Occupational Health: Core Areas of Knowledge and Competence, Part 1

It’s extremely hard to spell it out a very complex and dynamic process such as for instance occupational health nursing simply in terms of core activities or tasks. Occupational Health Nurse (OHA) are constantly learning new skills, adapting current practices to meet up new needs and developing new approaches to solving problems and therefore their practice is not static but is continually improving in relation to a core range of skills.

However, within this limitation it is possible to spell it out those core regions of knowledge and competence that occupational health nurses use. The next list is not meant to be exhaustive, but rather to give a sign of the wide variety of competencies that occupational health nurses demonstrate in practice.

The Clinician

Primary prevention

The OHA is skilled in primary prevention of injury or disease. The nurse may identify the need for, assess and plan interventions to, as an example modify working environments, systems of work or change working practices in order to reduce the chance of hazardous exposure. Occupational health nurses are skilled in considering factors, such as for instance human behavior and habits in relation to actual working practices. The nurse also can collaborate in the identification, conception and correction of work factors, choice of individual protective equipment, prevention of industrial injuries and diseases, in addition to providing advice in matters concerning protection of the environment. Due to the occupational health nurses close association with the workers, and knowledge and experience in the working environment, they’re in a good position to spot early changes in working practices, identify workers concerns over health and safety, and by presenting these to management in an independent objective manner could be the catalyst for changes in the workplace that cause primary prevention.

Emergency care

The OHA is a Registered Nurse with a great deal of clinical experience and expertise in working with sick or injured people. The nurse may, where such duties form part of the job, provide initial emergency care of workers injured at work just before transfer of the injured worker to hospital or the arrival of the emergency services. In many instances, where hazardous conditions exist at work, or where the workplace is far removed from other health care facilities, this role will form an important part of an occupational health nurse’s job. Occupational health nurses employed in mines, on oil rigs, in the desert regions or in areas where the health care systems are not even fully developed will be knowledgeable about a wide variety of emergency care techniques and may have developed additional skills in order to fulfill this role. For others, who work in situations where the emergency services are on hand, they could simply provide an additional degree of support beyond that given by the industrial first aider.

Nursing diagnosis

Occupational health nurses are skilled in assessing client’s health care needs, set up a nursing diagnosis and formulating appropriate nursing care plans, along with the patient or client groups, to meet up those needs. Nurses may then implement and evaluate nursing interventions designed to reach the care objectives. The nurse features a prominent role in assessing the needs of an individual and groups, and has the ability to analyze, interpret, plan and implement strategies to reach specific goals. By using the nursing process the nurse plays a part in workplace health management and by so doing helps to enhance the fitness of the working population at the shop floor level. Nursing diagnosis is a holistic concept that does not focus solely on the treatment of a certain disease, but rather considers the complete person and their health care needs in the broadest context. It is a health based model rather than a disease based model and nurses have the skills to use this approach with the working populations they serve.

General Health advice and health assessment

The OHA will be able to give advice on a wide variety of medical issues, and particularly on the relationship to working ability, health and safety at work or where modifications to the task or working environment could be designed to take account of the changing health status of employees.

In many respects employers are not solely concerned with only those conditions which are directly due to work, but do want their occupational health staff to greatly help address any health related problems that will arise that may influence the employees attendance or performance at work, and many employees appreciate this degree of help being provided to them at the workplace because it is so convenient for them. Particularly the development of health care services to men at work, younger populations and those from ethnic groups could be most reliable in reaching these sometimes difficult to reach populations.

Research and the utilization of evidence based practice

As well as utilizing information and knowledge produced by research in various fields to guide activities that relate to the occupational health element of their role, occupational health nurses may also utilize fully research information available from many fields to greatly help support the typical health of the working population.


Occupational health policy, and practice development, implementation and evaluation

The specialist occupational health nurse may be engaged, with senior management in the organization, in developing the workplace health policy and strategy including facets of occupational health, workplace health promotion and environmental health management. The OH nurse is in a good position to advise management on the implementation, monitoring and evaluation of workplace health management strategies and to participate fully in each of these stages. Possibility to execute that role will depend upon degree of nurse education, skills and experience.

Occupational health assessment

OHA’s can enjoy an essential role in health assessment for fitness to work, pre-employment or pre-placement examinations, periodic health examinations and individual health assessments for lifestyle risk factors.

Collaboration with occupational physician might be necessary in several instances, based upon exiting legislation and accepted practice. The nurse also can play an essential role in the workplace where informal requests for information, advice on health care matters and health related problems arrive at light. The nurse has the capacity to observe the individual or group of workers in relation to experience of a certain hazard and initiate appropriate targeted health assessment where necessary. These activities in many cases are, but not exclusively, undertaken along with the medical adviser to ensure that where issues are identified a safe system for onward referral exists.

Health surveillance

Where workers are exposed to a diploma of residual threat of exposure and health surveillance is needed by law the OHA will be engaged in undertaking routine health surveillance procedures, periodic health assessment and in evaluating the outcome from such screening processes. The nurse will require a higher level of clinical skill when undertaking health surveillance and maintain a higher level of alertness to any abnormal findings. Early referral to an occupational health physician and other appropriate specialist will be the responsibility of the occupational health nurse where any abnormality is detected. The nurse will be engaged in supporting the worker throughout any longer examination or investigation, and may help to monitor their health on come back to work. Once alerted to the chance of an adverse health effect the occupational health nurse is in a good position to co-ordinate efforts to re-evaluate working practices in order to help protect other individuals who might be similarly affected.

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