Occupational Health Nurse Career

Occupational health nurses are registered nurses who care for people in the workplace. Although they treat illnesses, injuries, and health problems, they are also involved with safety and health issues and prevention programs. An occupational health nurse may be an employee of a busi­ness, institution, or corporation or may be self-employed on a contract or freelance basis. Some nurses may be a part of a team or company that provides occupational health services on a retainer or contract basis. There are approximately 30,000 occupational health nurses in the United States.

Occupational Health Nurse Career History

The first occupational health nurses—or industrial nurses as they were known at the time—were Ada Mayo Stewart and Betty Moulder. In 1885, Stewart was hired by the Vermont Marble Company to care for its employ­ees and their families. Betty Moulder performed similar tasks for coal miners and their families in Pennsylvania in 1888. By the 1900s, industrial nurses were employed in our nation’s factories to diagnose and limit the spread of infectious diseases and to help employers reduce costs that were arising from workers’ compensation legisla­tion. The field grew steadily during the first half of the 20th century, and in 1942, the American Association of Industrial Nurses (AAIN) was created to represent the professional interests of these specialized nurses. (In 1977, the AAIN changed its name to the American Association of Occupational Health Nurses.) The Occu­pational Safety and Health Act of 1970 created a strong demand for occupational health nurses at work sites. According to the American Association of Occupational Health Nurses, today’s occupational health nurses have expanded their duties beyond basic care to focus on case management, counseling and crisis intervention, health promotion, legal and regulatory compliance, and worker and workplace hazard detection.

Occupational Health Nurse Job Description

Occupational Health NurseOccupational health nurses are responsible for providing health care services to the working population. These ser­vices may include emergency care in the case of an acci­dent or critical illness, caring for ongoing work-related injuries such as back strain, or monitoring a worker’s persistent high blood pressure or diabetes. Occupational health nurses are also responsible for assessing safety aspects of the workplace. Treating injuries includes ana­lyzing how and why the injury occurred as well as initiat­ing preventive measures in the plant or workplace.

On-site occupational health nurses may be required to treat illnesses and injuries and respond quickly to emer­gency situations or industrial accidents. They may also consult with an employee regarding medical insurance coverage, or an ongoing health problem such as high blood pressure, and they may serve as a one-on-one resource for general health and wellness information.

Cecelia Vaughn, R.N., is a certified occupational health nurse specialist who works on a contract basis with a wide variety of clients. “When I go into a facility I have to look at all aspects of the work environment,” she says. “Is the air clean? Is the worker exposed to harm­ful pollutants? Is the workplace lighting and ventilation satisfactory? Are workers tested periodically for chemical exposure, if necessary? Are safety programs presented on a regular basis?”

Vaughn adds, “I need to be able to relate personally to the workers. Are they stressed? Is the woman who has bruises a victim of abuse at home? Is a worker on drugs? Is there potential for violence at the workplace?”

Along with all the assessments and intervention, occu­pational health nurses are often responsible for mak­ing sure their company is following and documenting government-required workplace and health regulations. They may also be involved with company-sponsored health and safety workshops and may administer flu shots, be responsible for drug testing, and arrange for in-house mammograms and other wellness programs.

Like every nursing job, documentation and administra­tion are important aspects of the duties. Occupational health nurses are usually responsible for reporting and documenting worker’s compensation claims and for making sure the com­pany meets Occupational Safety and Health Act requirements or other government workplace regulations.

Occupational health nurses ensure that workers who have special needs have safe, accommodating work sta­tions. Teaching and demonstrating are also a big part of their responsibilities. Occupational health nurses may teach the proper way to lift heavy equipment to prevent back injury or train workers in cardiopulmonary resus­citation or emergency procedures.

“My job is so much fun,” Vaughn says enthusiastically. “Every day is a new challenge. I never know what the day will bring, and my plans can change so quickly. If a com­pany calls with an emergency situation, I might have to drop everything and go there.”

Occupational Health Nurse Career Requirements

High School

If you want to become an occupational health nurse, you will first need to become a registered nurse. To prepare for this career, you should take high school mathematics and science courses, including biology, chemistry, and physics. Health courses will also be helpful. English and speech courses should not be neglected because you must be able to communicate well with patients.

Postsecondary Training

You must be a registered nurse before you can become an occu­pational health nurse. There are three basic kinds of training pro­grams that you may choose from to become a registered nurse: associate’s degree, diploma, and bachelor’s degree. Which of the three training programs to choose depends on your career goals. A bachelor’s degree in nursing is required for most supervisory or administrative positions, for jobs in public health agencies, and for admission to graduate nursing programs. A master’s degree is usually necessary to prepare for a nursing specialty or to teach. For some specialties, such as nursing research, a Ph.D. is essential.

It is preferred that nurses entering the occupational nurs­ing field have a bachelor’s degree in nursing and nursing experi­ence, especially in community health, ambulatory care, critical care, or emergency nursing.

Certification or Licensing

Licensing is mandatory to prac­tice as a registered nurse. On the other hand, certification is voluntary and can be obtained through the American Board for Occupational Health Nurses. Certification reflects a mastery of the specialty practice in occupational health. Three levels of certification are available, depending on a candidate’s level of education and experience: Individuals can become a certified occu­pational health nurse (COHN), a certified occupational health nurse-specialist (COHN-S), or a certified occupa­tional health nurse/case manager (COHN/CM). See the end of this article for contact information.

Other Requirements

Because the duties of an occupational health nurse are so varied and unpredictable, the ability to think outside of the box is critical according to Cecelia Vaughn. “You must be able to look around a company and see the safety issues and the human issues, as well as the health issues. You must think about social responsibility. Is the work environment safe? Are harmful chemicals present? What emotional issues might employees be dealing with?” She adds, “This is a totally different kind of nursing than hos­pital bedside nursing.”

Occupational health nurses should be able to think independently and make decisions quickly. They should have good management skills as well as the ability to relate well to all people in all positions.

Exploring Occupational Health Nurse Career

Volunteer at a local hospital to see what a nurse’s day is like. While there talk to as many medical professionals as possible in different fields to gauge your interest in all areas of the profession, including occupational health. Ask nurses what schools they attended and how hard the training was to complete. This should help you get an inside scoop on nursing programs.

Another good way to explore nursing is to visit hos­pitals that are sites for a nursing program’s clinical rota­tions. You may even be able to attend an orientation for potential students.


Approximately 30,000 occupational health nurses are employed in the United States. They are employed by corporations and companies of all sizes, by schools, and by government agencies.

Starting Out

The only way to become a registered nurse is through completion of one of the three kinds of educational pro­grams plus passing the licensing examination. Registered nurses may apply for employment directly to hospitals, nursing homes, and companies and government agen­cies that hire nurses. Jobs can also be obtained through school career services offices, by signing up with employ­ment agencies specializing in placement of nursing per­sonnel, or through the state employment office. Other sources of jobs include nurses’ associations, professional journals, and newspaper want ads.


Administrative and supervisory positions in the nursing field go to nurses who have earned at least the bachelor of science degree in nursing. Nurses with many years of experience who are graduates of the diploma program may achieve supervisory positions, but requirements for such promotions have become more difficult in recent years and in many cases require at least the bachelor of science in nursing degree.


According to the U.S. Department of Labor’s Occupa­tional Outlook Handbook, registered nurses earned a median salary of $54,670 in 2005. Salaries ranged from less than $38,660 to $79,460 or more a year.

However, occupational health nurses, because of their specialty, can generally expect to earn more. The Ameri­can Association of Occupational Health Nurses reports that, of its members, the estimated average salary was $63,472 in 2005. Members with any level of certifica­tion earned significantly more than those who were not certified.

Salary is determined by many factors, including nursing specialty, education, and place of employment, geographic location, and work experience. Flexible schedules and part-time employment opportunities are available for most nurses. Employers usually provide health and life insurance, and some offer educational reimbursements and year-end bonuses to their full­-time staff.

Work Environment

Occupational health nurses work in a variety of envi­ronments from clean, healthy, well-lighted buildings to dusty, dirty, fume-filled manufacturing and mining facilities. Some nurses may have to spend time in hot plants analyzing safety and environmental aspects of the workplace.

All nursing careers have some health and disease risks; however, adherence to health and safety guidelines greatly minimizes the chance of contracting infectious diseases such as hepatitis and AIDS. Medical knowledge and good safety measures are also needed to limit the nurse’s expo­sure to toxic chemicals, radiation, and other hazards.

Occupational Health Nurse Career Outlook

Nursing specialties will be in great demand in the future. The U.S. Department Labor predicts that employment for registered nurses is expected to increase much faster than the average through 2014.

More and more companies are realizing the value of healthy and happy employees who work in safe, envi­ronmentally conscious workplaces. While these views support the need for companies to hire occupational health nurses, the reality is that some companies see eliminating the in-house occupational health nurse as a way to save money. This downsizing then creates a need for outsourcing, which may increase the employment opportunities for independent occupational nurses or those employed with contract service companies.

The fact that we are becoming an older working America means new demands and new problems in the workforce. “We are now dealing with workers in their 60s and 70s,” says Cecilia Vaughn. “This fact alone creates additional justification for the services of the occupa­tional health nurse.”

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