In some cases the occupational health (OH) nurse may act as the manager of the multidisciplinary OH team, directing and co-coordinating the work of other OH professionals. The OH nurse manager may have management responsibility for the whole of the occupational health team, or the nursing staff or management responsibility for specific programmes. The nurse manager may be the budget holder for the department and would have the skills necessary to sit alongside other line managers within the organization and contribute to organizational development.
The OH nurse can have a role in administration. Maintaining medical and nursing records, monitoring expenditure, staffing levels and skill mix within the department, and may have responsibility for managing staff involved in administration.
Where the senior OH nurse is the budget holder for the OH department they will be involved in securing resources and managing the financial assets of the department. The budget holder will also be responsible for monitoring and reporting within the organization on the use of resources.
Where the OH service is managed on an internal market system or undertakes commercial work the occupational health nurse will be involved in marketing services to customers. Even where no direct financial market exists, the customers or users of an OH service will need information and advice on the best use of services to meet their needs, often within financial constraints. The OH nurse is well placed to discuss customer's needs and expectations.
Service level agreements
Service level agreements are increasingly used in decentralized organizations in-order to ensure that both the user and provider of services have a clear agreement about the provision of services. The OH nurse may be involved in setting the service level agreements with internal or external customers and in monitoring the delivery of services against pre determined service level agreements.
As part of the delivery of a modern comprehensive OH service systems for quality assurance and quality improvement are essential. The occupational health nurse may be involved in quality assurance, audit and quality improvement initiatives, both for the delivery of services and for improving the professional standards within the department. Modern nursing practice is based on a philosophy of quality assurance and continuous quality improvement and therefore nurses can contribute to this development.
Audit and continuous quality improvement is an essential component of professional practice. The occupational health nurse will be involved in auditing the nursing practices within the department or in the wider clinical audit where all of the clinical team participates in multidisciplinary audit.
Continuing Professional development
The scope of professional practice in OH nursing is constantly developing. New information, new researches, changes in legislation, improved practices, technology are all areas of constant growth. The occupational health nurse has an obligation to constantly update their knowledge and skills in order to maintain competence, deliver high quality services and meet the needs of the companies they serve.
Within the profession a commitment to lifelong learning is expected in order to protect the client's safety; ensure the delivery of high quality nursing services and to maintain the appropriate level of competence for clinical practice. The nurse manager will be well placed to identify their own and their staffs' continuing professional development needs and to ensure that these are met in order to maintain the competencies of staff employed.
Occupational health team
The occupational health nurse, acting as a coordinator, can draw together all of the professionals involved in the occupational health team. In many instances the nurse will be the only member of the team who is permanently employed by the company or present on a particular site. Therefore they have a unique position and have access to valuable information that can be used to help shape and direct the occupational health program. In this role the nurse would exercise skills in communication, planning, involvement, management and in organizing the professional team.
Worker education and training
The OH nurse has a role in worker education. This may be within existing training programmes or those programmes that are developed specifically by occupational health nurses to, for example, inform, educate and train workers in how to protect themselves from occupational hazards, non-occupational but workplace preventable diseases or to raise awareness of the importance of good environmental health management practices.
Environmental health management
The OH nurse, particularly in those organizations, such as SME's, who may not have a designated environmental health manager, can advise the company on simple measures to reduce the use of natural resources, minimize the production of waste, promote re-cycling and ensure that environmental health management is placed on every organizations agenda. The OH nurse can also identify appropriate specialists in their locations to advice or deal with environmental health management. The occupational health nurse may contribute by taking these issues forward in the absence of other specialists.
Adviser tomanagement and staff on issues related to workplace health management
OH nurses involved in workplace health management can sometimes be asked to act as advisers to management and staff on the development of workplace health policies and practices, and can fulfill an advisory role by participating in, for example, health and safety committee meetings, health promotion meetings, and may be called upon to provide independent advice to managers or workers who have specific concerns over health related risks.
As a liaison to other external health or social agencies
OH nurses act in an advisory role when seeing individuals who may have problems that, whilst not directly related to work may affect future work attendance or performance. The nurse may be involved in advising individuals to seek advice from their own family doctor or general practitioner, or other external agency that may be better placed to assist the individual.
Workplace Health promotion
Health education as one of the key prerequisites of workplace health promotion is integral aspect of the OH nurses' role. In some countries the nurse is required to support activities aimed at adoption of the healthy lifestyles within on-going health promotion process, as well as participate in health and safety activities. OH nurses can carry out a needs assessment for health promotion within the company, prioritize activities in consultation with management and workers, develop and plan appropriate interventions, deliverer co-ordinate the delivery of health promotion strategies and can play a valuable role in evaluating the delivery and achievements of the health promotion strategy.
In the small or medium-sized company the occupational health nurse may be the only health care professional present most of the time and they can assist people working there in dealing with mental health and work-related stress. For many people the occupational health nurse, working at the company level, may be the first point of contact with health care providers and these nurses can do much to ensure that individuals are referred to the appropriate agency.
Health needs assessment
A specialist OH nurse will need to be well skilled in undertaking a nurse-based health needs assessment at both the individual and the organizational level. This type of assessment can be used as the basis for individual case management or occupational health program planning. OH nurses may use research based skills in carrying out the assessment, in handling the data generated in the assessment and in interpreting the results and advising management acting as a member of the multidisciplinary team.
Evidence based practice
Increasingly all health care providers are using evidence based approach to practice that requires the professional to seek the best available information on which to base their practice. Occupational health nurses are skilled in searching the literature, reviewing the evidence available, which may be in the form of practice guidelines or protocols, and applying these guidance documents in a practical situation.
Occupational health nurses should be well skilled in presenting the evidence, identifying gaps in current knowledge, and allowing others to review critically the implementation of care plans based on their assessment of the evidence.
The most widely used and accepted form of investigation into occupational related ill-health and disease is based on large-scale epidemiological studies. Occupational health nurses are advised to become familiar with the principles and basic methods used in epidemiology.Occupational Health: Core Areas of Knowledge and Competence, Part 3