Occupational Health Nursing – An Unexpected Journey

Most nurses do not enter the workforce with the ambition of becoming an occupational health nurse. In fact, most nurses likely have no clue that there is an occupational health nursing specialty, let alone all that the specialty encompasses. This was certainly true in my case.

I first became aware of the field of occupational health in 1993 as a new employee in a small suburban hospital in the Detroit, Michigan area. I was hired as a Nurse Extern, having completed one year of nursing school in an associate degree RN program. I recall going into the basement of the hospital to complete some new hire requirements, and seeing a sign hanging from the ceiling in a long dark hallway that read “Industrial Medicine.” It sounded so cold and foreign to me, and I had absolutely no clue what it meant. I only knew that was where I would receive my hepatitis B vaccinations. Once those were completed, I did not encounter that long dark hallway again until…

Fast forward a few years to somewhere between 1996 and 1997. I was working on the medical-surgical floor of that same small hospital. As a contingent employee, I was always the first to be cancelled when my unit had a low census. One particular day, I received a call to cancel my shift. However, on this day, I was also informed that the Industrial Medicine Department was in need of a nurse to administer hepatitis B vaccinations as part of a bloodborne pathogen training program at a local police department that morning.  I was asked if I would be willing to do this, and I hesitantly agreed. I had no idea what to expect, or what this “Industrial Medicine” thing was all about, but it turned out to be the best thing that has ever happened to me in my nursing career.  This was my introduction to occupational health nursing.

I still recall that day, sitting in a room filled with police officers, listening to the Industrial Medicine Director give a bloodborne pathogen presentation. At the conclusion, he explained the importance of hepatitis B vaccination, and he offered it to any of the attendees who were interested in being vaccinated. I have no recollection of how many hepatitis B vaccines I administered that day, but they were the first of thousands of vaccinations I would give in the years to come.

That first experience was an open door to a whole new dimension of nursing, and one I somehow knew suited me perfectly.  I developed a rapport with the Industrial Medicine Director, which led to increased opportunities for work. The Industrial Medicine program provided occupational medicine services for hundreds of area businesses and municipalities, and before long I had regular assignments with many of these clients. I remember one trucking business where I would sit weekly in the cafeteria as part of a wellness program, checking blood pressures, and offering counseling and educational material based on the needs of the employees. Some other memorable assignments involved providing monthly new hire tuberculosis and bloodborne pathogen training for county employees, performing tuberculosis exposure testing and follow up at the county jails, and administering flu shots at 4 am at a car manufacturing facility while automobiles on the assembly line circled overhead. My assignments took me to many unusual and interesting places, and I covered thousands of miles.

I continued accepting every opportunity that came my way while still working as a medical-surgical nurse at that same small hospital until 1997, when the hospital closed its doors.  Industrial Medicine became Occupational Medicine and relocated to a nearby healthcare center. I was able to transfer to a larger hospital in our system as a contingent medical-surgical nurse and continued working assignments for Occupational Medicine.

In 1998, a full-time position became available for a Case Manager at the Occupational Medicine Clinic, and I accepted. From there, I moved into a Clinic Manager position that lasted until 2001, when cuts eliminated RNs from the clinics.  Fortunately, the Occupational Medicine Department had contracts with a local automobile manufacturer to provide nursing staff in their facility medical departments. This allowed me to broaden my experience and work in automobile manufacturing for the next two years, providing injury care, physical examinations, and medical surveillance to employees at several area automobile manufacturing facilities. While working in this capacity, I became very acquainted with OSHA and all the wonderful things that are part of that arena.

2003 was another year of transition, as the contract for nursing staff with the automobile company was not renewed with my employer. Fortunately, a part-time Employee Health Nurse position opened up in one of the four hospitals in our organization, and I was hired into that position. I spent the next six years in that role, working 24 hours a week as a “one-person department,” serving more than 1,000 employees, physicians and volunteers.  That experience exposed me to every aspect of occupational health in healthcare.

In 2005, I was introduced to AOHP by a colleague and attended my first chapter meeting. I immediately recognized the value of AOHP, and I embraced the opportunity to connect with others who could relate to my situation, and who shared my questions and frustrations. My involvement with AOHP has greatly impacted my career, providing extensive educational and networking opportunities, as well as access to resources that are necessary to effectively carry out the responsibilities of an occupational health professional in healthcare.  I attended my first AOHP National Conference in San Antonio, Texas in 2005, where I also sat to take the ABOHN COHN exam. I was so excited when I learned I had passed!

As I worked in Employee Health, I found I particularly liked the area of workers’ compensation. Of course, I found it both frustrating and rewarding – depending on the particular case and circumstances. At one point, a position opened for a Workers’ Compensation Case Manager in our Corporate HR Department. I contemplated applying, but for some reason felt it was just not the right time for a move. I continued working in Employee Health, and in 2010, another opportunity for a Workers’ Compensation Case Manager became available. This seemed to be a logical next step for me, and I applied. I began working in that role in early 2010. I took the ABOHN Case Management Certification test that spring and passed. I continued on in that role, working with administrators to improve the Employee Health and Safety Program at our organization. I was able to use much of the knowledge obtained at AOHP National Conference sessions to make progress in our organization, and to affect positive changes.

In 2014, my employer joined forces with two other area healthcare organizations to form a new healthcare organization, employing more than 35,000 healthcare workers. As one can imagine, this has been a huge endeavor, presenting many challenges, while at the same time presenting a unique opportunity to develop a top notch Employee Health and Safety Program. We are now more than three years into this endeavor.  We still have a long way to go, but 2018 promises to be a year of great progress.

It is hard to believe I have been on this occupational health nursing journey for more than 20 years. I sometimes wonder where my nursing career would have taken me had I not accepted that first invitation to give hepatitis B vaccinations at the police station. I am so grateful for the broad range of opportunities I have had in occupational health nursing, and I think it is especially awesome that every opportunity came while working for one employer. There is no doubt in my mind that occupational health nursing was my calling, and I wouldn’t trade it for anything.

By Peggy Anderson, RN, COHN/CM