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?
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
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.
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.
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
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
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?
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.
High ethical standards are essential in healthcare. Four fundamental principles lay the foundation for healthcare ethics.
- Autonomy honors patients’ right to make their own decisions.
- Beneficence helps patients advance their own good.
- Nonmaleficence does no harm to patients.
- Justice ensures that patients are treated equally, fairly and impartially.
Current ethical issues in healthcare center on these guiding principles. Healthcare professionals must be prepared to navigate the following issues.
5 Ethical Issues in Healthcare
1. Improving Access to Care
The Department of Health and Human Services identified access to healthcare as an objective for its Healthy People 2010 and Healthy People 2020 initiatives. In 2012, only 83.1 percent of people had medical insurance. The latest figures from the National Health Interview Survey show that 12.5 percent of adults under age 65 are uninsured. Improving access to care has been a central issue in healthcare for many years. This includes not just private insurance but also Medicare, Medicaid, military and other government health insurance plans.
2. Protecting Patient Privacy and Confidentiality
Violating a patient’s privacy and confidentiality can have legal and ethical consequences for healthcare providers and professionals. Patients’ medical information is protected by the Health Insurance Portability and Accountability Act. Topics like increases in data breaches and smartphone usage highlight the ongoing need to understand this ethical issue.
3. Building and Maintaining a Strong Healthcare Workforce
“The U.S. has been dealing with a nursing deficit of varying degrees for decades, but today … this shortage is on the cusp of becoming a crisis, one with worrying implications for patients and health-care providers alike,” according to The Atlantic. An aging population, the rising prevalence of chronic disease and an aging nursing workforce are contributing to the shortage.
If healthcare providers are unable to develop and sustain a strong workforce, patient care will suffer, as the American Association of Colleges of Nursing notes. Yet, accomplishing this in the midst of a nursing shortage is difficult. Nurse retention strategies should become a central focus for all hospitals and healthcare institutions.
4. Marketing Practices
As of 2016, the U.S. healthcare industry was spending almost $30 billion per year in marketing and advertising to consumers, according to The Journal of the American Medical Association. Yet some question the ethics of a healthcare provider spending so much to promote its services or even a specific medicine or technology (whether or not the maker is named). Examples of hospitals getting involved in commercial endorsements for pay have highlighted this issue even more.
An institution can have ethics committees review the facility’s marketing practices to help prevent any missteps. Healthcare professionals should consult with their employer before making testimonials.
5. Care Quality vs. Efficiency
Balancing quality and safety with efficiency is a difficult challenge, which is amplified given the increasing pressure hospitals face to lower the cost of healthcare while improving quality. “It raises a real question about whether the right values are driving our focus in our healthcare system,” Cynda Hylton Rushton, PhD, RN, told AMN Healthcare Briefings. “Should efficiency be the driver?”
The Role of Nursing Leaders
Skilled and knowledgeable nursing leaders can oversee nursing staff members, helping and mentoring them along the way. More leadership in nursing is needed to achieve a higher quality of care and properly respond to major ethical issues.
Alvernia University’s online RN to BSN Completion Program helps nurses enhance their careers and pursue leadership positions. In a flexible and convenient online environment, the programs allow nurses to reach their goals while maintaining their current work and personal schedules.
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
“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!”
It’s no secret that the United States is in desperate need of nurses. Due to patients living longer, educational bottlenecks, and a staggeringly high turnover rate in the health care industry, the nursing shortage is a growing problem that’s putting serious pressure on nursing staff around the country.
As a nursing
student, you’re probably well aware of these issues. In fact, it may even be
one of the primary reasons you’re pursuing a nursing career in the first place.
After all, what could be more fulfilling than providing care and support for
patients who desperately need it?
There are several areas—both physical and occupational—where the need for nurses is at an all-time high. If your true calling is to make a difference in the lives of your patients, here are six nursing shortage facts that may influence where you end up after graduation.
1. California has the greatest nursing shortage of any state.
California employs the highest number of registered nurses in the country, it
needs more—a lot more, in fact. According to a 2017 report by the Health Resources and
Services Administration, California is predicted to have the highest demand for
nurses in the country, with a shortage of nearly 45,000 registered nurses.
With its strong economy and thriving metropolitan areas, California has long been a desirable place to live. If you’re thinking about working as a nurse in the Golden State, check out the California Nursing Students’ Association (CNSA) for mentorship and networking opportunities.
2. Rural towns need the most help.
If you prefer small town life to the hustle and bustle of urban living, health care institutions in rural America will gladly accept your help. Attracting and retaining qualified nurses has long been a problem for hospitals in rural locations, mainly due to the lower pay rate and less lively social scene.
While the pay may be lower, the cost of living is often lower as well. Plus, you’ll never deal with the insane traffic that you’d find in a metropolitan area. For nursing students who truly want to make a difference, the rural health care workforce is in desperate need of help.
3. Demand for certified nurse midwives is growing.
be more meaningful than caring for the newest generation? Certified nurse
midwives are experiencing a huge surge in demand lately as more couples wish
for positive and natural birth experiences.
According to statistics from the Bureau of Labor Statistics, employment of nurse midwives is expected to grow 21% by 2026, with 1,700 jobs created in this occupation. As an added bonus, you’re looking at a median wage of $106,910 for this field, per estimates from the Bureau of Labor Statistics.
4. Certified nurse anesthetists, dialysis nurses, and other nurse specialties are growing, too.
In addition to certified nurse midwives, there is a growing number of in-demand nurse specialties that nursing students should consider. Making one of these specialties your primary focus can help you facilitate change in the health care industry and pave the way towards a fulfilling career:
- Certified Registered Nurse Anesthetist (CRNAs): CRNAs work with surgeons, anesthesiologists, and other health care professionals to safely deliver anesthesia to patients. CRNAs are one of the higher-paying fields in the industry, with a mean annual wage of $174,790.
- Certified Dialysis Nurse (CDN): As our population continues to age, the need for dialysis services is growing. A CDN assists their patients with kidney function issues by supporting the administration of dialysis with a physician. Growth for this job is steady and is expected to increase 26% over the next decade.
- Pediatric Endocrinology (PED ENDO) Nurse: As a PED ENDO nurse, you’ll provide care and support for children with endocrine disorders such as diabetes or hypoglycemia. Unfortunately, the need for this occupation may be growing due to our increasing risk of diabetes and obesity.
5. The need for nurse educators has never been greater.
One of the reasons why the country is facing such an immense shortage of registered nurses is partly due to educational bottlenecks. With an aging faculty, budget issues, and low pay, the demand for nurse educators is at an all-time high.
a 2017 study published in Nursing Outlook, one-third of current nurse educators are expected
to retire by 2025. Most younger faculty members who may potentially replace them
don’t have nearly the same level of experience as their older counterparts.
To address this shortage, many nursing programs and organizations are providing more funding for nursing students to seek doctoral degrees to replenish the supply of nurse educators and researchers. If you’re a current nursing student, don’t be afraid to talk with your advisor or senior nursing students about pursuing a doctoral degree.
6. Travel nurses can greatly benefit nurses and hospitals alike.
Travel nursing is just one of the ways in which the nation
is addressing the decades-long nursing shortage. Being a travel nurse is
exactly what it sounds like: You sign a short-term contract and travel to wherever you’re needed
most, often for much better pay than
always dreamed of packing your nursing bag to see more of the world while
making a positive difference in the lives of your patients, becoming a travel
nurse can help you achieve both. Although you need roughly 18 months of
experience in a nursing specialty to be a travel nurse, the opportunity to
travel internationally or across the country for a high pay rate is undeniably
As a nursing
student, you have the potential to make a huge impact in your community.
Whether it’s by pursuing a doctoral degree or living the life of a traveling nurse,
your choices going forward can make all the difference. By keeping these six
nursing shortage facts in the back of your mind, you can opt for an extremely
rewarding career path that sets you up for success.
Nursing is consistently voted the most trusted of all professions. One that involves providing medical and personal care for individuals at their most vulnerable. So, why should nurses consider carrying nursing liability insurance to protect themselves from litigation? Because we live in an increasingly litigious society. Nurses are human, and, unfortunately, they can make mistakes.
Upping the Odds?
Having your own policy does not increase your chances of being brought into litigation. Whether or not you—as a named defendant—have your own malpractice insurance policy wouldn’t be discovered until the lawsuit was actually filed. A plaintiff’s attorney “names multiple defendants in a lawsuit in an attempt to access additional sets of insurance limits and increase the chance for a higher settlement,” according to nurse attorney Katherine J. Pohlman, MS, RN, JD.
Look Out for Number One
The employers’ coverage protects the hospital’s liability first and foremost. Nurse employees may have protection in the case of a lawsuit, but they’d be relying on the attorney retained to protect the hospital and not a privately retained attorney hired to protect the nurse and their own interests. Under an employers’ insurance, nurses share the liability limitations (how much money is available to cover the lawsuit) with every other employee named in the litigation. And it’s possible that the award settlement may not be fully covered by that policy, resulting in potential out of pocket legal expenses for employees, including nurses. Further, the employers’ policy protection for nurses ends when that employment ends, meaning you can still be held liable even if you are working elsewhere at the time of the lawsuit.
Is There Enough to Go Around?
There are some positions which may not be covered by an
employer’s liability insurance, such as contract workers or travelers. Nurses
should not assume that they are covered and should inquire with their employer.
And how do nurses know what the limitations of liability are for that
An individual policy belongs to the nurse and would clearly
identify what is covered and what the monetary limitations for litigation
awards would be. Most importantly, individual policies held by nurses will
follow them wherever they may work, even if they are a travel nurse or
Nurse liability insurance can protect nurses in ways that many nurses overlook. A nurse may not even make an error or cause harm to be named in a lawsuit. A patient who perceives wrongdoing can initiate litigation that can cause financial harm to individuals who have done nothing wrong. A nurse can be utterly meticulous in their practice and documentation and still find themselves embroiled in litigation, which can cost them dearly.
Many nurses are often casually asked for health-related advice by colleagues, friends, and family members. Well-intended advice that leads to someone pursuing a course of action (or not pursuing, as the case may be) could potentially lead to perceived or actual harm. An individual policy would protect a nurse in these circumstances as well.
Lastly, individual policies protect nurses from actions taken against them by their Board of Nursing. Legal representation in this instance would be covered by the policy as well. Many advanced practice specialty nurses would be unwise to practice without it, such as nurse midwives, nurse anesthetists, and nurse practitioners.
Insurance provides protection. It’s why we carry homeowners
and automobile insurance. Surely the annual cost of nurse liability insurance
is a worthwhile expenditure in the face of the risk that nurses take when
caring for their patients.
investment in knowledge pays the best interest.”
Benjamin Franklin had the right idea when he talked about using the knowledge you’ve earned and putting it to good use. As nurses, we have a desire for continual learning, especially with the ever-changing new practices and research in the health care profession. If you’re new to nursing and have been working for only a year or two, you may be wondering, “What path should I be taking?” or “How can I broaden my knowledge and skills?”
There are many ways you can develop your career as a new nurse with opportunities that are often within your area of employment.
1. Obtain a certification.
For as many different nursing specialties that exist, there are virtually as many certifications for each and every one of them. Many hospitals offer additional compensation for nurses who are “board-certified,” meaning you are recognized by a specialty association of nursing as an expert in that specific area of nursing. There are other specific roles within your field of nursing that you may choose to be certified in such as becoming a Certified Diabetes Educator or a Certified Childbirth Educator.
2. Join a committee.
Many hospitals have committees for nurses called Shared Governance. Shared Governance is a group of nurses working together to implement best practices on a hospital unit. These practices can range from work-related issues such as scheduling to practice-related issues such as updating a policy on the best way to monitor patients’ blood sugar. These unit-based councils may also collaborate with other hospital units within a specific department to address how to best work together and keep patients safe.
3. Find a nurse-residency program.
This is particularly for brand new nurses who are looking for their first job after nursing school. Many teaching hospitals offer a residency program for nurses to participate in for one year after the beginning of their employment. These programs meet monthly and are a way for new nurses to discuss struggles they may be having or learning issues they might be facing. Often there is a research project nurse residents complete specific to their area of practice. These programs are a great way to meet other new nurses and can often help ease the transition from being in school into working in nursing practice.
4. Participate in continuing education.
Many states require a certain number of CEU or continuing education unit hours to re-register as a licensed nurse. There are many local and national conferences nurses can go to for the latest topics in the nursing profession and within different specialty areas. Most hospitals, upon employment, allot nurses with a certain number of education hours they may use at their discretion and may reimburse for class or conference costs.
5. Go back to school.
Making the choice to go back to school is a huge decision. While some nurses may already know, specifically, what area they want to focus on during their time in nursing school, others may need a few working years under their belt to get a feel for different kinds of nursing practice. Masters programs range from specializing as a nurse practitioner or nurse educator to forensic nursing or public health. Getting an advanced degree may broaden your career options and opportunities. Many nurses continue to work full-time while getting their degree with the great advantage of tuition reimbursement from their employer.
Advancing your existing nursing knowledge is a great way to become an expert in your nursing specialty or to explore other paths in nursing you may want to take. It’s well known that nursing is one of the most trusted professions and patients appreciate the knowledge and skills you bring to their care. Take the time to find out what career opportunities exist within your place of employment and in your community.