How to Become an Occupational Health Nurse

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Occupational health nurses provide healthcare services and deliver health and safety programs to workers within the work environment. The ultimate goal of occupational health nurses is to achieve and maintain a safe and healthy work environment.

To this end, they focus on:

  • Promotion and restoration of health
  • Prevention of illness and injury
  • Protection from work-related and environmental hazards

Occupational Health Nurse Job Description: Duties and Responsibilities

Occupational nursing can be traced back to 1888, although the profession really began to grow during the early twentieth century when factories employed occupational nurses to combat the spread of infectious diseases and the health-related maladies resulting from poor working conditions. Career opportunities for occupational health nursing took off in the 1970s, thanks to the introduction of the Occupational Health and Safety Act (OSHA), which requires employers to provide their employers with work sites free from hazards.

The job scope of occupational health nurses has since increased exponentially, with these nursing professionals now responsible for everything from disease management and environmental health to emergency preparedness and disaster planning. Employers look to occupational nurses to maximize employee efficiency and productivity and reduce costs through fewer disability claims and on-the-job injuries.

Just a few of their job duties include:

  • Coordinating and managing the care of sick or injured workers including both work-related and non-work-related injuries and illnesses related to group health insurance, FLMA, workers’ compensation and short/long-term disability
  • Providing counseling and crisis intervention services related to issues such as mental health, substance abuse, and wellness/health promotion
  • Designing programs related to the support of positive lifestyle changes and personal changes to lower the risk of disease and injury
  • Designing and implementing preventive strategies to keep workers healthy and productive – including programs related to:
    • Immunizations
    • Smoking cessation
    • Exercise/fitness
    • Nutrition and weight control
    • Stress management
    • Chronic disease management
  • Working with employers to ensure compliance of regulations and laws related to OSHA, FMLA, and HIPAA, among others

Occupational Health Nurse Standards of Practice

The American Association of Occupational Health Nurses (AAOHN), the professional association for licensed nurses engaged in occupational and environmental health nursing, has established the standards of practice for occupational and environmental health nurses, which include:

  • Standard I: Assessment – Occupational health nurses systemically assess the health status of their clients.
  • Standard II: Diagnosis – Occupational health nurses analyze assessment data to formulate their diagnoses.
  • Standard III: Outcome Identification – Occupational health nurses identify outcomes specific to their clients.
  • Standard IV: Planning – Occupational health nurses develop comprehensive goal-directed plans to attain expected outcomes.
  • Standard V: Implementation – Occupational health nurses implement interventions to attain expected outcomes.
  • Standard VI: Evaluation – Occupational health nurses evaluate response to interventions and make changes to achieve desired outcomes.
  • Standard VII: Resource Management – Occupational health nurses secure and manage resources to support health and safety programs and services related to occupational health.
  • Standard VIII: Professional Development – Occupational health nurses seek professional development to enhance their personal growth and professional competency.
  • Standard IX: Collaboration – Occupational health nurses collaborate with clients to promote and restore health in a safe and healthy environment.
  • Standard X: Research – Occupational health nurses use research findings to contribute to occupational health nursing and advance the profession.
  • Standard IX: Ethics – Occupational health nurses adhere to an ethical framework when making decisions.

Competencies in Occupational and Environmental Health Nursing

The AAOHN also defines the competencies for occupational health nurses, which establishes the practice core of occupational health nursing. An occupational health nurse that is deemed competent is one who:

  • Manages total worker health, both independently and with other team members
    • Promotes a culture of health and safety through the use of best practices and evidence-based techniques
    • Identifies trends to control health and safety risks and implement policy decisions at all levels
    • Identifies hazards and exposures and recommends ways to mitigate them
    • Plans and implements programs and services designed to improve health and safety
    • Coordinates client care to promote health and manage illness and injury
  • Adheres to professional nursing practice principles
    • Practices nursing in an ethically and competently manner, within the legal scope of nursing
    • Seeks lifelong learning
    • Advocates for issues related to nursing in general and occupational nursing
  • Understands the business climate and its impact on the health of the community
    • Complies with applicable laws and regulations that affect the nursing practice, as well as workers and the workplace environment
    • Practices within budgetary constraints
  • Practices culturally appropriate nursing within licensed scope of practice
    • Educates, counsels, and coaches clients on identifying, reducing, and eliminating health and safety risks
    • Gathers knowledge to make accurate clinical decisions such as fitness for duty and placement

How to Become an Occupational Health Nurse: Earning a Qualifying Degree

According to the AAOHN, occupational health nurses typically possess a bachelor’s degree in nursing (BSN), along with experience in community health, ambulatory care, critical care, or emergency nursing. However, the AAOHN reports that a growing number of occupational health nurses possess a Master of Science in Nursing (MSN) in occupational health nursing or in an advanced practice role, or a Master of Public Health (MPH).

A number of institutions offer occupational health nursing concentrations within an advanced practice registered nursing (APRN) role and population focus (usually adult/gerontology/family primary care nurse practitioner). Other schools offer an MSN in Occupational Health Nursing (OHN).

Curriculum Requirements

A master’s degree in occupational health nursing focuses on occupational health services for working populations, emphasizing occupational health nursing practice and management skills with a strong interdisciplinary focus.

All MSN programs require the completion of a direct care core, which includes:

  • Physiology/pathophysiology
  • Health assessment
  • Pharmacology

Courses specific to an MSN in Occupational Health Nursing include:

  • Occupational Health and Environmental Diseases and Injuries
  • Occupational Health and Safety Programs
  • Leadership and Human Resource Management in Occupational Health
  • Principles of Occupational Exposure Assessment
  • Occupational Health, Hygiene, and Safety
  • Occupational Safety Engineering
  • Finance and Economics of Healthcare

In addition to completing didactic coursework requirements, students of MSN degrees in Occupational Health Nursing must also satisfy clinical requirements, which often include completing practice hours in a variety of occupational health settings, such as industrial, corporate, hospital-based, and nurse-managed sites.

Admission Requirements

Admission into an MSN program requires, at a minimum, a current and unencumbered RN license and a Bachelor of Science in Nursing (BSN) degree. However, many programs also require candidates to possess one or more of the following:

  • Clinical RN experience
  • Minimum undergraduate GPA
  • Minimum GRE scores
  • Resume or CV
  • Letters of recommendation

Many institutions also feature MSN programs that appeal to RNs with different educational backgrounds. For example, RN-to-MSN degree programs allow RNs with associate’s degrees in nursing to complete their BSN and MSN in one, streamlined program, while direct-entry MSN programs accommodate candidates that possess a bachelor’s degree in another field. These programs allow students to earn their RN and MSN through one, combined program.

Program Delivery Options

A number of colleges and universities have begun offering their MSN programs in partially or fully online formats, thus appealing to working professionals and students looking for a more convenient way to earn their MSN. Online programs allow students to complete most or all of the program’s didactic requirements through interactive, web-based study and then satisfy the clinical requirements of the program at partner sites close to home.

Professional Certification Requirements for Occupational Health Nurses

Professional certification in occupational health nursing is a voluntary process, although many professionals in the field choose to pursue certification as part of their ongoing professional development and rising competency in the field.

The American Board of Occupational Health Nurses (ABOHN) is the sole provider of certification in occupational and environmental health nursing in the U.S. and is accredited by the National Commission for Certifying Agencies. More than 5,000 certified occupational health nurses practice in the U.S.

ABOHN uses the definition of occupational and environmental health nursing and the standards of practice to determine eligibility for certification. ABOHN offers two core credentials:

  • Certified Occupational Health Nurse (COHN)
  • Certified Occupational Health Nurse – Specialist (COHN-S)

To qualify to take the COHN exam, candidates must possess:

  • RN license; AND
  • At least 3,000 hours in occupational health nursing in the last 5 years; OR
  • The completion of a certificate program in occupational health nursing

To qualify to take the COHN-S exam, candidates must possess:

  • RN license; AND
  • A bachelor’s degree or higher; AND
  • At least 3,000 hours in occupational health nursing in the last 5 years; OR
  • The completion of a certificate program in occupational health nursing; OR
  • The completion of a graduate level of education with a concentration in occupational health

Candidates who have met the eligibility requirements must achieve a passing score on the COHN or the COHN-S exam. Both exams include 160 multiple-choice questions. Students can take the exam at AMP testing centers throughout the U.S.

To maintain the COHN or the COHN-S credential, certification holders must pay the annual renewal fee of $150 and complete recertification paperwork every 5 years. Completion of the recertification process must include evidence of:

  • Active RN license
  • At least 3,000 hours of occupational health nursing practice
  • 50 continuing education contact hours related to occupational health practice