Occupational Health

As an occupational health nurse, you may be an independent practitioner or employed as part of an occupational health service team. Occupational health nurses are in charge of safeguarding public health in the workplace setting. The occupational health nurse role is varied and includes:

• identifying and preventing work related health problems
• promotion of healthy living and working conditions
• understanding the effects of work on health and health at work
• provide advice on first aid management
• provide health screening services
• workforce and workplace monitoring and health need assessment
• health promotion
• education and training
• counselling and support
• risk assessment and risk management.

Occupational health nurses may lead or work within a multidisciplinary team alongside other occupational health professionals, such as doctors, physiotherapists, counsellors, psychologists, liaison psychiatrists, ergonomists, occupational hygienists etc, supported by a framework of clinical leadership and governance with direct support from accredited specialists in occupational medicine, as needed, see: Faculty of Occupational Medicine Occupational Health Service Standards for Accreditation, SEQOHS standard C2.3. Occupational health nurses often work closely with employee line managers, Human Resource and Health and Safety advisers to support good health at work.

As an occupational health nurse you may be expected to perform clinical tasks such as:

• providing statutory medical examinations (except where it is specified that these must be done by a registered medical practitioner, such as asbestos and ionising radiation medicals)
• administering staff flu jabs
• supply and/or administration of medicines under the written instruction of a medical practitioner. The scope of this is much broader and simpler than the use of Patient Group Directions in NHS settings. See: RCN clinical topic: Medicines optimisation. 

Occupational health nurses have direct contact with employees and are often approached with health-related questions and problems. They have a unique position between the workforce and management and can support the improvement of health in the workplace in order to improve health, social wellbeing and the quality of working lives.

Occupational health nurses protect and promote the health of people at work. They need to be able to respond to a wide range of questions and health related issues. People will seek advice from their occupational health nurse on matters such as seeking attention for some non-work related condition; or how to access the best advice to help them resolve a health issue or personal problem at home; or they may raise concerns about the health or safety performance of their managers or colleagues at work.

It is recognised in the Boorman review into NHS health and wellbeing and in Dame Carol Black’s report Working for a Healthier Tomorrow that the health of the working population is a priority and individuals’ concerns about their health should be addressed. The health of the workforce affects overall productivity and an individual’s health will affect their ability to concentrate, attend or perform well at work.

Early advice and intervention can help to avoid long term problems. This is increasingly important when discussing how to improve the health and wellbeing of the population and their quality of life.

Helen Kirk, an RCN Public Health forum committee member, provides an insight into the role of occupational health nursing: 

"Occupational health can be a bit like dealing with a trick question: Too often the obvious answer is the wrong answer. A nurse who’s had a stroke and has significant upper limb weakness so can’t do CPR, can’t work on a cardiology unit can she? The obvious answer is no she can’t but is that the correct answer?

What matters is: knowledge about cardiological nursing; experience in monitoring clinical measurements and patient wellbeing; expertise in supporting and advising patients and their families - things the best cardiac nurses do all day every day. The need to instigate resuscitation is important but it is not the essence of the job.

This nurse is almost never on the unit alone and always has immediate access to colleagues who can assist. The likelihood of a serious adverse impact of this nurse not doing CPR is tiny but the impact of losing her expertise is substantial. Replacing her twenty years of experience and expertise takes a long time (twenty years!) Retaining that expertise takes a bit of imagination, a few conversations, some education and a little planning.

Mostly occupational health nursing is just sorting out quite practical things with managers. Finding remarkable answers for patients with unremarkable health issues is the only tricky part."