What Does an Occupational Health Nurse Do?

What Does an Occupational Health Nurse Do?

Within the nursing field, there are a wide variety of specialties that nurses can pursue as a career choice. In this post, we’re spotlighting the occupational health nurse (OHN).

Barb Maxwell MHA, RN, COHN-S, CCM, CWCP, QRP, FAAOHN, is the President of the American Association of Occupational Health Nurses (AAOHN), as well as the Division Director of Company Care Occupational Health Services for HCA West Florida Division. She explains what OHNs are and what they do.

What is an Occupational Health Nurse?

Occupational Health is a specialty within nursing that cares for our own employees, employers within the communities, insurance companies, and community health needs. Depending on the role that is chosen (Employee Health within an organization or working in industry) will depend on the tasks that will be deemed necessary to deliver.

We perform pre-employment post-offer nursing assessments, medical surveillance, drug screening, case management within workers’ compensation claims, and many more duties as assigned.

Why did you decide to become an Occupational Health Nurse?

I was an Emergency Department RN, then promoted to Director caring for emergent patients. Our facility appointed me to establish an initiative to start up a comprehensive Occupational Health Program to service our employers within the community. After much training in Occupational Health, our facility opened the program in October 1986 to service our employers.

While reflecting back within our own hospital, we had an opportunity to enhance the existing Employee Health Program to collaborate with the new developed program. Our employee health program was very weak, and we identified many opportunities to improve the processes. 

We changed that concept quickly with our facility being the first customer of our newly developed Occupational Health Program. We realized the increase in employee satisfaction was meeting their needs.

What could an OHN do on a regular day? Please explain.

Occupational Health Nurses do so many things on a day-to-day basis. We have good intentions of setting our schedules that can change quickly depending on what the priorities are. 

We perform pre-employment post offer assessments; identify and assess risks from hazards in the workplace; medical surveillance that may affect our employees; advise on occupational health, safety, and ergonomics; first aid; and prevention of occupational disease and accidents. 

What are some of the greatest challenges of being an OHN?

Proving our worth to our organization. Getting everything accomplished in a day. The need of staffing ratios.

What are the greatest rewards?

Caring for our employees and helping them through their medical and vocational issues.

If nurses want to become OHNs, what would you say to them? What kind of training/education do they need?

It is the most rewarding position I have worked in. You will never regret taking a position in Occupational Health. You are the employee’s nurse.

Occupational Health Nurses are typically registered nurses, with education backgrounds varying from diploma nurses to doctoral degrees. There is no “set” educational requirement, but practice expectations would be dependent on the scope of practice of their educational preparation. When I hire nurses to become occupational health nurses, I look for strong clinical backgrounds; personalities that will meld with the employees; team players; critical thinkers who can work autonomously. Emergency and Critical Care backgrounds are a plus.

Is there anything else about being an OHN that is important for people to know?

Occupational health is a specialty field with a generalist approach. We work in tandem with other medical disciplines, human resources, and safety professionals. We recognize that our role extends beyond just the employees at the workplace, but also their families and support they have at home. This is considered a Total Worker Health approach, since the profession is truly an interprofessional collaboration in order to keep worker and worker families healthy and safe.

Nursing Side Gigs: Financial Blogger

Nursing Side Gigs: Financial Blogger

This is the first of a monthly feature about interesting side gigs or hobbies that nurses do outside of their full-time jobs.

By day, Lauren Mochizuki, RN, BSN, has been an ER nurse for more than a decade. But at night and during free time, she’s a successful financial blogger.

About eight years ago, Mochizuki began blogging about finances because she and her husband were tired of being in debt. She began writing her first blog, NurseFrugal.com, to document and share their journey about becoming debt-free. They paid off $266,000.

You read that correctly — $266,000 of debt.  

After Mochizuki became debt free, she took a break from blogging because she and her husband had started their family. Last year, she began blogging again at CasaMochi.com so that she could inspire others to live a great life on a budget. 

“What I love most about blogging is similar to nursing: with both professions I have the chance to connect with others and make a positive difference,” says Mochizuki about her side gig.  

Mochizuki says that according to the Federal Reserve Board, 40% of Americans can’t cover a $400 emergency expense, and less than 40% of working Americans feel that they are on track for retirement. Because of this, she says that her goal “is to help others change the way they collectively think about money, how to spend their money, and save — so that they can enjoy life, and simultaneously be good stewards of their money.” About every other week, Mochizuki publishes a new article on finances.

“I feel like my nursing job and blogging complement each other. With nursing, I have learned how to be personable and to apply interventions to help my patients feel better. My nursing career has directly affected my blog because it has shaped me into a caring and problem-solving person that I am today,” says Mochizuki.

“The greatest reward of blogging, is receiving responses from individuals that I have made an impact to their lives. I feel incredibly fulfilled when I inspire someone to become debt free, and introduce them to a step-by-step guide on how to achieve this goal,” says Mochizuki. “Creating a community of like-minded people has also been another reward of blogging. I started the #debtfreecollective hashtag, and it’s been so fun to see all of the accomplishments and real-life issues that come up during one’s debt-free journey.”  

“I am a firm believer that anyone can achieve financial freedom if you are willing to work for it,” says Mochizuki. “There were many times when I doubted if my husband and I could pay off $266,000 of debt, but after consistently implementing everything we learned about money, we did it!” 

Recognizing Postpartum Depression in New Moms

Recognizing Postpartum Depression in New Moms

According to the CDC, about one in nine women experience postpartum depression. Oftentimes, nurses may be able to recognize this in their patients and assist them in getting help. First, though, you have to know what you’re looking for.

Susan Altman, DNP, CNM, FACNM, a clinical assistant professor and midwifery program director at the NYU Rory Meyers College of Nursing, has been a midwife for more than 20 years. She took some time to answer our questions on recognizing postpartum depression in new moms.

What are the main symptoms of postpartum depression in new moms? How can nurses learn to recognize what are the signs of PPD as opposed to something else?

Many women who give birth experience changes in mood due to significant changes in hormone levels after the birth. These changes do not cause depression in all women. The most common of perinatal mood changes in the postpartum period is postpartum blues or “baby blues,” which manifests itself with such symptoms as sadness, crying, and mood swings. Most often these signs begin 5-7 days after the birth, lasting just several weeks.

PPD, a major depressive disorder, can also begin in the days following birth, and may be mistaken for baby blues at first. But the symptoms are more commonly noticed several weeks or months after the birth, and their duration is usually much longer. Symptoms are more severe in PPD than they are in postpartum blues. Those diagnosed with PPD often have symptoms with severe features such as feeling sad and hopeless, crying for no apparent reason, being worried or overly anxious, oversleeping, having difficulty concentrating or remembering things, losing interest in activities that were once enjoyed, being angry, withdrawing from family and friends, not feeling emotionally attaching to baby, and thinking about harming themselves.

Nurses and midwives are experts in assessment and should carefully investigate and look more closely at the postpartum person who is frequently crying, having trouble sleeping, reports low energy or appetite changes or loss of enjoyment of activities that were once enjoyed.

It is important to be mindful that increased anxiety is often associated with perinatal depression, so assess for signs of this as well. A thorough, comprehensive review of the person’s prenatal history in order to flag certain risk factors for PPD is important to help clinicians distinguish between diagnoses. Risk factors include prior history of any depression or mental illness, stressful life events during pregnancy, and little or no social support, just to name a few.

Most importantly, providers must listen to what the person is saying about what they are feeling or experiencing. Most patients know that something is not right. They know themselves the best.

If a nurse recognizes some of the signs in a new mom, what should s/he do? Approach the mom? What should s/he say? Please explain.

Nurses and midwives who suspect postpartum mood disorders in anyone they take care of must intervene.  PPD should not be ignored.

In approaching a mom, nurses and midwives need to let the person know what symptoms they are observing and why they are concerned. The person must be educated that postpartum depression is common and that they are not alone. Explaining that PPD is simply a complication of birth can be helpful. Always acknowledge that the person has done nothing wrong. Include that although PPD may be difficult to deal with, it is possible that with the right individual treatment and emotional support, management of symptoms and recovery is very likely.

Suppose the mom denies it. What should the nurse do then?

From my experience, when someone is approached, they rarely deny it. They often already know that something is not right in how they are feeling, and they are often relieved that someone has reached out to them to help. Again, telling them that they are not alone and that there is care that they can get which can make them feel better is helpful.

If the person really does deny it and does not see the need for help, this is where family members and friends should be recruited to help. Family and friends may actually have already recognized the symptoms of PPD in this person and are often very willing to get involved. They can help reinforce what the nurse has explained and encourage the person to meet with a mental health care provider. They can also offer ongoing emotional support, assist with transportation to appointments, and care for the baby or help with household chores—freeing up the person to go for care. Again, underscore that the person is not alone in this recovery process. 

What if the nurse recognizes the symptoms after the mom has left the hospital—like in a home health visit? What should s/he do?

Because, in most cases, PPD does not manifest itself until weeks or months after birth, it is quite common that the nurse who works at the bedside immediately postpartum will not be the one to recognize the signs and symptoms of postpartum depression.

Our standard system of postpartum care for birthing individuals is generally only a postpartum visit at six weeks after birth with little or no communication until that visit. Many suffer with signs of PPD during this six-week window, not knowing that what they are feeling is not normal and may require professional help. More often than not, recognition of signs and symptoms of PPD can come from nurses other than those working in the postpartum unit. For instance, nurses making home visits, taking office phone calls, or perhaps taking care of the baby in the pediatrician’s office are sometimes the ones who bring the symptoms to the postpartum person’s attention.  

Any nurse who recognizes PPD has the responsibility to educate and then provide resources and referral to providers skilled in caring for those with symptoms noted. In this way, nurses can be instrumental in helping women get the care they need in a timelier manner.

What It’s Like to Work as a Nurse Researcher

What It’s Like to Work as a Nurse Researcher

While some nurses have an ardent passion to become researchers, Elizabeth Johnston Taylor, PhD, RN, FAAN, a nurse researcher at Loma Linda University Health in Southern California, admits that she kind of fell into it. But that doesn’t mean she doesn’t love her job. In fact, it’s quite the opposite.

“I find great joy in doing research,” she says.

According to Taylor, nurse researchers will begin a research project by looking for an answer to a problem. For example, she says, “How can we improve the quality of life or decrease depression among people with disease X? or “How can the health care system better provide care for those with condition S?” S/he will identify something that needs further study. She says that once they decide what question needs to be answered, they design a study using scientific methods that will best answer it—whether they are quantitative or qualitative, use a small sample or big data, are biological in nature or psychological, etc.

“Each phenomenon you want to study obviously is going to require its own unique approach,” explains Taylor.

Oftentimes, nurse researchers will get others to help them with data collection, and then may work with a statistician or a team to analyze the data that is collected. Once they’ve found information that may or may not completely answer the question, it’s important to write about the results to disseminate the findings. “What good is it if you don’t share it with the world and allow the world to benefit from it?” she points out.

Taylor’s program of research—which is a researcher’s area of expertise or what s/he often studies—explores patients’ spiritual responses to illness and how nurses can support or nurture spiritual well-being. “From attending some conferences and just having conversations with chaplains, I got anecdotal evidence that some chaplains believe nurses are inappropriately providing spiritual care and/or doing things with patients that they think are within their purview, but a chaplain doesn’t think it is,” explains Taylor. “I’m doing an exploratory study where I’m asking chaplains to tell me more about these kinds of phenomena.”

For nurses thinking about getting into research, Taylor says that they need to realize that this isn’t a part-time job or something you take on with only minimal interest. They will need to earn a PhD and then obtain funding to pursue a program of research. “It really takes a lot of effort,” says Taylor. “Most academics who have a successful program of research probably work anywhere from 40 to 60 hours plus a week. So it really requires a great deal of commitment as well as a great deal of curiosity and passion.”

Time’s Up Healthcare: Advocating for Health Care Professionals

Time’s Up Healthcare: Advocating for Health Care Professionals

In the fall of 2017, the #MeToo and TIME’S UP movements began in Hollywood. While lots of organizations were advocating to protect women in a number of fields, they weren’t solely based in health care. On March 1, 2019 that all changed when Time’s Up Healthcare launched.

According to Tiffany A. Love, PhD, FACHE, GNP, ANP-BC, CCA, CRLC, Regional Chief Nursing Officer with Coastal Healthcare Alliance as well as one of the organization’s founders, Time’s Up Healthcare was “established in response to the common experience of power inequity, unsafe work environments, and a lack of inclusion at every level of health care leadership. The aim is to drive new policies and decisions that result in more balanced, diverse, and accountable leadership; address workplace harassment and other types of discrimination; and create equitable and safe work cultures within all facets of the health care industry.”

She took the time to answer our questions about the organization. What follows is an edited version of the interview.

You’re a founding member of the initiative. Why did you get involved?

I have worked in health care since the age of fifteen. I’ve experienced a lot of harassment and other types of discrimination over the years, and I had accepted it as a normal aspect of working in the health care environment. In more recent years, I decided that I would take a stand to create the change I wanted to see, and Time’s Up Healthcare offered me that opportunity.

What is the mission for Time’s Up Healthcare? What does the group hope to accomplish?

Our mission is to unify national efforts to bring safety, equity, and dignity to our workplace. We want to engage and support health care professionals and organizations from all disciplines to change policy and practices to support safe, equitable, and inclusive work environments. We want to raise awareness about the issues that health care professionals face. We also want to provide support for survivors through the Time’s Up Healthcare Legal Defense Fund.

Why is it important for this group to exist? How do you hope to change healthcare?

Time’s Up Healthcare is important because health care professionals need a group who will advocate for them without expecting anything in return. Time’s Up Healthcare is a 501(c)(3) foundation. Most of the work is done by volunteer health care professionals who donate their time and money to this important initiative.

As health care professionals, we are aware of the research that has proven patient safety is at risk when health care workers are forced to work in an environment that is not safe, equitable, or inclusive. The health of the employees as well as the patients is impacted by these conditions.

What do most health care workers not realize about harassment in the workplace? Or assault?

Many health care workers have been desensitized to harassment because it is so common. Harassment can be in the form of verbal aggression, exclusion, bullying behaviors, and the threat of physical violence. It can also take the form of assault through unwanted touching and even physical violence.

If nurses want to get involved with the group, what can they do?

We welcome you to join us at https://www.timesuphealthcare.org. You can sign up for our newsletter or purchase a pair of Time’s Up Healthcare scrubs under the shop tab. A portion of the proceeds will assist survivors through the Time’s Up Healthcare Foundation and Legal Defense Fund. You can also become a sponsor or encourage your organization to become a signatory who pledges commitment to align with Time’s Up Healthcare’s core statements.

You can also follow us on social media. We are on Twitter: @TIMESUPHC, Facebook: Time’s Up Healthcare, and Instagram: timesuphc. Look for Time’s Up Healthcare. You can also search the hashtags: #TimesUpHealthcare #TIMESUPHC and #TUHHERO.

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