You're an Occupational WHAT? Occupational Health Nurse.
Can you pair a starched white veil with your steel cap safety boots?
Being issued with a starched white veil in the laundry of the Princess Alexandra Hospital – as part of his student nursing uniform - was a far cry from the high vis Peter Gould (Work Health On Wheels) would later wear. It certainly didn’t stop him from carving out his future as an Occupational Health Nurse (OHN). If anything, this somewhat inauspicious start gave him insights that would later become his trademark – a community building approach.
It was a slightly different story for Adrienne Tracy (Tracy Consulting). Adrienne cut her teeth as an OHN in the early 1990’s in the La Trobe Valley at the heart of coal mining country in Victoria. Work for an OHN then was mostly about injury management not prevention. Adrienne’s passion was to get ahead of the injury journey, so she undertook further training to complement her skills in nursing with ergonomics.
Peter and Adrienne have generously shared their experiences with us.
What is an Occupational Health Nurse (OHN)?
Historically, OHNs were involved in onsite injury management and first aid, but this adaptive group of professionals has developed a scope which is much broader. Fast forward to current day OHN’s who provide proactive screening and advice for workers and organisations – with a particular focus on health policy; health management, health surveillance and vaccination. You will find OHNs working for large organisations in-house, with insurers or as independent contractors.
Highly qualified, under-recognised.
Currently in Australia, occupational health nursing is not recognised by the Australian Health Practitioner Regulation Agency (AHPRA) as a nursing specialty. According to the Australian and New Zealand Society of Occupational Medicine (ANZSOM) there is no specific qualification required (over and above a nursing qualification) to work in this field or describe yourself as an OHN.
In practice, Peter notes that most OHNs have additional qualifications in safety, ergonomics or occupational hygiene.
‘Uni’s have dropped the ball and don’t see OHN as a specialty. ANZSOM is trying to set standards. You won’t see many OHN roles being advertised these days. Now you’ll see roles advertising for a consultant with a nursing background.’
But we all know that qualifications on paper are only half the story. Peter adds,
‘When you work with people, you need to have that essential human connection. High level interpersonal skills with the ability to welcome people in. And of course, personality - with enough confidence to pull off whatever it is you have to do!’
OHN and OEP – where does it get confusing?
With the evolution of their role within industry – from injury treatment alone to that of injury and illness prevention – OHNs are health professionals whose expertise is not clearly understood.
‘A lot of older workers hear the word “nurse” and equate that with a hospital RN in a unform and expect us to put bandaids on. ‘But that’s what first aiders or paramedics on site do.’
Adrienne says whilst hospital based RNs are incredibly important, it can be hard for OHNs to define their role based on what RN’s do in hospital alone.
‘We bring our expertise in proactive screening and advising to industry. Practically that looks like monitoring a person’s health in the workplace.’
Workers with long term health conditions
Adrienne offers an example of a worker with diabetes.
‘There are 100’s of people with diabetes in industry and so many companies are not managing their health risks related to workers’ long-term conditions. A worker’s role may mean they have to drive plant or machinery. An OHN would make sure the worker has a health management plan and are maintaining their health.’
Peter agrees, ‘OHNs scope out the problem from a health (not just safety) perspective. We help manage the risk.’
A risk which can be substantial. To continue the diabetes example, hypoglycemia (due to insulin treatments in people with diabetes) can potentially lead to cognitive impairment, altered levels of consciousness and delayed reactions. If this happens while driving a motor vehicle, or plant, the outcomes can be injury or death to the worker and others.
OHN and OEP – working together
OHNs and OEPs have long worked together within industry.
Peter describes his experiences as positive ones – ‘It’s a case of mutual respect. OHNs in business pull all the information together, ponder the case and refers on. The OEP makes the decision, and the OHN implements it in the workplace’
Adrienne also emphasises the importance of working within your own lane. ‘If in doubt refer it out. Don’t overstretch. A good 15-20% of people I see will need to be referred on to a medical specialist. We all need to be very aware of own scope of practice.
An OHN may refer to an OEP for a variety of reasons.
These can include:
- Alcohol and other drug testing – managing non-negative results
- Developing a Q-Fever vaccination policy and its roll out
- Fitness for Duty assessments.
Peter emphasises that as an OHN he is an advocate for the worker – one who truly understood the workplace and the health condition.
“I would prepare the worker for what’s going to happen and why before they would need to go to and see the OEP. Makes the consultation more meaningful and less fear-inducing. Then after the appointment I would follow up with the worker, their manager and HR, to make sure we were all on the same page.”
Sometimes if might be providing advice and boosting health literacy for non-work-related but work-relevant issues.
“The OHN can offer so much – in the psych space; ageing workforce; holistic accessible health – especially for young men in blue collar sectors.”
Mistaken identity story?
While both Peter and Adrienne have had their fair share of band-aid and bodily function tales from their time in OHN, it is perhaps Peter’s story about ‘mistaken expectations’ that takes the cake.
‘I have to say the biggest concern of workers coming through my office before attending the appointment with the OEP is, “Are they going to make me drop my daks and stick their finger up my bum?”’
We are grateful for Peter and Adrienne’s time and sharing their experiences with us.