To apply or not to apply...

[jsterling01]

Hi there fellow nurses!

This is my very first New Topic so I hope I'm doing this right. I've got 8 years experience as an RN, first two on a cardiac step-down unit and the past 6 in ambulatory surgery as a pre-op and recovery room nurse. I enjoy the surgical setting and feel comfortable there but I'm feeling it's time to move on and grow in a different area of nursing. I am leaning toward case management later on down the road but am not ready to completely give up the "hands on" direct patient care of nursing just yet.

There is a position posted at the medical center where I work for a Employee Health/ Occupational Health RN. I'm pretty certain I'm going to apply for it as I meet all of the required qualifications but I'm concerned as to whether I would take it or not if offered. I think I understand what an OCC Health nurse does but I don't know if know enough about what my day would be like. I'm not sure what types of questions to ask about the job to help my decide if this is what I would want to do or not.

Can anyone share any insight on this with me as to the actual daily duties of a nurse in this type of position. I sure would appreciate it!

[nurseladyk]

I would love to see a response to this! I have an interview tomorrow for an Employee Health Manager position...I am currently and ED nurse, so this would be a change!

[42pines]

Hi jssterling01

My answer is a simple: Apply and if accepted you'll be trained to do everything that you need to do. That was easy--eh?

A day in the life of Employee/Occ RN in a medical center/hospital is quite--quite different than it is, for instance, at a manufacturing facility--maybe.

Why maybe? Because the job can be divided into two distinct areas, and I'll deal with them separately.

Probably, as a guess the job will be within the medical center environment, serving only those within the system--from maintenance staff to docs (now they won't willingly come to you, but may have to begrudgingly). Usually there is an Advanced Nurse Practitioner in such a setting (but not always) so if, for instance, a worker comes to you and says: "I got stuck with a used sharp." Well, that's not likely to be in your ball field, so that person goes off someplace ASAP (either to the ANP, or to the Medical Director).

Ok, so much for scary things. Other things that I suspect you will encounter/be responsible for: Boo boos, ("oh my, let's wash and put a bandaid on that." We call that "first aid." Usually you'd be responsible for Spirometry--blow--blow--blow! They'd send you out to a course not to be certified, but in a way to be certified. There really is no cert, but you take a NIOSH approved Spirometry (one day usually) course and though not certified because NIOSH does not certify but you'll have a certificate. As part of the blow-blow-blow part you'll be expected to "fit test" respirators. There's no cert for that and you'll have either quantitative (computer) or qualitative, "put that on...breath in...can you taste the saccharin?" You've probably been there, sort of done that (on the receiving end).

You'll be expected to do vaccine admin and may do urine drug testing. You might even have to do BAT (Breath alcohol testing). You may do post-hire physicals or may not, though you may be the one to do: "this is how you lift--is there any reason why you can't lift this 20lb box," sort of stuff. You'll probably do and read those TB "make a bleb on the forearm" tests, the OhMan2 tests...

So much depends upon whether you are the top dog there, or an assistant. If the top dog, you'll be expected to know OSHA stuff, especially related to the healthcare arena. You may or may not be active in FMLA. Though FMLA is admin'd by HR, but someone down the line has to be the one to say to the EE: "Yes, I know it's important, but 3 weeks off under FMLA for your facelift, even though it's so, so important, simply doesn't fall under FMLA--so sorry." It is important too, to not underestimate that you DO need to know it all--make a mistake and terrible things can happen.

You might be expected to know ADA and be the one who gives the EE with the bad ankle strain a handicapped pass for x number of days. You might be the one (or not) to report accidents to your state and do OSHA logs.

You may be the one who sends the EE off to the back doc, but who will be the one who works with the Workers' Comp people and you may be "the" case manager. (I find that area fun.) You will likely co-ordinate return to work plans. You may (or may not) be the person who says: "let's go assess your workstation--maybe we can fix that re-occurring stiff neck with an ergo eval.

You may or may not teach Bloodborne Pathogens, easy and fun.

'Nuff of that--if they intend to "ship you out," you may be expected to become a Jack (or Jill) of Occ Health Nursing. In such a case you may travel to who knows where? You might go to the local sewage treatment facility, or a manufacturer of widgets, or a big office building sort of company. In this case you might do some of the above but might be expected to know stuff related less to the healthcare worker and more to another type of worker.

You may work at one location for half a day, and then be at another type of location the next day following WC cases, doing fit testing/spirometry. You may or may not need phlebotomy skills. In such cases usually you will be expected to do vaccinations/flu clinics, maybe give wellness talks and be responsible for return-to-work management. You may be expected to know OSHA regs as related to that arena.

If covering manufacturing you will likely be required to do hearing testing and will be required to become COHC (Certified Occupational Hearing Conservationist) usually a two day class, or maybe three.

Perhaps now you see why nobody has answered this--but heck, I type fast, and somebody's got to do it.

Occupational Health Nursing is in rapid decline, hand in hand with the decline of manufacturing in the US. Paradoxically while creating a decrease in the need for dedicated Occ RN's, it's creating an increased need that translates into Agency related Occ Healthcare. What I mean by this is where, once upon a time, there were dedicated in house Occ Health Clinics, now, more likely, EE's are sent to the local hospital/clinic or Walgreens for Occ Health Care (yes Wallgreens does quite a lot of Occ Health activity as clinics).

Occ RN requires a vast amount of experience, or maybe not--it is so hard to say.

Working with Union workers coming from a local factory is quite different than what you "might" find in your clinic. Becoming certified may or may not be required. COHN/COHN-S is a tough exam and requires lots of CE units along with the required RN units, and the exam is $400 + (I think) $150, and requires $150 in fees to maintain every year. Your clinic may or may not care about that (but they certainly should, and probably will).

So, can you do it? Sure--if they hire you they will need to bring you up to speed but I'm sure you can do all this. I hope the above helps and remember YMVV.

[ICRN2008, BSN, RN]

The previous response was great. I found the "Getting Started in Occupational Health Nursing" CD by AOHP to be super helpful, along with my local AAOHN chapter for education, networking and support. And, of course, the AAOHN Core Curriculum

Be prepared to spend a lot of time studying at first (in your off hours) but I find it to be a quite enjoyable field. This is especially true if you have a good support network of colleagues you can turn to when you're new.