Primary prevention

The occupational health nurse is skilled in primary prevention of injury or disease. The nurse may identify the need for, assess and plan interventions to, for example modify working environments, systems of work or change working practices in order to reduce the risk of hazardous exposure.

Emergency care

The occupational health nurse is a Registered Nurse with a great deal of clinical experience and expertise in dealing with sick or injured people. The nurse may, where such duties form part of their job, provide initial emergency care of workers injured at work prior to 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 a major part of an occupational health nurse’s job.

Treatment services

In some countries occupational health services provide curative and treatment services to the working population, in other countries such activities are restricted. Where treatment services are provided the occupational health nurse will be involved in delivering and monitoring these services, often in close contact with other primary care providers, such as the family doctor or general practitioner, or company physician, who is responsible for prescribing the particular course of treatment.

Nursing diagnosis

 Occupational health nurses are skilled in assessing client’s health care needs, establish a nursing diagnosis and formulating appropriate nursing care plans, in conjunction with the patient or client groups, to meet those needs. Nurses can then implement and evaluate nursing interventions designed to achieve the care objectives. The nurse has a prominent role in assessing the needs of individuals and groups, and has the ability to analyse, interpret, plan and implement strategies to achieve specific goals.

General Health advice and health assessment

The occupational health nurse will be able to give advice on a wide range of health issues, and particularly on their relationship to working ability, health and safety at work or where modifications to the job or working environment can be made to take account of the changing health status of employees.

Occupational health assessment

Occupational health nurses can play 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 may be necessary in many instances, depending upon exiting legislation and accepted practice.  The nurse can also play an important role in the workplace where informal requests for information, advice on health care matters and health related problems come to light.

The nurse is able to observe the individual or group of workers in relation to exposure to a particular hazard and initiate appropriate targeted health assessment where necessary. These activities are often, but not exclusively, undertaken in conjunction with the medical adviser so that where problems are identified a safe system for onward referral exists.

Health surveillance

Where workers are exposed to a degree of residual risk of exposure and health surveillance is required by law the occupational health nurse will be involved in undertaking routine health surveillance procedures, periodic health assessment and in evaluating the results from such screening processes. The nurse will need a high degree of clinical skill when undertaking health surveillance and maintain a high degree of alertness to any abnormal findings.

Early referral to an occupational health physician or other appropriate specialist will be the responsibility of the occupational health nurse where any abnormality is detected. The nurse will be involved in supporting the worker throughout any further examination or investigation, and may help to monitor their health on return to work. Once alerted to the possibility of an adverse health effect occurring the occupational health nurse is in a good position to co-ordinate efforts to re-evaluate working practices in order to help protect others who may be similarly affected.

Maintenance of work ability

The occupational health nurse may develop pro-active strategies to help the workforce maintain or restore their work ability. New workers, older workers, women returning to work following pregnancy or workers who have been unemployed for a prolonged period of time may all benefit from health advice or a planned programme of work hardening exercises to help maintain or restore their work ability even before any health problems arise.

Health and safety

The occupational health nurse can have a role to play in developing occupational health and safety strategies. Where large, or high risk, organizations have their own in house health and safety specialists the occupational health nurse can work closely with these specialists to ensure that the nurses expertise in health, risk assessment, health surveillance and environmental health management is fully utilized into the health and safety strategy.  

Occupational health nurses are trained in health and safety legislation, risk management and the control of workplace health hazards and can therefore make a useful contribution to the overall management of health and safety at work, with particular emphasis on ‘health’ risk assessment.

Hazard identification

The occupational health nurse often has close contact with the workers and is aware of changes to the working environment. Because of the nurses expertise in health and in the effects of work on health they are in a good position to be involved in hazard identification.