roles is worth the risk. Furthermore, as this occupational health nurse on Reddit shared, perhaps there isn’t much of a risk at all.  

“’ll always be able to get into any nursing field no matter what path you choose. I don’t believe in the idea that once you lose some skills you’re dead ending your career. I learned those skills as a new grad with ZERO experience so I can certainly learn them again in the future if I wanted to do ED again…”

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