Tell the world project: Employee Health Nursing

As graduation quickly approaches at James Madison University, in Harrisonburg, VA. My time in the RN - BSN program is ending and one of my final assignments is to "Tell the World" about my profession and my personal role in nursing. I have worked in many different areas of nursing over the past 20 years, 17 years as an licensed practical nurse (LPN) and the past three years as a registered nurse (RN). One of my favorite areas of nursing has been working as an employee health nurse (EH). From medical surgical units, health and rehabilitative facilities, cardiology, to primary care facilities my time in nursing has been interesting and educational. The EH department stands out to me because of the relationships I have made and the lives I have helped make better. EH nursing can be a very rewarding field in nursing.

Like many other areas in nursing, EH needs nurses with skill, compassion, and patience. With the ability to listen beyond the subjective data. There is not a provider in our department, the medical director is off site. We are staffed by two RNs most days. Job duties range from pre employment physicals, drug screens, annual fit testing, tuberculin skin testing, vaccinations, managing the workers compensation injuries, blood borne pathogen exposures, nurse evaluations, and infectious disease management. Maintaining compliance with agencies such as the Joint Commission, OSHA, and our states workers compensation laws/guidelines. That is the pen and paper description but those job duties do not describe for you the picture of the fulfillment I get from helping my patients (the employees). So, lets talk about my personal role and some of the reasons I love EH nursing.

When I look back on my time in EH, I have many situations that stand out to me and make me proud of the work I do, and the lives I have made a difference in. One such example was an older female who came to EH for a pre-employment physical. this was the first time she had been in our office and upon taking her vital signs I noticed her heart rate was low. When I investigated further she was not a very active person and she had been feeling very tired for months. She told me she did not have a primary care doctor but she did go to her gynecologist (GYN) yearly. She said the GYN checks her cholesterol each year and she had just been for her appointment. I let the patient know I was concerned, especially with her age and symptoms. After we talked further she told me she would make an appointment to have a checkup.

A few weeks later she called back to EH to speak to me. When I answered the phone, she thanked me for being so concerned and for encouraging her to get this checked out. She went on to tell me, when she left my office the first day she had stopped by an urgent care facility, that doctor referred her to a cardiologist, who scheduled her for a heart valve replacement surgery. She continually thanked me for my concern and help. I was reminded why each patient encounter is important. If I had not taken the time that day to investigate further and talk to her about my concerns, her outcome may have been very different.

I have many stories I could tell you like this where someone's life was helped and outcomes were changed. EH patients are not always medical personal. We see a variety of people; employees, volunteers, students, and contract staff. Individuals come to us for many things including nurse evaluations. Which is sometimes a patient with a headache for days or high blood pressure and after investigating further, they sometimes begin telling me of a sick parent they have been taking care of for months with no help. Or an anxiety problem that caused them to start an unhealthy or even harmful habit. You never know what each day will bring in the EH department. I tell my patients often about our hospitals employee assistance program and often give out numbers for the local free clinics and other offices that help patients with no insurance or no money for co-pays. I jokingly refer to my exam room chair as a bar stool, because my patients open-up and tell me very personal information, they know I care about them. I encourage everyone to listen, care, and set aside any preconceived ideas. Most people are under so much pressure, they need resources and encouragement for living a healthy life.

Many of the patients come back to tell me how they are doing, how the doctor is helping them, or how the counseling sessions are going. My manager jokes that I am the "favorite" because associates will sometimes ask for me by name, they are like my family and they know I care about them. My philosophy of nursing is that nursing is about knowledge and improving quality of life while showing accountability, respect, competence, and compassion. Acting as an advocate for the patient, being fully present always. Listening attentively to hear the unspoken message or question. EH is much more than physicals and mandatory requirements. I get to make a difference in people's lives, sometimes by simply listening and allowing them time to vent frustrations, other times by evaluating the situation and giving them resources for help they may not have known they needed. That is my professional role in nursing at this time in my life, who knows what the future holds for me since nursing is a vast array of opportunity, experiences, and education.