Part 1: Occupational Health Core Areas of Knowledge and Competence

It is impossible to simply describe an extremely complex and dynamic process like occupational health nursing by focusing on its core tasks or activities. Occupational Health Nurses (OHA) learn new skills every day, adapt current practices to meet changing needs, and develop new solutions to problems. Their practice is never static and is always improving based on a core set of skills.

However, it is possible to identify the core competencies and knowledge that occupational health nurses use within this limit. This list is not meant to be comprehensive, but to provide an indication of the broad range of skills that occupational health nurses use in their practice.

The Clinician

Primary prevention

OHAs are skilled in primary prevention. In order to minimize the danger of exposure, the nurse can identify, assess, and plan interventions. Occupational nurses have the ability to consider factors such as human behavior and patterns in relation to current working practices. The nurse can help with the identification, correction, and adjustment of work factors, the selection of personal protective equipment, and the prevention of industrial diseases and injuries. She also provides advice on matters related to protecting the environment. The occupational health nurses are close to the workers and have the knowledge and experience to help identify and correct any problems in the workplace.

Emergency care

OHA is a registered nurse with extensive clinical experience and expert knowledge in caring for sick and injured patients. If such duties are part of their job, the nurse may provide first aid care to workers who have been injured at work. This role is often required in cases where there are hazardous conditions at work or the workplace is far from other healthcare facilities. The occupational health nurse who works in mines, oil rigs, desert areas, or other locations where there is not yet a fully developed health care system will have a broad range of emergency techniques and may have acquired additional skills to help them fulfill their role. Others may provide additional support to those who work in areas where emergency services are available.

Nursing diagnosis

Occupational health nurses can assess client’s needs and formulate appropriate nursing care plans. They work with clients or groups of patients to address those needs. The nurse can then evaluate and implement nursing interventions to meet the care goals. A nurse plays a key role in assessing individual and group needs and can plan, analyze, interpret and implement strategies to reach specific goals. The nurse uses the nursing process to help improve workplace health and the overall health of the workers. Nursing diagnosis is holistic and does not only address a specific disease. It also considers the entire person and their needs. This is a health-based model, not a disease-based one. Nurses have the skills to use this approach with the patients they care for.

General health advice and health assessment

The OHA can offer advice on a variety of health issues and in particular on the relationship to work ability, safety and health at work. It will also be able advise on where changes to the job and working environment could be made to accommodate changing health status.

Employers aren’t only concerned about the conditions directly related to work. They also want their occupational health staff available to address any health issues that could affect employees’ attendance and performance at work. Many employees appreciate the convenience of having this help at work. The best way to reach these populations, especially those who are younger and from minority groups, is to provide health care services at work.

Evidence-based research and practice

OSHA nurses will use all the research information from different fields to support occupational health activities.

Specialist

Practice development, implementation, and evaluation of occupational health policies and practices

A specialist occupational health nurse might be involved with the company’s senior management in developing the workplace strategy and health policy. This includes aspects such as occupational health, workplace promotion, and environmental health management. The OH nurse can advise the management on how to implement, monitor and evaluate workplace health management strategies. They are also able to fully participate in each stage. The level of nursing experience, education and skills required to fulfill this role is dependent on the nurse’s qualifications.

Assessment of occupational health

OHAs can be a vital part of health assessment for fitness for work, pre-employment examinations or pre-placement examinations. They also perform periodic health examinations as well as individual health assessments to assess lifestyle risk factors.

Depending on the state of the law and acceptance of practice, collaboration with an occupational physician might be required in some cases. In workplaces, the nurse can play an important role by providing information and advice to workers on health-related issues. A nurse can observe workers and conduct targeted health assessments if necessary. These activities are usually done in conjunction with the physician to ensure that if problems are found, a safe referral system is in place.

Health surveillance

Workers who are exposed to residual risks of exposure, and where health surveillance is required by law, the OHA will participate in routine health surveillance procedures and periodic health assessments and in evaluating results from these screening processes. A nurse must have high levels of clinical skills when performing health surveillance. She also needs to be alert for any unusual findings. If there is any concern, the occupational health nurse will refer the patient to the appropriate specialist or occupational health physician immediately. The nurse will support the worker through any further investigation or examination and may also monitor their health upon return to work. The occupational health nurse can coordinate efforts to reevaluate work practices to protect other workers who might be affected by the adverse health effects once they are alerted.

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