How to Become an Occupational Health Nurse

Occupational Health Nursing Overview

• What You Will Do: Provide health care services in the workplace, promoting health and safety programs and services.
• Where Will You Work: Most occupational health nurses work in venues such as manufacturing and production facilities, within corporations and businesses throughout the US.
• Employment Projections: Nursing is expected to be the fastest-growing professions, with growth projected at 16% – 26%; similarly, the employment outlook for occupational health nurses is excellent, with an growth rate of 19%.
• How Much Will I Earn: The median annual salary for occupational health nurses ranges from $76,810 to $94,783, with an average annual salary of $85,266..
• Requirements to Become One: Become a Registered Nurse (RN) by completing an accredited nursing program earning an Associate’s Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN), then passing the NCLEX-RN examination to obtain licensure.

Steps to Become a Occupational Health Nurse

• Earn Your RN: You must earn an RN degree from an accredited nursing program, earning an Associate’s Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN). It is important to note that many employers prefer a minimum of a BSN degree.
• Pass the NCLEX-RN Exam: All RNs must pass the NCLEX-RN exam to obtain licensure to practice nursing in your state.
• Gain Clinical Experience as a Professional Registered Nurse: Typically nurses entering the field of occupational health nurse come to the specialty with experience in emergency, critical care, community health or ambulatory care.
• Seek Employment in an Occupational Health Venue. You must have 3000 hours experience over five years as an occupational health nurse in order to progress to certification.
• Obtain Certified Occupational Health Nurse (COHN) Credential: Obtain this certification from the American Board for Occupational Health Nurses (ABOHN).

What is an Occupational Health Nurse?

The American Association of Occupational Health Nurses defines an occupational health nurse as one who “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 have a combined knowledge of health and business that they blend with health care expertise to balance the requirement for a safe and healthful work environment with a ‘healthy’ bottom line.”

Occupational health nurses are engaged in working in concert with employers and employees to identify health risks and safety concerns within the workplace. Specific nursing actions include:

• Coordination and delivery of  related services and programs
• Promoting an interdisciplinary approach to health care
• Act as an advocate for the employee’s right to prevention-oriented, cost-effective health and safety programs.
• Encouraging workers to take responsibility for their own health through health education, promoting wellness strategies and disease prevention/management programs.
• Monitoring the health status of workers, worker populations and community groups.
• Conducting research by gathering health and hazard data, such as on the effects of workplace exposures.

How Do I Become an Occupational Health Nurse?

The first step toward becoming an occupational health nurse is to become a Registered Nurse, earning a Bachelor of Science in Nursing degree (BSN) from an accredited nursing program. After graduation, you must obtain RN licensure by taking the NCLEX-RN examination in your state. Once you have achieved licensure, you will need to gain clinical experience as an RN, preferably in an area such as emergency or critical care, community care or ambulatory care. Following gaining this experience, then seek employment in an occupational health setting, in order to progress toward the COHN credential.

The Certified Occupational Health Nurse (COHN) credential is awarded by the American Board for Occupational Health, Inc (ABOHN). Eligibility requirements are:

• Current, unencumbered licensure
• 3000 hours in occupational health nursing in the past 5 years; or
• Completion of a certificate program in occupational health nursing for academic credit; or
• Completion of a graduate level of education with a concentration in occupational health.
• Successful completion of the certification examination.

Certification is valid for 5 years, after which it must be renewed by meeting the renewal requirements in place at the time of renewal, such as specialty-related professional development and practice activities. If this is not possible, the certification exam must be retaken. The next level of certification is the Certified Occupational Health Nurse-Specialist (COHN-S) credential. While eligibility requirements are similar, a Bachelor’s degree is a requirement. The roles associated with this credential include Clinician, Manager, Educator, Consultant and Case Manager.

A third certification offered by the ACOHN is the Certified Occupational Health Nurse – Case Management (COHN-CM). Eligibility requirements include:

• Current RN licensure
• Occupational health nursing certification (COHN or COHN-S) in good standing (Active Status) with ABOHN;
• 10 documented contact hours of occupational health nursing case management related continuing education earned within the five years prior to the date of application.

Where Do Occupational Health Nurses Typically Work?

 While occupational health nurses may work in the hospital/medical center venue, most will be employed within corporations or businesses, or in the government sector. Typical workplace activities include; development and implementation of workplace safety procedures, case management, infection control, disaster preparedness, in roles such as clinicians, case managers, educators, consultants or corporate managers.

Specific activities include; treating occupational injuries and illness, referring workers to emergency or other medical services as needed, performing pre-employment physical examinations, providing screening activities such as vision and hearing screening, and administering flu vaccinations. The occupational health nurse maintains employee medical records and ensure medical record confidentiality, and administers workers’ compensation, disability, family and medical leave, and various health and safety programs.

How Much Do Occupational Health Nurses Earn?

Nursing, in general, is identified as one of the fastest growing professions in the US in terms of salary, with a projected growth of 16% +, much higher than the national average. Specialty certification can increase earnings significantly; the median average annual salary for occupational health nurses is of $85,266 annually, with a range of $76,810 and $94,783. This is dependent on the job, and the geographical area. Salaries are generally higher in urban areas, however, the cost of living is typically higher, as well. In addition, bachelor’s prepared nurses tend to earn higher salaries than nurses with associate degrees. According to the Bureau of Labor Statistics the top five states for general nursing salaries are (range 96,470 – 81,380);

• California
• Hawaii
• Alaska
• Oregon
• Massachusetts

Occupational Health Nurse Programs

At the undergraduate level, specialty-related education consists of continuing education activities, such as conferences or online CEU providers. Examples of related topics include:

• Wellness and safety
• Public health emergencies
• Disaster preparedness
• Mental health issues
• Chronic disease
• Infection control
• Physical assessment

Certified Occupational Health Nurses can access field training programs through the National Institute for Occupational Safety and Health (NIOSH), a part of the Centers for Disease Control and Prevention.

The North Carolina Occupational Safety and Health Education and Research Center, University of North Carolina at Chapel Hill, offers an academic Occupational Health Nursing Certificate.

The Global Program in Occupational Health Practice (GPOHP), Chicago, Illinois, offers the Occupational Health track of courses, available to physicians, nurses, and other healthcare professionals involved in screening, providing care, return to work, and disability management.

Course topics include:

• Occupational safety and ergonomics
• Occupational exposure
• Occupational health surveillance
• Management of occupational safety, health and hygiene programs

At the graduate level, programs may offer an occupational nursing specialty as a primary track, or as a sub-specialty related to adult health nursing. Examples of graduate programs preparing Occupational Health Nurse Practitioners include:

•  University of Alabama School of Nursing, Deep South Center for Occupational Health & Safety; Adult Nurse Practitioner with a specialty in occupational health, MSN, DNP and PhD level programs. https://www.soph.uab.edu/dsc/occupationalhealthnursing
• University of California, San Francisco School of Nursing; Occupational and Environmental Nursing MSN program. https://nursing.ucsf.edu/academics/programs/master-science-advanced-practice-programs/occupational-environmental-health-nursing
• University of South Florida, College of Nursing, Occupational Health/Adult-Gerontology Primary Care Nurse Practitioner, DNP program. https://health.usf.edu/nursing/graduate/programs/dnp/occ-health
• University of California Los Angeles, School of Nursing, Adult/Gerontology Primary Nurse Practitioner Occupational and Environmental Health Specialty, MSN program.  https://www.nursing.ucla.edu/admissions/degree-programs/master-science-nursing-advanced-practice-nurse/adultgerontology

What is a Typical Occupational Health Nurse Practitioner Curriculum?

Topics addressed in OHNP curricula include:

• Advanced health assessment
• Advanced pathophysiology
• Occupational health and safety
• Occupational health, hygiene and safety
• Advanced pharmacology
  • Contraception prescription and indications
• Aging and palliative care
• Clinical prevention and population health
• Management of Clinical Occupational Health Problems
• Counseling for behavioral change
• Complex health problems
• Occupational Biomechanics

The Role of the Occupational Health Nurse During the Nursing Shortage

The Bureau of Labor Statistics cites that employment for nurses will increase at a rate of 16% by 2024. There is a national shortage of nurses in general related to the Baby Boomer population entering retirement, and the increased health needs of the growing aging population. It is projected that the South and West will be hardest hit by the nursing shortage. The 12 states expected to have the most acute shortages are: Florida, Georgia, Texas, Virginia, Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada and New Mexico.

Occupational Health Nursing represents one of the fastest growing specialty areas, with a projected growth rate of 19%, as employers seek to avoid illness and injury in the workplace, take precautions against potential litigation, keep abreast of related employment legislation, and mitigate high costs related to health care. In many states, healthcare funding has been shifted to support home-based care, for follow-up after hospitalization, long term care, home health nursing, and hospice care.

Occupational Health Nurse Resources

• American Association of Occupational Health Nurses – http://aaohn.org/
• American Board for Occupational Health Nurses –  https://www.abohn.org/
• American College of Occupational and Environmental Medicine –
• International Commission on Occupational Health – https://acoem.org/ http://www.icohweb.org/site/homepage.asp
• National Institute for Occupational Safety and Health – https://www.cdc.gov/niosh/
• Occupational Safety and Health Association – https://www.osha.gov/
• Office of Occupational Medicine and Nursing – https://www.osha.gov/dts/oomn/index.html
• Workplace Health and Safety Journal – http://aaohn.org/page/wh-and-s-journal

References  

• American Association of Occupational Health Nurses – http://aaohn.org/
• American Board for Occupational Health Nurses –  https://www.abohn.org/
• Nurse Journal – https://nursejournal.org/
• Nursing License Map – https://nursinglicensemap.com
• Salary.com – https://www1.salary.com
• The National Institute for Occupational Safety and Health – https://www.cdc.gov/niosh/
• US Department of Labor; Bureau of Labor Statistics – https://www.bls.gov/