Future direction OH Nursing...?

Specialties Occupational


  • by qatrat
    Specializes in ICU/ED/CCU/OH/Hyperbaric.

I'm thinking about my future as an OHN - I like what I do but it's groundhog day...

10 years (onshore / offshore heavy industry, remote are support) and wondering what's next. I live / work in jurisdictions (Middle East / Australia) that don't and probably wont recognize OH NPs, so why bother fighting it. I watch my profession being dumbed down and the wages with them - 2 years ER will get you a job with OHN title in most countries, in some you can call yourself a OHNP with no OH background at all. Guess I took the long / wrong route: BNursing, hyperbaric and ICU certification, Post Grad Dip Safety Science, Master Occ Med, chartered professional membership of safety institutes, certified auditor etc etc...

Looking at opportunities for senior corporate level positions, it appears the preference (outside the US - dunno about that market, not eligible to work there) is for Occ Therapists or Occ Hygienists (IHs) and rarely Occ Physicians - most Health, Safety and Environment Managers generally only have either an engineering degree or a trade certificate / NEBOSH dip etc without any specific specialty in any of the disciples (H,S or E)... I'm yet to see a high level position that invites OHN's. Typically the interview goes something like, "...oh I see you are a nurse. That's nice but we're looking for someone with more experience in engineering / process control / construction / safety. Thanks for coming..".

I pride myself on being a good ambassador of OHNs, I strive to educate junior nurses entering the profession, but I find it harder every day. What do I tell a bright young thing - that you will rapidly hit a ceiling and to chose another specialty.

Reading the boards it seems that RNs want to transition to OHN because they don't like hospitals - that's fine, but OH nursing is somewhat more complex than just nursing outside a hospital. Throw in case management, business management, administrative law and compliance, health promotion, emergency medicine, pre-hospital care, travel medicine, public health, cross overs in safety / occ hygiene / IH and you have a much better description of our role. Or perhaps I'm the one looking at this all-wrong...

So, I'm looking for global thoughts. To all the experienced / certified / qualified OHNs out there - how do you see the future of the specialization going? What would you recommend to a new grad planning an OH career? How do we claw back our professional credibility? Or do we bother?


31 Posts

As an OH nurse for over 8 years I would personally recommend that OH is not for a new grad. Since there are so many asects like you have mentioned a person needs to gain experience before moving into the OH field. Often the OH nurse works alone, no physician to assist in decision making. An OH nurse needs to have very good assessment skills in addition to people skills. He/she needs to be a self starter and comfortable in decision making both medical and business. I have always been one that feels a new grad should get at least 1-2 years in a hospital for clinical experience then branch out after that.


96 Posts

Specializes in Occupational Health Nurse/ case manager.


Good post! I am a COHN-S and what I am seeing especially in the northeast market is that there are not too many job opportunities at the moment, due to downsizing and budgetary constraints. I am seeing alot of multi-tasking at jobs, where there is an overlapping of OHN tasks, safety, and other disciplines, often to the point of not being sound practice, because the work force is being cut and those who remain must take up the responsibility. I believe the specialty of OHN is evolving due to research PLUS the ever-changing face of businesses and their economic health. I see more and more nurses doing the safety and environmental piece, especially in a manufacturing setting, and am wondering if more and more OHN's will be "favored" if they become certified as a COHN-S's safety manager? Perhaps, a COHN certification is no longer enough these days???

Specializes in Occupational health, Corrections, PACU.

I believe that the OHN market is saturated at the moment, and that since so many businesses have downsized and had lay-offs (including the nurses), the job outlook is grim. I do see some areas of the country using OHN's more (by tracking what appears on monster.com and careerbuilder.com), but overall I see a vast decline in demand. I would not encourage any new grad at this time to go for Occ Health.

I have been in the biz of Occ Health for 9 years, and last year switched to working in other areas due to lack of demand (and a career misstep on my part). I also see more demand for case managers than OHN's onsite. Sad, since the hands on, onsite nurse can bring so much to the company. I think this will turn around again, when the economy does, but that will take a long while.


96 Posts

Specializes in Occupational Health Nurse/ case manager.

Yes, I agree with you! There arer more case management positions out there than Occ Health. Companies are focusing on how the nurse will save them money! The focus, unfortunately is less on the employee and more on the business. It IS about the dollars and cents!


5 Posts

Specializes in cardiac, trauma surg. ,Occ health x 13 y.

The economy has taken a big toll on our contract services. Our client population is down over 50% and as the program manager (plus I have my own clinic) - I am down to a part time job for a few months. If the free market is not constrained in the future, I am anticipating a recovery. But if the government continues on its current path, I anticipate that a great number of private industries will end up closing their doors. I have expanded my capabilities in as many directions as I can think of to show my value. Claims cost analysis and working to reduce cost of litigated claims has been a focus. This is NOT a job for a new grad in any way. You have to have some good experiences in nursing in order to function at an independent and high level.


96 Posts

Specializes in Occupational Health Nurse/ case manager.

Well, I DID it!....I left the field of Occupational Health Nursing. I did not want to do it but I needed to live....I took an in-house position with an old employer in another specialty field. Perhaps, there I will pick up new skill sets that will give me a stable job. When I look back at my time in Occupational Health nursing I have not advanced in the specialty and looking forward, the prospects are grim. There are few positions available that are in-house, and fully benefited. It seems that others are making a reasonable living except the OHN! The majority of jobs are either "feast or famine" temporary contract jobs or are going to NP's. As occupational health nursing moves forward, employers are moving toward a total care model that bypasses the OHN and Doctor and there is no stability for the average OHN. By all means, this is not to bash NP's, but it is not always cost-effective to hire a NP.(I believe new studies are starting to confirm this) While they have their place, I believe that in the end the NP will be required to take on too much responsibility because the employer wants to cut costs. This will ultimately burn out the NP and unfortunately, dis-enfranchises the Occupational Health Nurse. I am so sad to leave my specialty, but I need some stability. I need to earn a living! How do other occupational health professionals feel?


31 Posts

My job must be feast. I have been in a stable position for 10 years now, gaining more skills but along with that is more responsibility. I have now started doing CM for those on disability/WC trying to get them back to work sooner. I am employed by the company and not contract so I guess I should consider myself lucky.


15 Posts

Specializes in L/D, OHN, NSF, Home health.

I have been in (industrial nursing) since Jan of 2006. I had vast experience in hospital settings but nothing prepared me for this job. ALOT of my experience was learning on the job. The main focus of my job is safety/health, keeping employees healthy AND AT WORK. There is a huge shift in safety as indicators of a companys reputation. When jobs are bidded on by different companies, customers are looking at metrics specifically EMR's and such. It really does come down to how much the company will save with the OHN in place.

With the economy the way it is, I consider myself VERY lucky to have this job, as many manufacturing companys that have been in place for over 50yrs are closing. I find myself at times overwhelmed with what im responsible for : Audiograms, OSHA recordkeeping, Metrics, eye exams, respiratory fit testing, safety incident reports with root cause analysis. I couldnt possibly list everything, yet the biggest task is nurse case manager with work related incidents. Returning the employee back to work FULL DUTY being the main focus. There are so many loops, bumps and hurdles working with Workmans Comp AND working in a Union environment does not help any!

Along with some of the above I also provide nursing-first aid to employees (which is what I thought I would mainly be doing when I interviewed) **smirky chuckle***. I cant forsee a NEW nurse coming in directly to this job. Asessment skills are so critical and detrimental to this job. On any given day I will see abcesses to gums, and all other body parts, ear and sinus infections, and have referred employees to Dr.'s when a simple mole looked odd (4 out of the 5 times they had surgery). Praying I can keep this job for a lot longer!


96 Posts

Specializes in Occupational Health Nurse/ case manager.
My job must be feast. I have been in a stable position for 10 years now, gaining more skills but along with that is more responsibility. I have now started doing CM for those on disability/WC trying to get them back to work sooner. I am employed by the company and not contract so I guess I should consider myself lucky.

Yes, this is key!!--You are employed by the company so you are part of their staff. There is a committment to you along with other perks, like benefits and a pension! Yes, you are lucky! :yeah:

Here is a great article about contractor workers vs permanent workers:


Well, I DID it!....I left the field of Occupational Health Nursing. I did not want to do it but I needed to live....I took an in-house position with an old employer in another specialty field.

Hi JerseyLilly! What other specialty field are you in now? Do you miss Occ Health or are you enjoying your new job? Your posts have provided so much information to me while I try to transition to an OHN position. I'm still working in Work Comp case management for the time being but keep scouting the job ads for an OHN position near me, although there are very few positions advertised. I've interviewed for a few jobs but they've always chosen someone with Occ Health experience over me. It's become very frustrating...they say they want someone with more then just work comp experience yet no one will hire me so I can get the Occ Health clinical experience! :mad: I've gotten all the certifications they require; I just can't seem to find a job where I can use them! :crying2:

Keep us posted on how your new job is going! I'm wishing you the best! Who knows, maybe I'll go back to Public Health Nursing. The pay isn't great but I sure miss the benefits, hours, etc. As we get older, it's amazing how those things become so important! :)


1 Article; 369 Posts

Specializes in Occupational Health; Adult ICU.

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.

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