Great responses by all, thank you. I've been full-time Occ-Med for about 5 years, coming from Med-Surg and ICU. I'm contracted to a major corporation and love the job, the management and the Union (UAW) which seems to be contrary to what everyone else feels. Sadly, our plant closes in a few months and it's decision time. A local headhunter sends out a list of jobs periodically. Three years ago the average list was about ten Occ-Med RN's and maybe a part time LPN. These days, the list is usually 8 NP's, and one part-time LPN. Clearly becoming a NP is becoming more essential. Combo setups like COHN-S/SP or CMM helps. It's sad to hear the situation in foreign countries, for I had thought about that. As a lot we are becoming more and more pushed to extinction.
Contract job seem the norm, and my contract company has reduced (through cuts in pay/insurance, etc.) my real income by about 8% each of the past three years. I no longer recommend OHN to students; sadly I actually no longer recommend nursing of any sort, even though a few years back I was a proselytizer. I'm trying to find a NP program, but being older, taking a loan is either very wise or very stupid (it's hard to collect from the aged infirm, or dead, but I online tests say I will live to be 90+, and there it is hard to consider paying $600/month for student loans. Still there will always be a need for those who hold experience and skills. COHC, being able to do fit-checking, spirometry, being an instructor (BBP; First Aid, CPR) helps. Even becoming a certified fitness instructor can help land a nice job if the corporation has a fitness center. I read that 20 years ago that the norm was one OHN for every ~150 employees, then it changed to every ~400, and in some places is as high as one per 700 ee's, due to reduction in manufacturing, and thus reduction in injuries in many areas. Lacerations, crushing injuries, strains have moved aside for office ergo issues and slips and falls on the way to the entrance.
America's economic situation has brought hard times for all, exemplified by my being so happy about being terminated in a few months from the best job I have ever had (due to reductions making it no longer to live/work in MA). *pfft* I'm delaying paying my fee to AAOHN till August, and then will delay taking the COHN-S test till next year because I doubt I'll need it this fall/winter due to a paucity of jobs.